Transcription of Provider Manual Blue Cross Community MMAI (Medicare- …
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Provider Manual Blue Cross Community MMAI (Medicare- …
blue Cross and blue Shield of Illinois Provider Manual blue Cross Community MMAI ( medicare - Medicaid Plan)SM. 2022. blue Cross Community MMAI ( medicare -Medicaid Plan) is provided by Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC), an independent licensee of the blue Cross and blue Shield Association. HCSC is a health plan that contra cts with both medicare and Illinois Medicaid to provide benefits of both programs to enrollees. Enrollment in HCSC's plan depends on contract renewal. blue Cross Community MMAI Provider Manual Updated December 2021 1. Table of Contents Overview .. 3. Key Contact Information .. 4. Benefits and Beneficiary 5. Provider Training .. 12. Performance Standards and Compliance .. 13. Membership Information .. 20. Scope of Benefits .. 23. Utilization Management .. 27. Benefit Prior Authorization List .. 31. Quality Improvement 37. Claims Processing & Provider Compensation.
About the Provider Manual This Provider Manual is designed to provide information regarding MMAI operations and plan benefits. BCBSIL shall notify independently contracted providers of any changes to the Provider Manual. If you have any questions regarding the information outlined in this Provider Manual, please contact the Provider
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