When an active member goes to an in-network provider, the provider submits the claim to the local BC/BS office that they would submit any BC/BS claim to. If an active member goes to an out-of-network provider, the provider will, in most cases, also submit the claim to the local BC/BS office. If not, then the Read More
The claim was received with a code which indicates a possible accident/injury.
INDECS does not have an updated COB form on file and it has to be completed and returned timely to avoid delays in claims processing.
Under the OU Plan referrals are not required and you do not need a pre-certification for an MRI or CAT scan, however, when using US Imaging, have your doctor first call HealthCare Strategies (1-800-764-3433) for pre-notification before you go to US Imaging.
We are not currently set up for Medicare crossover.
The doctor that rendered services was not in network with BC/BS and the Plan has a deductible for out of network services. Because you are in an in network facility does not mean that every physician who sees you will also be in the network.
The member usually receives a check when the provider is not in the BC/BS Network.
Member’s frequently contact INDECS regarding coverage under their Dental and/or Vision Plan
The health Plan issues cards with only the member’s name printed on the card.
INDECS will verify eligibility and advise if there is an update needed for their dependent such as Age 26 or perhaps a COB update is needed. If the member lost their prescription they should contact CVS Caremark at 844-345-2792 or for a vacation override they should also contact CVS Caremark as they are allowed two overrides per Read More