Blue Rewards: What You Need to Know

February 12, 2016 -

What is Blue Rewards?

The Blue Rewards program is a wellness incentive program designed to reward members who work closely with their primary care providers (PCPs) to better understand and manage their care. To earn their reward, members must complete four steps, including selecting a PCP who also participates in our Patient-Centered Medical Home (PCMH) program and submitting their Health & Wellness Evaluation Form to CareFirst within 120 days of their effective date.

Blue Rewards and You: 5 Key Things You Should Know

• When your patients call to set up an appointment, work with them to find a time within their 120-day window and ask them to have their lab work completed prior to the appointment.
• While your patients are responsible for submitting the Health & Wellness Evaluation form to CareFirst, you can help them earn their reward by making sure the form is filled out correctly:
  • Include your 8-digit provider number
  • Indicate whether this is an initial screening or rescreening
  • Provide dates and health measures for all sections of the form
  • Sign and date the form
• Certain patients are eligible to earn additional rewards for meeting certain health goals. If your patients qualify for additional rewards, but their results fall outside of the desired ranges, work with them to develop a goal that would be attainable within the year and schedule a rescreening appointment to track their progress.
• If it is not medically advisable for your patient to be measured according to the goal, there is a “waiver” option on the form.
• Use the proper codes when billing for your patients’ visit to get reimbursed.

Learn More

To learn more about your role in the Blue Rewards program and how to get reimbursed, check out our Health & Wellness Evaluation Form Checklist, read our Blue Rewards FAQs or register for training at www.carefirst.com/cpet.

Not a PCMH Provider?

Visit www.carefirst.com/pcmhinfo to learn more.