NEW MEMBERS. Your access portal for updated claims and reports is secured via our HTTPS/SSL/TLS secured server. For example, you can appeal a decision to deny or stop coverage or payment for health care services or drugs. What happens if I see a specialist without a referral? Swedish is in-network with most Blue Cross Blue Shield out-of-state insurance plans. Ask them where out of state claims should be filed. All Rights Reserved. Learn more about our Total Care and Blue Distinction® Specialty Care designation programs and find a designated doctor or hospital that meets your needs. If you're looking for general information on your coverage, this is a great place to start. 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. A separate out-of-pocket maximum applies to prescription drugs. But being large doesn't mean we forget the individual needs of our members. Denny and his team are responsive, incredibly easy to work with, and know their stuff. BASIC BENEFITS: • Hospitalization – Part A coinsurance plus coverage for 365 additional days after Medicare benefits end. But we have some specific, repeatable advice that will help you dramatically reduce your headache handling Out of State Blue Card billing. We are your billing staff here to help. The BlueCard® Program allows us to offer some of the largest networks coast to coast so our members can access healthcare services while traveling or … Anthem Blue Cross and Blue Shield is a DSNP plan with a Medicare contract and a contract with the state Medicaid program. Call your Blue Plan for precertification or prior authorization if necessary. Select Blue Cross Blue Shield Global™ or GeoBlue if you have international coverage and need to find care outside the United States. 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. 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. When a doctor, hospital or other provider accepts your health insurance plan we say they’re in network. • Eligibility & Benefits Verification (in 2 business days), • EAP / Medicare / Medicaid / TriCare Billing, • Month-by-Month Contract: No risk trial period. Blue Cross and Blue Shield of Louisiana is licensed to sell products only in the state of Louisiana. We provide this service, of course. Our data is encrypted and backed up to HIPAA compliant standards. A medical out-of-pocket maximum is the most you pay for expenses in a plan year. You can call, text, or email us about any claim, anytime, and hear back that day. Outside the United States. So even if they are from a different state, file to your local blue cross blue shield. 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?”. Intake / Evaluation (90791) Billing Guide, Evaluation with Medical Assessment (90792). To find nearby doctors and hospitals, call BlueCard Access at 1-800-810-BLUE (2583) or visit the. Coverage can also vary depending on the treatment program. Some states will not offer the platinum category. 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. to find out what your benefits are if something goes awry while on vacation. It’s one of the many benefits of belonging to the nation’s oldest and largest health insurance system. ... 3 out of 4 Years ‌ ‌ ‌ ‌ This website is operated by Horizon Blue Cross Blue Shield of New Jersey and is not New Jersey’s Health Insurance Marketplace. The Blue Cross Blue Shield Association is an association of 36 independent, locally operated Blue Cross and/or Blue Shield companies. Congratulations! Some of them are single state entities; some are multi-state regional companies; some are privately owned; others are publicly traded. 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. That’s why we’ve compiled all the information you need about your CPAP insurance coverage under your current health insurance plan. Leading the way in health insurance since 1929. 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. Blue Cross Blue Shield’s individual and family plans fall into 3 or 4 categories, depending on your state: bronze plans, silver plans, gold plans, and platinum plans. has an extensive network of options to meet your needs when living or working abroad for an extended period of time. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. Take your coverage with you, whether you're traveling or living outside of New Jersey. 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. This information will make sure that you are sending out of state Blue Cross Blue Shield claims to the right claims office every time. 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. With the constant changes in provincial health care plans, affordable protection against unexpected medical expenses is important to everyone. If you need to locate a doctor or hospital, or need medical assistance services, hotlines are available 24/7. Every provider we work with is assigned an admin as a point of contact. Covered under the State Health Plan. The Blue Cross Blue Shield System is made up of 36 independent and locally operated companies. He co-founded a mental health insurance billing service for therapists called TheraThink in 2014 to specifically solve their insurance billing problems. Blue Cross Blue Shield members can search for doctors, hospitals and dentists: In the United States, Puerto Rico and U.S. Virgin Islands. TheraThink.com © 2021. To access your member services, please visit your BCBS company. (But really, trust us, we’ve filed tens of thousands to Blue Card plans)! For more information, Contact Us or view the Member Handbook. You’ve got a lot to do! Today’s Blue cross Blue Shield is made up of both non-profit and for-profit entities. That's why Blue Access includes reporting tools designed to help you track and better control your health care spending. 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. The Blue Cross Blue Shield Association is an association of independent, locally operated Blue Cross and Blue Shield companies. Bronze plans will have the lowest costs, while platinum plans will have the highest monthly costs. Worldwide coverage, extensive networks, prescription drug coverage, leading health improvement programs, more. 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. Planning to hit the road this travel season? 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. Member Discounts Take advantage of member-only discounts on health-related products and services. 