Blue Cross and Blue Shield of Kansas City
Missouri • Medicare Advantage, HMO, Traditional Indemnity
Medicare Advantage (MA) coverage means this member receives their Medicare benefits through a private BCBS plan rather than through original Medicare. MA plans may have different payer IDs and claims addresses than the commercial plan. Check with the payer to confirm the correct submission details for Medicare Advantage claims.
HMO (Health Maintenance Organization) plans require members to choose a primary care physician (PCP) and obtain referrals before seeing specialists. Out-of-network services are generally not covered except in emergencies. Claims must be submitted to the payer listed above and should include referral authorization when applicable.
This is a traditional indemnity prefix. Unlike managed care plans (HMO, PPO, EPO), indemnity plans do not use provider networks. There are no referral requirements and no restrictions on which providers the member can see. Submit claims to the payer listed above for reimbursement at the plan's allowed rate.
Independent licensee serving Kansas City area and northwest Missouri.