Services that require precertification
• Lumbar discectomy, foraminotomy, and laminotomy † • Lumbar fusion and treatment of spinal deformity (including scoliosis and kyphosis)† • Lumbar laminectomy † • Meniscal allograft transplantation of the knee † • Obesity surgery • Shoulder arthroplasty † • Shoulder arthroscopy and open procedures †
Download Services that require precertification
Information
Domain:
Source:
Link to this page:
Documents from same domain
2018 Blue Solutions Plan Overview - Independence …
www.ibx.combetter for you. With our Blue Solutions ® health plans, Independence Blue Cross (Independence) provides your employees and their families with comprehensive, affordable coverage and resources to help them
#6 Appeal - Independence Blue Cross
www.ibx.comAt each level of appeal, you or your designee may, at any time, request the aid of a Plan employee in preparing or presenting your appeal at no charge. This employee has not participated in the previous decision to deny
ICD-10 Putting Codes into Practice
www.ibx.comdesigned to communicate various coding conventions, general guidelines, and chapter-specific guidelines in ICD-10.
Keystone Point of Service - Independence Blue …
www.ibx.comemployee 1. each time you request benefits, sign section a and complete section b (items 1 - 14) on the reverse side of this form. use a separate benefit request form for each member of the family.
Healthy LifestylesSM Solutions Tobacco Cessation Program
www.ibx.comIndependence Blue Cross is an independent licensee of the Blue Cross and Blue Shield Association. 17889 2013-1467 (1/14) TOBACCO For more information,
Notice of Privacy Incident - ibx.com
www.ibx.comInformation privacy and security are among highest priorities. our Independence has strict security measures in place to protect information in its care. Upon learning of this incident, Independence quickly took steps to ensure ... privacy, data breach, data security, privacy notice, …
Quick guide to Blue member ID cards - PA
www.ibx.comQuick guide to Blue member ID cards A guide for providers who treat out-of-area Blue Cross® Blue Shield® members Independence Blue Cross offers products through its subsidiaries Independence Hospital Indemnity Plan, Keystone Health Plan East,
#1 Appeal - Independence Blue Cross
www.ibx.comAn appeal for benefits that, under the terms of this Contract, must be precertified or preapproved before medical care is obtained in order for coverage to be available.
MEMBER DENTAL CLAIM FORM - ibx.com
www.ibx.comMEMBER DENTAL CLAIM FORM HEADER INFORMATION INSURANCE COMPANY/DENTAL BENEFIT PLAN INFORMATION OTHER COVERAGE (Mark applicable box and complete 5-11.If none, leave blank.) RECORD OF SERVICES PROVIDED
MEMBER DENTAL CLAIM FORM - ibx.com
www.ibx.commember dental claim form header information insurance company/dental benefit plan information other coverage (mark applicable box and complete 5-11. if none, leave blank.) record of services provided authorizations ancillary claim/treatment information treating dentist and treatment location information 1.