Had you been near this family’s home, it would have sounded like an explosion as the Blue Shield member vented to me about the incompetent billing system of Blue Shield.
Blue Shield of California
Posts related to Blue Shield of California for individuals, families, small groups, Medicare, Medi-Cal, Covered California.
Blue Shield Fined For Transgender Health Care Claims Processing
In March of 2021, Blue Shield approved the plan member to receive gender dysphoria health care services from an out-of-network provider. Unfortunately, Blue Shield, according to the press release, inappropriately adjusted several of claims submitted by the health care professional. The payment dispute led to the health care professional suspending continued treatment until the claims dispute was resolved.
Blue Shield In-Home Healthcare For HMO and PPO Members In Southern California
Blue Shield PPO members can schedule a visit by calling the Blue Shield Nurse Hotline or contacting Dispatchealth directly via website or telephone. Blue Shield HMO members must call their Primary Care Physician for a referral for an in-home visit to treat a medical condition. In-home visits are grouped into 5-hour windows corresponding to morning, afternoon or evening. Appointments can be as early as 7 AM or as late as 10 PM, sometimes on the same day as the request. Care is available in English and Spanish.
Blue Shield PPO Covered California Rate Increase 2022 vs 2023
Where households realize a dramatic increase in Blue Shield PPO Covered California premiums is when the SLCSP has a small increase or negative rate change. Consumers in regions 2, 3, 4, 6, 7, 15, 16 and 18, where the SLCSP rate increases were in the low single digits will see a smaller subsidy. In other words, the Blue Shield PPO plan rate increases in those areas was greater than the SLCSP that the subsidy is based upon. The subsidy did not keep pace with the Blue Shield PPO rate increase like they did in regions 1 and 10.
Blue Shield Abortion Travel Reimbursement Benefit
While prior authorization is not required, Blue Shield of California members should become familiar with all of the conditions of the program for proper reimbursement. The abortion services must be provided by a licensed practitioner in a state other than the member’s residence where pregnancy termination can be lawfully provided.
Blue Shield BlueCard Is Back for 2022
The BlueCard program allows members to receive some health care services outside of California. This is an important feature for individuals who routinely spend weeks or months outside of California on business. With the exception of emergency services, if an individual needed small health care service in another state, they were almost forced to buy two health plans; one for California and one for the other state.
Unique Blue Shield Bronze Plan for 2022
Many people want predictable copayments for routine services and are willing to accept a large deductible and maximum out-of-pocket amount for the rare and unexpected hospitalization. Blue Shield of California has come pretty close to designing such a plan with their 2022 Bronze 7500 HMO individual and family plan. Services with a set copayment and not subject to the medical deductible are:
Out of State Emergency and Urgent Care With California Health Plans
Unbeknownst to many people, most California health plans cover emergency care anywhere in the United States and treat it as if it were in-network. This means that if you have a Silver 70 plan and are rushed to the emergency room of the nearest hospital while on vacation in upstate New York, your copayment will be $400 just as if the emergency services were performed at your local home office.
Blue Shield Premium Refunds For 2020
Not all Blue Shield health plans will be receiving the premium credit. The credits will be applied to fully-insured employer groups (except flex-funded), dental and/or vision plans, Medicare Supplements, and individual and family dental and/or vision plan subscribers. Blue Shield states they are issuing premium credits as permitted by state regulators and Covered California.
Blue Shield Add Chiropractic, $0 Copay Telemedicine
LifeSpring, a free meal delivery service, is also available to Trio HMO members experiencing a serious illness. In addition to meals, Trio HMO members can also use the Call the Car benefit. Call the Car is free non-emergency medical transportation for medical appointments, dialysis or other healthcare service appointments. Blue Shield Case Managers will determine eligibility for the Call the Car program.