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A PCP is a physician whose principal medical specialty is in family practice, internal medicine, OB/GYN, general practice or pediatrics. Get recipes and nutritional tips to prep your next meal. Read reviews and ratings of excellus. The website includes Frequently Asked Questions and search capabilities. Information about services, staff, hours of operation and your benefits, including access to routine services as well as after-hours and emergency services, and members' rights and responsibilities; Participate in decision-making with your physician about your health care; Obtain complete, current information concerning a diagnosis, treatment and prognosis from a provider in terms that you can reasonably be expected to understand; Refuse treatment as allowed by law, and be informed by your physician of the medical consequences; Confidentiality of medical records and information, with the authority to approve or refuse the re-disclosure by us of such information, to the extent protected by law; Receive all information needed to give informed consent for any procedure or treatment; Access to your medical records as permitted by New York State law; Express concerns and complaints about the care and services provided by physicians and other providers, and have us investigate and respond to these concerns and complaints; Candid discussion of appropriate or medically necessary treatment options for your condition, regardless of cost or benefit coverage; Care and treatment without regard to age, race, color, sex or sexual orientation, religion, marital status, national origin, economic status or source of payment; Voice complaints or appeals and recommend changes in benefits and services to staff, administration and/or the New York State Insurance Department or Department of Health, without fear of reprisal; Formulate advance directives regarding your care. P.O. <]>> In California, Anthem Blue Cross and Blue Shield are actually different companies and are competitors. Its imperative to take your part ID card with you when you look for care, so your PCPs office has your protection data. To make recommendations regarding the organization's members' rights and responsibilities. Check your local phone directory for specific agency listings. Most managed care plan members must have a referral from their PCP prior to seeking emergency room care if the condition does not appear to be for an emergency medical condition. Do I need to get a referral from my PCP before I obtain services from other providers or facilities? What is the policy number? Excellus bcbs participating brokers may register for an online account. The New York State Partnership for Long Term Care is a unique program that combines private long term care insurance and Medicaid to help New Yorkers prepare financially for the possibility of needing nursing home or home care. ; Wegovy contains semaglutide and should . Your part ID number interfaces you to your data in our frameworks, and is the thing that suppliers use to ensure you are secured for a treatment or medication when you look for care. Phone - 1-877-846-7369 Contact us at the phone number on your member card for personalized care. Your ID number is likewise the key that gets you into Blue Access for Members, your online asset for dealing with your medical services inclusion. Because of HIPAA, we cannot release any information regarding your policy, claims or benefits without your express permission. any time, you may also file a complaint with the State Department of Health, (800) 206-8125, or the State Department of Insurance, (800 . What is group number for Excellus? How do I read my Blue Cross Blue Shield insurance card? Our Behavioral Health Advocate can be reached at 1-844-635-2662. If your group number is available, you'll find it directly below your member number. The New York Consumer Guide to Health Insurers is available from the New York State Insurance Department. %%EOF BCBS Prefix List WAA to WZZ - RCM Revenue Cycle Management We also offer Behavioral Health Advocacy services to our members and providers when a request for treatment has been denied. This . OnTrackNY is an innovative treatment program for adolescents and young adults who have had unusual thoughts and behaviors, or who have started hearing or seeing things that others dont. Each employer choses a package for their employees based on price, or types of coverage. All Children and Family Treatment and Support Services can be delivered in the community where the child/youth lives, attends school, and/or engages in services. Call: 1-800-650-4359 (TTY711), Closed: Thanksgiving, Day after Thanksgiving, Christmas Eve, Christmas Day, New Years Eve, New Years Day. View or Pay Bills, Setup AutoPay and more. Insurance Group Number: Where to find it on your Insurance Card If you're lost regarding finding your group number on your insurance card, worry no further. 