Traditional indemnity coverage under this prefix is a fee-for-service plan. Members can see any provider without network restrictions or referral requirements. The plan reimburses a set percentage of usual and customary charges. Claims are submitted directly to the payer listed above.
Under this EPO prefix, the member has no out-of-network coverage for routine care. However, unlike HMO plans, no referral is needed to see a specialist within the network. When billing, confirm the provider's network participation status with the plan before submitting the claim.
This prefix is associated with Medicare Advantage. MA plans combine hospital (Part A) and medical (Part B) coverage, and many include prescription drug coverage (Part D). When billing, confirm whether the plan uses the same payer ID for MA claims as for commercial claims, as many BCBS companies use separate IDs.
Independent licensee of the Blue Cross Blue Shield Association providing commercial, Medicare and Medicaid plans in Idaho.