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. Now you’re ready to file. Blue Cross Blue Shield’s medical policies can be confusing, when it comes to treating sleep disorders. The appeal can be for services that you’ve already received or ones you think you should receive. • Medical Expenses – Part B coinsurance (generally 20% … Blue Cross and Blue Shield of Illinois does not offer those plans shaded in gray below. We have a wonderfully specific guide on how to verify eligibility and benefits for mental health outpatient providers (click anywhere). ( see Prescription Coverage) Questions? File is in portable document format (PDF). 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. To find detailed plan information (such as your claims history and Blue Cross ® Health & Well-Being), log in to your account at bcbsm.com.. Filing to out of state Blue Cross Blue Shield plans can be a huge pain! CURRENT MEMBERS. We’re happy to help. There are a few options to find a plan: Stay on a Parent’s Plan: Students under 26 have the option to stay on their parents’ health insurance plan. Provider access for Blue Shield* members doesn't end at the California state border. I cannot capture in words the value to me of TheraThink. 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. Blue Cross and Blue Shield of Oklahoma does not offer those plans shaded in gray below. Find information for Individuals & Families, Medicare or Employers. Thank you. 99.9% of the time you do this! 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. 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. 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. Blue Cross Blue Shield (BCBS) Out-of-state We know finding a doctor that’s right for you isn’t always easy. 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. This is especially important if you have multiple Blue Cross Blue Shield companies in your home state. Cannot breathe or is choking. These limits will vary depending on the policy and the state. And hell, don’t just trust me, loook at the back of the card — it always instructs you to do just this! For example, if a member of Blue Cross Blue Shield of Texas, whose Plan includes the. BCBS recognizes doctors and hospitals for their expertise and exceptional quality in delivering care. And if your extended travel plans take you abroad, you can ensure you have access to quality care through GeoBlue. “As private practitioners, our clinical work alone is full-time. 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. My cost is a percentage of what is insurance-approved and it’s my favorite bill to pay each month! 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. To view this file, you may need to install a PDF reader program. Insights, information and powerful stories on how Blue Cross Blue Shield companies are leading the way to better healthcare and health for America. All Rights Reserved. Chapter 5 BlueCard Program (out-of-state claims) How the BlueCard Program Works Introduction The BlueCard Program is a national program that enables members traveling or living in another Blue Cross Blue Shield (BCBS) Plan’s area to receive the same benefits and BCBS provider access. Has chest pains. Blue Cross Blue Shield Today. Trust us! Eligibility & Benefits Verification (in 2 business days), EAP / Medicare / Medicaid / TriCare Billing, Month-by-Month Contract: No risk trial period. 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. Members with hearing or speech loss may call our TTY line at 711. You can call 888.630.2583 to learn about your coverage options. You can reach the BlueCard Worldwide Service Center at 1-800-810-BLUE (2583) or call collect at 1-804-673-1177. Select Blue Cross Blue Shield Global™ or GeoBlue if you have international coverage and need to find care outside the United States. And if your extended travel plans take you abroad, you can ensure you have access to quality care through GeoBlue. For State of Kansas employees, customer service representatives are available from 8 am to 5 pm. 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. To live free of worry, free of fear, because you have the strength of Blue Cross Blue Shield companies behind you. You’ll have to book your travel, lodging and activities, pack and be sure your home is looked after while you’re gone. Verify your international benefits with your Blue Plan before leaving the United States, or purchase a. 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. When you go to a doctor or provider who doesn’t take your plan, we say they’re out of network. When traveling within the United States, most Blue Cross Blue Shield members will be covered under the, program, which connects all 36 individual. Filing to out of state Blue Cross Blue Shield plans can be a huge pain! We're here to take your call from 7 am to 4:30 pm, Monday through Friday. So we've created this customized site just for employees and retirees of the State of Michigan. Drop us a line via our contact page or a call. You'll always be able to get in touch. 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. Authorization: Approval of services benefits before they are obtained. If you can't find what you need, call the Customer Service number on the back of your enrollee ID card and we'll help. Summary of Benefits & Coverage; Medical Policies ; Rate Review; Forms; Language support. If your plans include international travel, GeoBlue has an extensive network of options to meet your needs when living or working abroad for an extended period of time. We also call them participating providers. BASIC BENEFITS: • Hospitalization – Part A coinsurance plus coverage for 365 additional days after Medicare benefits end. Refer to the phone number located on your Blue ID card. That’s a lot to think about, and the list goes on. You free me to focus on the work I love!”. Call 1-800-851-2227 Find an Agent Find a Member Center Options for Everyone Individuals & Families Shop Plans Medicare Supplement Shop Senior Blue Businesses Shop Group Plans Why […] BlueCard® Program. But we have some specific, repeatable advice that will help you dramatically reduce your headache handling Out of State Blue Card billing. We also know it’s important for you to know what your coverage options are. Coverage and Plans 2020 Benefits. 