0000002121 00000 n %PDF-1.4 % You will be prompted to log in. Find a plan that works in your service area. UM decision-making is based solely upon the application of nationally recognized clinical criteria and transparent corporate medical policies. National Eating Disorder Association will provide information on the diagnoses and also provides assistance with finding eating disorder providers and supports. Whether or not your program requires a referral, it is a good idea to discuss your concerns with your primary care physician who may be able to assist in selecting a mental health specialist. Improve your quality of life with our support. Group number: Identifies your employer plan Each employer choses a package for their employees based on price, or types of coverage. All information regarding your care and treatment is confidential and protected by law. Both versions are valid until january 1, 2011. Excellus BlueCross BlueShield is an HMO plan and PPO plan with a Medicare contract. Website - www.oasas.ny.gov/hopeline, SAMHSA - an Agency of the U.S. Department of Health & Human Services Most often these services are provided in facilities that are licensed by the Office of Alcohol and Substance Use and provide individual, group and family counseling. 6 10.0 government programs excellus bluecross blueshield program id card designation id number child health plus group code c prefix zfb . The telephone numbers you require for everything from client assistance to qualification questions are generally found on the rear of your card. All calls are toll-free, anonymous and confidential. . Information for Pharmacies. Can you help me decide which PCP to select? This is when you or a family member requires medically necessary treatment in a facility that provides 24-hour care. To learn about specifics, refer to Mental Health Parity Member Disclosure. At the point when you see the PPOB in a bag logo on the front of an ID card, it implies the part has chosen a PPO/EPO item from a BCBS Plan and the part approaches BlueCard PPO Basic. Zt \5@J0XFB!\IQ(2938 You can view this report online at www.dfs.ny.gov/consumers/health_insurance/health_insurance_complaint_rankings or use the addresses below to request a printed copy: * If requesting by email or mail, please provide Your Name, Address, City/State/ZIP. What can I do if my benefits are exhausted for medical services? Your bcbs id card has your member number, and in some cases, your employer group number. View Our Policies | Providers | Excellus BlueCross BlueShield Read on to understand more about the components of a Blue Cross Blue Shield insurance card and how to read them. If you have our prescription drug coverage and need to fill a prescription while traveling, you can use FLRx, our National Pharmacy Network. The group number is created when a company first signs up for insurance. Programs are located throughout New York State. You can find this important number on the front section of your card. If the provider is not satisfied with our payment, he/she may submit the claim to an independent dispute resolution entity who will determine whether our payment or the providers charge is most reasonable. Manager Case Management (SN LTSS) Job in Rochester, NY - Excellus Nonetheless, there are a few exemptions. Prescription Drug ClaimOpen a PDF. Individuals who have Consumer-Directed Healthcare (CDHC) designs frequently convey medical care charge cards that permit them to pay for cash based costs utilizing assets from their Health Reimbursement Arrangement (HRA), Health Savings Account (HSA) or Flexible Spending Account (FSA). Your group number will appear on your premium bills, and you'll use it for electronic and web enrollment activity. This will allow your Mental Health or Chemical Dependency specialist to share information with your Primary Care Physician concerning your treatment plan and medical condition. You can find us in the guide under the name Excellus BlueCross BlueShield. Usually, ID cards dont list the full complexities of your coverage, like the types or amounts. Create an Account View your Summary of Benefits and Coverage Find a doctor, estimate medical cost and track your deductible and spending Some examples include severe chest pain, poisoning or unconsciousness. We use cookies to ensure that we give you the best experience on our website. Your card contains key information about your health insurance coverage that is required when you need care or pick up a prescription at the pharmacy. If you're wondering where to find your group number on your insurance card, that answer is that it usually will show on the front of your card. We offer a variety of direct payment policies (when a member purchases coverage from us directly, not through an employer or group). If the denial was based on your contract, you may file a grievance. Case Manager, RN or Licensed Behavioral Health Professional (DUALS) Select Blue Cross Blue Shield Globalor GeoBlue if you have international coverage and need to find care outside the United States. Visit yourlocal BCBS companys websitefor details. Typical co-pays for a visit to a primary care physician range from $15 to $25. Our Find A Doctor online tool is designed to help you connect with any doctor participating in our network, including Primary Care Physicians. PDF Understanding your health insurance card - Boston Medical Center