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Blue cross blue shield claim california Form: What You Should Know

The first year, you will be eligible for a “100% Rebate” if you use a service year that includes the 1st of the month within the 1st year you submitted the claim. After that, the rebate will be reduced by 10%.  What is an “eligible” service year? The criteria are based on your health coverage under the Blue Shield Plan as an individual health plan member or a member of a group of members or eligible dependents. Blue Shield's “Eligible” Service Years are as follows: You may use this form ONLY if you are NOT a Member for any year included in each of the examples above. 1. The period beginning on the first day of covered services (or on the effective date of health coverage in the months preceding coverage), and includes the 1st of the month included in each of the examples above. 2. If you use a covered service in each month during the applicable service year, you will receive the above-specified rebate no later than the first day of coverage. NOTE, if you are using a qualified group health plan, you will also receive the above-specified rebate for each month in the same service year that you choose (i.e., no rebate for days when you are not in such a plan.) For example: You are the sole member of a group health plan and a qualified individual and your service year includes February 1, 2018, through January 31, 2019. This group health plan provides you with your 1st monthly health plan reimbursement starting on February 1, 2018, using the following example: Your first eligible covered service will be provided by April 30, 2018, and you will be using Blue Shield's M1 Individual plan. At the time of service you will be eligible, for a first-month rebate. You will NOT receive a rebated service year for periods beginning with April 2, 2018. This will occur as a result of you using covered services in each month of the applicable service year. Your rebate will be applied on November 1, 2024 (month zero) and will remain on your account until you pay your monthly bill on or before January 1, 2024 (month six). In summary: If you use services that satisfy the “first-month” criteria in each month of an applicable service year, you will receive a rebate no later than the first day of that month.

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Video instructions and help with filling out and completing Blue cross blue shield claim form california

Instructions and Help about Blue cross blue shield claim form california

Hi, my name is Kim Crumpton. I work at Healthcare Express and I handle Blue Cross Blue Shield insurance. Today, I would like to explain the differences between urgent care, specific PCPD, and specialty care. When you visit one of our offices, the cost for an office visit is $215. Blue Cross Blue Shield allows $107.40 and disallows $107.60. This means that we have to write off the $107.60. Blue Cross Blue Shield will pay us $107.40. Your copay may vary depending on your insurance policy. Some policies have a copay of $35. Blue Cross Blue Shield is actually better in terms of copay, as they will pass $72.40. After deducting the $35 copay, we are left with $107.40. If you have any issues with understanding your payments or if something is not covered, please call us and we will coordinate with your insurance company to resolve any confusion. If you visit a regular doctor at another clinic in town, your copay might be $25. However, at an urgent care setting like ours, you may have to pay a $50 copay or your specialty copay. Urgent care benefits are relatively new and if you don't have them, you will be charged the higher specialty copay. We deal with many insurances, ranging from 2 to 10. Each insurance pays differently, for example, Blue Cross Blue Shield pays $107, while another insurance pays $215. Now, let me explain the BlueCross BlueShield federal plans deductible. Each year, the plan may change, either slightly or significantly. It is important to stay informed about these changes. This year, for Blue Cross federal groups 104 and 105, the deductible is $350. Once you meet or satisfy this deductible, your plan will cover your urgent care expenses.