Anthem Blue Cross and Blue Shield of Georgia
Georgia • Traditional Indemnity, Medicare Advantage, HMO
Under this indemnity prefix, the member has fee-for-service coverage. There is no provider network, no referral requirement, and no primary care physician gatekeeper. Claims are processed based on the plan's fee schedule. While less common than managed care plans, indemnity coverage is still offered by some BCBS companies.
Medicare Advantage coverage under this prefix means the plan administers Medicare Part A and Part B benefits on behalf of CMS. These claims may have different processing rules than commercial claims, including different prior authorization requirements and appeal timelines. CMS timely filing rules (365 days) typically apply.
Under this HMO prefix, the member's coverage is limited to the plan's provider network. Care is coordinated through a primary care physician. Specialist visits require a referral from the PCP. When billing, confirm that the referring provider and the referral authorization number are included on the claim.
Independent licensee of the Blue Cross Blue Shield Association providing commercial, Medicare, and Medicaid plans in Georgia.