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Using your preventive benefits
• Sterilization forwomen. Pregnancy • Anemia screening • Aspirin for pregnant women whoareathighriskfor preeclampsia;over-the-counter,aspirin-only products (75–325mg). Requires a written prescription. • Bacteriuria urinary tract infection screening • isavailable from your doctor during pregnancyand after the birth.
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Other Coverage Questionnaire Enrollment
www.premera.com017316 (11-2007) www.premera.com Page 1 of 2 An Independent Licensee of the Blue Cross Blue Shield Association Other Coverage Questionnaire Enrollment
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www.premera.comVehicle Ramp/Lift: Van lifts (used to lift a wheelchair/scooter into a truck or van), wheelchair lifts, wheelchair/scooter racks, vehicle ramps and other vehicle modifications or additions are excluded from coverage because they do not meet the definition of medical equipment.
Incident Questionnaire (Member Version) - Home | Visitor
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Request for Certification of Disabled Dependent
www.premera.comMembership & Billing, MS 737 PO Box 3048 Spokane, WA 99220 Request for Certification of Disabled Dependent An Independent Licensee of the Blue Cross Blue Shield Association
10.01.520 Review for Coverage in the Absence of a Medical ...
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Formulary Premera Medicare Advantage
www.premera.comiii immediately remove the drug from our formulary and provide notice to members who take the drug. Other changes. We may make other changes that affect members currently taking a drug.
Modifier 90 - Reference (Outside) Laboratory - Visitor
www.premera.com2 Center for Medicare and Medicaid Services (CMS) CMS Healthcare Common Procedure Coding System (HCPCS) code set Clinical Laboratory Improvement Amendments (CLIA) …
8.03.502 Physical Medicine and Rehabilitation Physical ...
www.premera.comPage | 2 of 19 ∞ Type of Therapy Medical Necessity Physical medicine and rehabilitation — physical therapy (PM&R – PT) Physical medicine and rehabilitation — physical therapy (PM&R – PT), including medical massage therapy services — may be considered medically necessary when ALL of the
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