We also call them participating providers. We provide free eligibility and benefits verification as part of our billing service so you can skip insurance phone calls. Coverage and Plans 2020 Benefits. Blue Cross and Blue Shield of Oklahoma does not offer those plans shaded in gray below. Type of Rehabs Covered by Blue Cross Blue Shield . With the constant changes in provincial health care plans, affordable protection against unexpected medical expenses is important to everyone. If your question involves other party liability/duplicate coverage, pre-existing conditions or payment recovery, specialists are available to assist you after 8 am. When a doctor, hospital or other provider accepts your health insurance plan we say they’re in network. What happens if I see a specialist without a referral? Blue Cross Blue Shield Association (BCBSA) is a federation of 36 separate United States health insurance companies that provide health insurance in the United States to more than 106 million people. And if your extended travel plans take you abroad, you can ensure you have access to quality care through GeoBlue. That’s why we’ve compiled all the information you need about your CPAP insurance coverage under your current health insurance plan. Blue Cross and Blue Shield of Illinois does not offer those plans shaded in gray below. You’ve got a lot to do! Telligent is an operating division of Verint Americas, Inc., an independent company that provides and hosts an online community platform for blogging and access to social media for Blue Cross and Blue Shield of Texas. Every provider we work with is assigned an admin as a point of contact. Learn how to offload your mental health insurance billing to professionals, so you can do what you do best. You want to know you can call your billing admin, a real person you've already spoken with, and get immediate answers about your claims. Has passed out … If selecting this option, it’s a good idea to contact your Blue Cross Blue Shield company to get details about out-of-state coverage if you need it. If you want to skip the pain completely, consider trying our insurance billing service exclusively for mental health providers. See how to find out what’s covered by your Blue Cross and Blue Shield of Minnesota or Blue Plus health plan. When you go to a doctor or provider who doesn’t take your plan, we say they’re out of network. So we've created this customized site just for employees and retirees of the State of Michigan. Our data is encrypted and backed up to HIPAA compliant standards. Note: We only work with licensed mental health providers. In Connecticut: Anthem … Congratulations! I cannot capture in words the value to me of TheraThink. Select Blue Cross Blue Shield Global™ or GeoBlue if you have international coverage and need to find care outside the United States. But we have some specific, repeatable advice that will help you dramatically reduce your headache handling Out of State Blue Card billing. Worldwide coverage, extensive networks, prescription drug coverage, leading health improvement programs, more. Blue for All Whatever your needs, whatever your budget, Blue Cross Blue Shield of Wyoming has a coverage plan to fit you, your family, or your business. If you are moving to a new state, changing jobs, out of work, getting ready to retire, or your employer has stopped offering insurance, Blue Cross Blue Shield can help. Blue Cross and Blue Shield of Minnesota offers individual and group health plans. Likewise, a BCBS Wyoming member who falls ill in Dallas would be charged the rate BCBS Texas has negotiated with its local providers. Treatment programs can include counseling, behavior modification treatment, inpatient and outpatient … Denny has interviewed hundreds of mental health practitioners to better understand their struggles and solutions, all with the goal of making the professional side of behavioral health a little easier, faster, and less expensive. Questions? For State of Kansas employees, customer service representatives are available from 8 am to 5 pm. Intake / Evaluation (90791) Billing Guide, Evaluation with Medical Assessment (90792). Out-of-Network Coverage In most cases, you must receive your care from a Blue Cross Community MMAI (Medicare-Medicaid Plan) SM in-network plan provider. Search for Doctors, Hospitals and Dentists Blue Cross Blue Shield members can search for doctors, hospitals and dentists:. And you won’t have to wait in line to verify any of the above information — we always take care of it on your behalf. The steps are simple and there are just three: Not as hard as you think, but honestly, this is a pain in the butt and this is why many providers end up hiring TheraThink (we turn these around in two days for free). Some states will not offer the platinum category. So even if they are from a different state, file to your local blue cross blue shield. Most Blue Cross Blue Shield members can rest easy since Blue Cross Blue Shield coverage opens doors in all 50 states and is accepted by over 90 percent of doctors and specialists. This is especially important if you have multiple Blue Cross Blue Shield companies in your home state. Take your coverage with you, whether you're traveling or living outside of New Jersey. • Medical Expenses – Part B coinsurance (generally 20% of Medicare-approved expenses), or copayments If you’re a GeoBlue member, call collect at 1-610-254-8771, or 1-800-257-4823 from inside the U.S. Free Account Setup - we input your data at signup. Blue Cross Blue Shield members can search for doctors, hospitals and dentists: In the United States, Puerto Rico and U.S. Virgin Islands. This plan has an out-of-pocket maximum of $3,100 per member ($6,200 per family) for in-network services and $6,000 per member ($12,000 per family) for out-of-network services. so that members can enjoy access to the savings the local Blue Cross Blue Shield plan has negotiated with its doctors and hospitals. TheraThink.com © 2021. To find nearby doctors and hospitals, call BlueCard Access at 1-800-810-BLUE (2583) or visit the. The Blue Cross Blue Shield Association is an association of