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