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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.

professional provider (i.e. annual well woman exam, annual routine eye exam) as indicated by the member’s benefit plan. ... Quick Reference Guide • Submit requests managed by AIM: (1)Online at www.aimspecialty health.com (2)Phone - 1 …

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