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Medicare AdvantageAdministrativeMedium impact

Regence uses its passion for innovation to make healthcare better

Regence BlueCross BlueShield of Oregon·ID, OR, UT, WA · Cardiology·Provider News
Effective date
Not stated
We identified it
Jul 7, 2026
Days to comply

Summary

Regence announced innovation initiatives including SmartAuth (automated prior authorization with 94% immediate approval rates), AI-powered customer service tools, and strategic investments in virtual care services. This is a company-wide announcement focused on process improvements and new care delivery partnerships rather than a specific billing policy change.

Action Required

Action needed
Billing team should: (1) Verify if your practice is enrolled in Regence SmartAuth program and confirm EHR integration capabilities for direct prior authorization requests from patient records; (2) If not yet enrolled, contact Regence provider relations to request SmartAuth enrollment to enable automated approvals and reduce manual prior auth processing time; (3) Train billing and clinical staff on SmartAuth functionality to maximize the 94% automatic approval rate and reduce the 6% manual review cases. No immediate deadline stated, but implementation should be prioritized to capture documented productivity gains (MultiCare increased PA processing from 3-5 to 10-12 per hour). Inform providers about Heartbeat Health (virtual cardiology) and Sempre Health (prescription discount program) availability for eligible commercial and Medicare members to support care coordination and medication adherence.