Under this PPO prefix, members are covered for both in-network and out-of-network care. The plan pays a higher percentage of allowed charges when members use participating providers. No gatekeeper or primary care referral is required. Verify the member's specific benefits for cost-sharing details.
Under this prefix, the member may have Medicare Advantage coverage administered by this BCBS plan. MA claims are subject to CMS regulations in addition to the plan's own policies. Balance billing restrictions apply. Verify the member's specific MA plan details and confirm the correct payer ID for electronic submission.
This is a High-Deductible Health Plan (HDHP) prefix. These plans have minimum deductible thresholds set by the IRS. Members often use HSA funds to cover out-of-pocket costs. The plan's claims processing and payer ID are the same as the standard plan, but expect higher patient responsibility amounts on remittance.
Nonprofit health insurance company providing coverage to over 3 million members in Alabama. Member of the Blue Cross Blue Shield Association since 1936.