Transcription of Blue Advantage HMO Quick Reference Guide
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Blue Advantage HMO Quick Reference Guide
Major Characteristics Benefits, Eligibility, Claims Status or Verification Claim Reviews, All Correspondence Prior Authorizations and Referrals Laboratory Services Behavioral Health Services (Mental Health and Chemical Dependency) Blue Advantage HMO membersmust select a Blue Advantage HMOP rimary Care Physician (PCP). Blue Advantage providers may onlybill for copayments, cost share(coinsurance) and deductibles, whereapplicable. Some services may be self-referredto a Blue Advantage HMO physician orprofessional provider ( annual wellwoman exam, annual routine eye exam)as indicated by the member s benefitplan. To receive benefits, all medical caremust be directed by the selected BlueAdvantage HMO PCP. A PCP referralis required to all Blue Advantage HMOspecialist receive benefits, referrals to out- Eligibility and benefitinformation may be obtainedthrough or aweb vendor of your choice orcall Blue Advantage HMOP rovider Customer Service:1-800-451-0287* Claim Status may beobtained through the AvailityClaim Status Tool or a webvendor of your choice.
instructions. This guide is intended to be used for quick reference and may not contain all of the necessary information. ... submitting a referral request. ... - Reminders to check for grace period status will be included on correspondence related to predeterminations, prior authorizations and referrals. page 2 of 2 . Blue Advantage HMO Quick ...
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