independent, locally operated Blue Cross and Blue Shield companies. With so much to do, it’s easy to overlook one item that might prove crucial: ensuring that you will be covered if you need medical care while traveling. As a general rule, Blue Cross Blue Shield of Massachusetts will not pay for care from a specialist without a referral from your PCP. Covered under the State Health Plan. And hell, don’t just trust me, loook at the back of the card — it always instructs you to do just this! Substance Use Treatment & ResourcesLearn more about substance use disorders and find a treatment provider that meets your needs. • Medical Expenses – Part B coinsurance (generally 20% … Search for Doctors, Hospitals and Dentists Blue Cross Blue Shield members can search for doctors, hospitals and dentists: In the United States, Puerto Rico and U.S. Virgin Islands. For more information, Contact Us or view the Member Handbook. Call your Blue Plan for precertification or prior authorization if necessary. But being large doesn't mean we forget the individual needs of our members. to find out what your benefits are if something goes awry while on vacation. Has chest pains. Provider access for Blue Shield* members doesn't end at the California state border. If you need to locate a doctor or hospital, or need medical assistance services, hotlines are available 24/7. We're here to take your call from 7 am to 4:30 pm, Monday through Friday. Blue Cross Blue Shield of Michigan and Blue Care Network members under age 65. Blue Cross Coverage Whether you're an employer looking for a benefits plan to offer your employees, self-employed, between jobs or retired, there is a perfect health care package of benefits available through the Blue Cross in your area. Member Discounts Take advantage of member-only discounts on health-related products and services. Blue Cross and Blue Shield of Texas (BCBSTX) Customer Service at 1-888-657-6061. Select Blue Cross Blue Shield Global™ or GeoBlue if you have international coverage and need to find care outside the United States. Cannot breathe or is choking. We understand that it's important to actually be able to speak to someone about your billing. You free me to focus on the work I love!”. Add in the unnecessarily difficult insurance billing system and we run the risk of working way over full-time. Blue Cross and Blue Shield of Louisiana and its subsidiaries, HMO Louisiana, Inc. and Southern National Life Insurance Company, Inc., comply with applicable federal civil rights laws and do not exclude people or treat them differently on the basis of race, color, national origin, age, disability or sex. Your Blue Cross and Blue Shield of Illinois (BCBSIL) benefits are designed to provide coverage for the care you need, encourage you to maintain your good health and help you manage your health care costs. Most Blue Cross Blue Shield members can rest easy since Blue Cross Blue Shield coverage opens doors in all 50 states and is accepted by over 90 percent of doctors and specialists. To access your member services, please visit your BCBS company. You can call, text, or email us about any claim, anytime, and hear back that day. • Free Account Setup - we input your data at signup. To find detailed plan information (such as your claims history and Blue Cross ® Health & Well-Being), log in to your account at bcbsm.com.. Some of them are single state entities; some are multi-state regional companies; some are privately owned; others are publicly traded. Blue Shield of California has quietly scaled back the national Blue Card program that has allowed its members to receive a range of services out of state in an effort to reduce costs. Insights, information and powerful stories on how Blue Cross Blue Shield companies are leading the way to better healthcare and health for America. NEW MEMBERS. Blue Cross Blue Shield of Michigan is proud to be the state's largest insurer, and your insurer. Blue Cross Blue Shield’s medical policies can be confusing, when it comes to treating sleep disorders. We take care of this nightmare for you. A request for Blue Cross to reconsider a coverage decision. We’re happy to help. You can reach the BlueCard Worldwide Service Center at 1-800-810-BLUE (2583) or call collect at 1-804-673-1177. BASIC BENEFITS: • Hospitalization – Part A coinsurance plus coverage for 365 additional days after Medicare benefits end. Trust us! Coverage can also vary depending on the treatment program. ( see Prescription Coverage) We provide this service, of course. These limits will vary depending on the policy and the state. A separate out-of-pocket maximum applies to prescription drugs. Select Blue Cross Blue Shield Global™ or GeoBlue if you have international coverage and need to find care outside the United States. Outside the United States. Members with hearing or speech loss may call our TTY line at 711. File is in portable document format (PDF). That's why Blue Access includes reporting tools designed to help you track and better control your health care spending. You want to get paid quickly, in full, and not have to do more than spend 10 or 15 minutes to input your weekly calendar. The appeal can be for services that you’ve already received or ones you think you should receive. You can call, text, or email us about any claim, anytime, and hear back that day. Blue National Doctor & Hospital Provider Finder, How High Performance Networks Will Change Healthcare, How the 2020 election will impact healthcare, Learning & leading with compassion through COVID-19. Learn how we can handle your mental health insurance billing and credentialing headache: It's our goal to ensure you simply don't have to spend unncessary time on your billing. You will be covered for emergency services in the U.S. even if the emergency services provider is not part of the Blue Cross and Blue Shield of Texas (BCBSTX) network. Here are a few steps you can take to take charge of your health while traveling: To learn more, visit BCBS.com or the GeoBlue website. For example, you can appeal a decision to deny or stop coverage or payment for health care services or drugs. Though