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PAP800

BlueCard PPO


Provider Administrative Policy

Section
BlueCard
Policy Date
April 2007
Status/Date
Reviewed/May 2008
Provider Type(s)
All Providers  

Disclaimer

Our provider administrative policies contain information regarding claims submission, reimbursement, and other information in order to achieve an efficient relationship with our providers. These policies are not an authorization or explanation of benefits. Blue Cross of Idaho retains the right to add to, delete from and otherwise modify this policy in accordance with our provider contracts.

Policy

BlueCard PPO

The Blue Cross Blue Shield BlueCard Program includes out-of-state enrollees covered by a preferred provider organization (PPO) policy issued by the home plan. These members receive in-network benefits while they are traveling through or visiting another state, as long as the service is obtained from a PPO provider in that state.

Out-of-state enrollees can locate Blue Cross of Idaho providers by calling a toll-free telephone number, (800) 810-BLUE. Your name will be made available to these out-of-state enrollees if you are a Blue Cross of Idaho preferred provider.

BlueCard PPO enrollees can be identified by the suitcase logo with the PPO designation inside   on their identification cards. Eligibility and benefits can be verified for any BlueCard enrollee by calling (800) 676-BLUE and entering the three-letter alpha prefix indicated on the subscriber’s identification card.

Claims for all BlueCard enrollees should be sent to Blue Cross of Idaho for processing. Payment information will appear on a Blue Cross of Idaho remittance. Reimbursement for PPO enrollees will be made to Preferred Blue contracting physicians using the appropriate Blue Cross of Idaho allowance. You may collect any coinsurance, copayment, deductible or non-covered amounts from Blue Cross or Blue Shield enrollees at the time of the visit.


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