Transcription of Provider Administration Manual - Health Insurance
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Provider Administration Manual - Health Insurance
Provider Administration ManualRevised June 2018 bluecross blueshield of tennessee Provider Administration Manual i TABLE OF CONTENTS I. INTRODUCTION A. bluecross blueshield of tennessee Statement of Purpose B. Descriptions of Networks C. Individual Product and Plan Options D. Health Insurance Portability and Accountability Act of 1996 (HIPAA) 1. Health Information Privacy Policies and Procedures 2. Protected Health Information-allowable disclosures under HIPAA E. General Information 1. Fraud and Abuse Hotline 2. Interpretation Services 3. Provider Communications 4. Pre-existing Condition II. bluecross blueshield OF tennessee QUICK REFERENCE TELEPHONE GUIDE III. HOW TO IDENTIFY A bluecross blueshield MEMBER A. Identifying a Member s ID Card B. Determining Eligibility C.
BlueCross BlueShield of Tennessee Provider Administration Manual ii VI. BILLING AND REIMBURSEMENT (cont’d) A. How to File a Claim (cont’d)
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