many Blue Cross Blue Shield plans cover international care in emergency situations, GeoBlue plans offer the most complete set of benefits and access to services like emergency medical evacuation, which might not be covered by your regular plan. We are your billing staff here to help. CURRENT MEMBERS. Q.I have HMO Blue. Anthem Blue Cross and Blue Shield is the trade name of: In Colorado: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. • Eligibility & Benefits Verification (in 2 business days), • EAP / Medicare / Medicaid / TriCare Billing, • Month-by-Month Contract: No risk trial period. Outside the United States. The Blue Cross Blue Shield Association is an association of 36 independent, locally operated Blue Cross and/or Blue Shield companies. Let us handle handle your insurance billing so you can focus on your practice. © 2021 Blue Cross Blue Shield Association. For example, if a member of Blue Cross Blue Shield of Texas, whose Plan includes the. coverage opens doors in all 50 states and is accepted by over 90 percent of doctors and specialists. If your state has multiple brands (WA, CA, OR, NY, NJ, to name just a few) then you’ll want to ask for the exact address to file to. You can call 888.630.2583 to learn about your coverage options. Thank you. Ask them where out of state claims should be filed. A person should go to the emergency room if he or she: May die. Eligibility & Benefits Verification (in 2 business days), EAP / Medicare / Medicaid / TriCare Billing, Month-by-Month Contract: No risk trial period. TheraThink provides an affordable and incredibly easy solution. For example, if a member of Blue Cross Blue Shield of Texas, whose Plan includes the BlueCard program, falls and breaks his arm while hiking in Yellowstone, he will be charged the rate Blue Cross Blue Shield of Wyoming has negotiated with the local hospital rather than paying the steep fees he would otherwise encounter. Here’s my NPI and Tax ID” * Ask the rep to verify mental health outpatient benefits * Tell them that you will be filing claims in your local state — “Services will be rendered in _____” * If they quote you a coinsurance or deductible, check out guide about understanding them here. Skip to main content ... To see your plan’s coverage information, log in or register on the member site or call customer service using the number on the back of your ID card. We also know it’s important for you to know what your coverage options are. All Rights Reserved. You might have Anthem Blue Cross, for instance, or Regence Blue Shield, or Blue Cross Blue Shield, and to make matters worse the mental health policy for that insurance company might be “subcontracted” (claims are sent to and handled) by a different insurance company. Our mental health insurance billing staff is on call Monday – Friday, 8am-6pm to ensure your claims are submitted and checked up on with immediacy. But we have some specific, repeatable advice that will help you dramatically reduce your headache handling Out of State Blue Card billing. Ask them “Where do I file claims in _____ State?” and “Please tell me the claims address” and finally, if you file claims electronically, ask “Can you let me know the payer ID?”. 99.9% of the time you do this! When traveling within the United States, most Blue Cross Blue Shield members will be covered under the BlueCard program, which connects all 36 individual Blue Cross Blue Shield companies so that members can enjoy access to the savings the local Blue Cross Blue Shield plan has negotiated with its doctors and hospitals. Out-of-Area Coverage. Denny and his team are responsive, incredibly easy to work with, and know their stuff. If you're looking for general information on your coverage, this is a great place to start. Blue Cross Blue Shield (BCBS) Out-of-state We know finding a doctor that’s right for you isn’t always easy. My daily insurance billing time now is less than five minutes for a full day of appointments. A medical out-of-pocket maximum is the most you pay for expenses in a plan year. Blue Choice ® and Blue Choice New England SM members have the option to self-refer for covered services at a higher out-of-pocket cost. If you aren’t sure what’s covered, it’s a good idea to call your Blue Cross Blue Shield company to find out what your benefits are if something goes awry while on vacation. BCBS recognizes doctors and hospitals for their expertise and exceptional quality in delivering care. Blue Cross and Blue Shield of Louisiana is licensed to sell products only in the state of Louisiana. Learn more about our Total Care and Blue Distinction® Specialty Care designation programs and find a designated doctor or hospital that meets your needs. But quickly, the basics: * Call and get a rep on the phone (always) * Hit 0 or say representative until it works * Ask to verify your network status — “am I in network with your insurance panel? plans offer the most complete set of benefits and access to services like emergency medical evacuation, which might not be covered by your regular plan. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. You'll always be able to get in touch. 24 Hour Nurse Advice Line, your 24-hour nurse help line at 1-844-971-8906 (TTY 711). Quality Care That’s Right for YouWhether you need a routine check-up or a specialty procedure, you want the best care you can find. Reader program for their expertise and exceptional quality in delivering care provide free eligibility and for. Local Blue Cross Blue Shield depends on contract renewal Minnesota or Blue plus health plan forms ; Language.... The savings the local Blue Cross Blue Shield system is made up of 36 independent, locally operated.!, please visit your BCBS company to find out what your benefits are if something goes awry on.! ” TheraThink in 2014 to specifically solve their insurance billing to professionals, so you can on. 'Re traveling or living outside of New Jersey portal for updated claims and reports is secured via contact! What is insurance-approved and it ’ s oldest and largest health insurance billing so you can,... 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