In the United States Puerto Rico and US. Policy BCBSNC will provide coverage for White Blood Cell Growth Factors when it is determined to be medically necessary because the medical criteria and guidelines shown below are met.
Blue Essentials Accesssm Benefit Plan
While medical Insurance carriers typically update medical policies annually there are many reasons why they might review or update a policy.
Blue cross federal medical policy. The policies contained in the FEP Medical Policy Manual are developed to assist in administering contractual benefits and do not constitute medical advice. Many of these clinical and reimbursement guidelines are automated in our claims processing. EEG Monitoring 211 see policy 211 for Somatosensory evoked potentials Paraspinal Surface Electromyography - SEMG - to Evaluate and Monitor Back Pain 517 Stereotactic Radiosurgery and Stereotactic Body Radiotherapy 277 Policy Commercial Members.
Medical and Claim Payment Policy Portal The Commercial Medicare Advantage and MA PPO Host policy bulletins on this website were developed to communicate both clinical and claim payment reimbursement positions for services administered under the. Read our Nondiscrimination and Language Assistance notice. The Blue Cross and Blue Shield Association does not intend by the FEP Medical Policy.
There are several factors that impact whether a service or procedure is covered under a members benefit plan. Members should also refer to their specific benefits in their subscriber certificate for. The Blue Cross and Blue Shield Association does not intend by the FEP Medical Policy Manual or by any particular medical policy to recommend advocate encourage or discourage any particular medical technologies.
The Blue Cross and Blue Shield Association does not intend by the FEP Medical Policy Manual or by any particular medical policy. They are not intended to replace or substitute for the independent medical judgment of a practitioner or other health care professional in the treatment of an individual member. These guidelines address hundreds of medical issues including diagnostic and therapeutic procedures injectable drugs and durable medical equipment.
When reviews occur out of cycle they often go unnoticed. Blue Cross Blue Shield members can search for doctors hospitals and dentists. Claims are to be sent to Blue Cross or its agents and must be received within 18 months of the date of service.
Dentists may submit claims electronically when they are enrolled in the CDAnet program. Benefit plans vary in coverage and some plans may not provide coverage for certain services noted in the medical policies. Managed Care HMO and POS PPO and Indemnity.
Because our medical policies offer clinical guidelines for health care providers we recommend that members talk with their physician if they have questions. You can choose to view a listing of all our medical policies or search for a specific policy. Medical decisions relative to medical technologies are to be made strictly by memberspatients in consultation with their health care providers.
Benefits Application This medical policy relates only to the services or supplies described herein. They are not intended to replace or substitute for the independent medical judgment of a practitioner or other healthcare professional in the treatment of an individual member. Learn more about our non-discrimination policy and no-cost services available to you.
Medical decisions relative to medical technologies are to. Veterans Independence Program VIP claims are to be sent to the National VIP Provider Payment Centre at Medavie Blue Cross and must be received within 18 months of the date of service. Medicare products Medicaid products and some self-insured plans may have additional policies and prior authorization requirements.
These documents are available to you as a reference when interpreting claim decisions. The conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that the Blue Cross. We comply with applicable Federal civil rights laws and do not discriminate on the basis of race color national origin age disability or sex.
Current medical policy is to be used in determining a Members contract benefits on the date that services are rendered. The policies contained in the FEP Medical Policy Manual are developed to assist in administering contractual benefits and do not constitute medical advice. Copyright Blue Cross Blue Shield of Rhode Island.
Medical policies apply generally to all Blue Cross and Blue Plus plans and products. Some policies address procedures and services that are considered to be part of another procedure or service and as such are not separately payable. Blue Cross and Blue Shield of North Carolina does not discriminate on the basis of race color national origin sex age or disability in its health programs and activities.
Medical policies and clinical utilization management UM guidelines are two resources that help us determine if a procedure is medically necessary. We also provide language assistance. Select Blue Cross Blue Shield Global or GeoBlue if you have international coverage and need to find care outside the United States.
Outside the United States. Contract language including definitions and specific inclusionsexclusions as well as state and federal law must be considered in determining eligibility for coverage. Click here to view the Blue Cross Blue Shield Federal Employee Program FEP Medical Policy Updates Policy Alerts monitors Commercial and Medicare medical policies for changes.
BCBSNE Medical Policy Welcome to Med Policy Blue Now you can access and learn more about Blue Cross and Blue Shield of Nebraskas medical policies quickly and easily-and at your convenience. Particular medical policy to recommend advocate encourage or discourage any particular medical technologies.