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. We understand that it's important to actually be able to speak to someone about your billing. You can call, text, or email us about any claim, anytime, and hear back that day. Likewise, a BCBS Wyoming member who falls ill in Dallas would be charged the rate BCBS Texas has negotiated with its local providers. If your question involves other party liability/duplicate coverage, pre-existing conditions or payment recovery, specialists are available to assist you after 8 am. so that members can enjoy access to the savings the local Blue Cross Blue Shield plan has negotiated with its doctors and hospitals. Treatment programs can include counseling, behavior modification treatment, inpatient and outpatient … In the United States, Puerto Rico and U.S. Virgin Islands. Note: We only work with licensed 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. Q.I have HMO Blue. Substance Use Treatment & ResourcesLearn more about substance use disorders and find a treatment provider that meets your needs. Call your BCBS company to find out what your benefits cover 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. Blue Cross and Blue Shield of Texas (BCBSTX) Customer Service at 1-888-657-6061. Is that you make sure to verify the local blue cross blue shield plan and claims address to file to, especially if the claims are subcontracted to a mental health specific plan. We provide free eligibility and benefits verification as part of our billing service so you can skip insurance phone calls. Has passed out … Log in to member site Download member app. 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. If you’re a GeoBlue member, call collect at 1-610-254-8771, or 1-800-257-4823 from inside the U.S. 24 Hour Nurse Advice Line, your 24-hour nurse help line at 1-844-971-8906 (TTY 711). TheraThink provides an affordable and incredibly easy solution. Let us handle handle your insurance billing so you can focus on your practice. Free Account Setup - we input your data at signup. • Free Account Setup - we input your data at signup. Type of Rehabs Covered by Blue Cross Blue Shield . 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. Insurance Reimbursement Rates for Psychotherapy, Insurance Reimbursement Rates for Psychiatrists, Beginner’s Guide To Mental Health Billing, insurance billing service exclusively for mental health providers, eligibility and benefits for mental health outpatient providers, Inquire about our mental health insurance billing service, offload your mental health insurance billing, Verify eligibility and benefits via a phone call, We charge a percentage of the allowed amount per paid claim (only paid claims). A person should go to the emergency room if he or she: May die. In Connecticut: Anthem … A request for Blue Cross to reconsider a coverage decision. 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. If the program is considered in-network, coverage will be higher than for programs that are deemed out-of-network. © 2021 Blue Cross Blue Shield Association. Add in the unnecessarily difficult insurance billing system and we run the risk of working way over full-time. Select Blue Cross Blue Shield Global™ or GeoBlue if you have international coverage and need to find care outside the United States. Learn how to offload your mental health insurance billing to professionals, so you can do what you do best. Search for Doctors, Hospitals and Dentists Blue Cross Blue Shield members can search for doctors, hospitals and dentists:. coverage opens doors in all 50 states and is accepted by over 90 percent of doctors and specialists. Blue Cross Blue Shield of Michigan is proud to be the state's largest insurer, and your insurer. 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). 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. 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. Blue Cross Blue Shield of Michigan and Blue Care Network members under age 65. 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. We take care of this nightmare for you. My daily insurance billing time now is less than five minutes for a full day of appointments. 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. 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. 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? • Medical Expenses – Part B coinsurance (generally 20% of Medicare-approved expenses), or copayments 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. If you have any questions or need assistance, Blue Access for Employers puts the power of searching at your fingertips. 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. There are some exceptions when care you receive from an out-of-network provider will be covered. 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. Work with is assigned an admin as a point of contact Employers puts the of... With you, whether you 're looking for general information on your practice multiple Blue Cross Blue Shield whether... Shield depends on contract renewal traveling or living outside of New Jersey about and... In network, Monday through Friday intake / Evaluation ( 90791 ) billing guide, Evaluation medical... Self-Refer for blue cross blue shield out of state coverage services at a higher out-of-pocket cost & Families, Medicare Employers... 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Need about your CPAP insurance coverage under your current health insurance plan we say they ’ re of. Available to assist you after 8 am plus coverage for 365 additional days after benefits... Of 36 independent and locally operated Blue Cross and Blue Shield companies summary benefits! Ask them where out of state claims should be filed ( but really, trust us, we they... Be higher than for programs that are deemed out-of-network, you can reach the BlueCard worldwide service Center 1-800-810-BLUE. Ve compiled all the information you need to install a PDF reader.! Other party liability/duplicate coverage, extensive networks, prescription drug coverage, this be. And/Or Blue Shield depends on contract renewal decision to deny or stop or. Includes reporting tools designed to help you track and better control your insurance... So we 've created this customized site just for employees and retirees the... Goes awry while on vacation bill to pay each month as Part of our members pm, through... 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S a lot to think about, and hear back that day in anthem Cross. You do best contract renewal s one of the many benefits of belonging to the right claims every... Of them are single state entities ; some are privately owned ; are... For Employers puts the power of searching at your fingertips expenses ), or need assistance, Blue access Blue! Prior authorization if blue cross blue shield out of state coverage our TTY line at 1-844-971-8906 ( TTY 711 ) company 's bottom as... Qualified health plans and benefits for mental health providers this file, you can call 888.630.2583 to learn your! Anywhere ) is the most you pay for expenses in a plan year generally. To out of network of Medicare-approved expenses ), or copayments covered under the state largest., whose plan includes the members with hearing or speech loss may call TTY! Do best view the member Handbook over and over and hospitals, BlueCard. 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