Blue Shield Global Core Sample Clauses

The Blue Shield Global Core clause defines the terms under which members can access healthcare services internationally through the Blue Shield network. It typically outlines the process for obtaining medical care while traveling or residing outside the home country, including how to locate participating providers and submit claims for covered services. This clause ensures that members have access to necessary medical treatment worldwide, addressing the challenge of continuity of care and financial protection when abroad.
Blue Shield Global Core. If Members are outside the BlueCard Service Area, they may be able to take advantage of Blue Shield Global Core when accessing Out-of-Area Covered Health Care Services. Blue Shield Global Core is unlike the BlueCard Program available in the BlueCard Service Area. Although Blue Shield Global Core assists Members with accessing a network of inpatient, outpatient, and professional providers, the network is not served by a Host Blue. As such, when Members receive care from providers outside the BlueCard Service Area, Members will typically have to pay the providers and submit the claims themselves to obtain reimbursement for these services. Details for Blue Shield Global Core claim submission are provided in the Out-of-area services section of the EOC.
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Blue Shield Global Core. If you are outside the United States (hereinafter “BlueCard service area”), you may be able to take advantage of the Blue Cross Blue Shield Global Core when accessing covered healthcare services. The Blue Cross Blue Shield Global Core is unlike the BlueCard Program available in the BlueCard service area in certain ways. For instance, although the Blue Cross Blue Shield Global Core assists you with accessing a network of inpatient, outpatient and professional providers, the network is not served by a Host Blue. As such, when you receive care from providers outside the BlueCard service area, you will typically have to pay the providers and submit the claims yourself to obtain reimbursement for these services. • Inpatient Services: In most cases, if you contact the service center for assistance, hospitals will not require you to pay for covered inpatient services, except for your cost-share amounts/deductibles, coinsurance, etc. In such cases, the hospital will submit your claims to the service center to begin claims processing. However, if you paid in full at the time of service, you must submit a claim to receive reimbursement for covered healthcare services. Preauthorization may be required for non- emergency inpatient services. • Outpatient Services: Physicians, urgent care centers and other outpatient providers located outside the BlueCard service area will typically require you to pay in full at the time of service. You must submit a claim to obtain reimbursement for covered healthcare services. Preauthorization may be required for outpatient services. • Submitting a Blue Cross Blue Shield Global Core Claim: When you pay for covered healthcare services outside the BlueCard service area, you must submit a claim to obtain reimbursement. For institutional and professional claims, you should complete a Blue Cross Blue Shield Global Core claim form and send the claim form with the provider’s itemized bill(s) to the service center (the address is on the form) to initiate claims processing. Following the instructions on the claim form will help ensure timely processing of your claim. The claim form is available from BCBSRI, the service center or online at ▇▇▇.▇▇▇▇▇▇▇▇▇▇▇▇▇▇.▇▇▇. If you need assistance with your claim submission, you should call the service center at ▇.▇▇▇.▇▇▇.▇▇▇▇ (2583) or call collect at ▇.▇▇▇.▇▇▇.▇▇▇▇, 24 hours a day, seven days a week.
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Blue Shield Global Core. If you are outside the United States, the Commonwealth of Puerto Rico and the U.S. Virgin Islands (BlueCard® Service Area), you may be able to take advantage of Blue Shield Global® Core when accessing Out-of-Area Covered Health Care Services. Blue Shield Global® Core is not served by a Host Blue. As such, you will typically have to pay the providers and submit the claims yourself to obtain reimbursement for these services. If you need assistance locating a doctor or hospital outside the BlueCard® Service Area you should call the service center at (▇▇▇) ▇▇▇-▇▇▇▇ (2583) or call collect at (▇▇▇) ▇▇▇-▇▇▇▇, 24 hours a day, seven days a week. Provider information is also available online at ▇▇▇.▇▇▇▇.▇▇▇: select “Find a Doctor” and then “Blue Shield Global Core.” Submitting a Blue Shield Global® Core claim
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Blue Shield Global Core. If Members are outside the United States, the Commonwealth of Puerto Rico, and the U.S. Virgin Islands (the "BlueCard service area"), they may be able to take advantage of Blue Cross Blue Shield Global Core. Blue Cross Blue Shield Global Core is unlike the BlueCard Program available in the BlueCard service area in certain ways. For instance, although Blue Cross Blue Shield Global Core helps Members access a provider network, they will typically have to pay the provider and submit the claims themselves to get reimbursement for covered services. However, if Members need hospital inpatient care, the Service Center can often direct them to hospitals that will not require them to pay in full at the time of service. These hospitals will also submit the Member's claims to Blue Cross Blue Shield Global Core.
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Blue Shield Global Core. If you are outside the United States, the Commonwealth of Puerto Rico and the U.S. Virgin Islands (BlueCard® Service Area), you may be able to take advantage of Blue Shield Global® Core when accessing Out-of-Area Covered Health Care Services. Blue Shield Global® Core is not served by a Host Blue. As such, you will typically have to pay the providers and submit the claims yourself to obtain reimbursement for these services. If you need assistance locating a doctor or hospital outside the BlueCard® Service Area you should call the service center at (▇▇▇) ▇▇▇-▇▇▇▇ (2583) or call collect at (▇▇▇) ▇▇▇-▇▇▇▇, 24 hours a day, seven days a week. Provider information is also available online at ▇▇▇.▇▇▇▇.▇▇▇: select “Find a Doctor” and then “Blue Shield Global Core.” Submitting a Blue Shield Global® Core claim When you pay directly for Out-of-Area Covered Health Care Services outside the BlueCard® Service Area, you must submit a claim to obtain reimbursement. You should complete a Blue Shield Global® Core claim form and send the claim form with the provider’s itemized bill to the service center at the address provided on the form to initiate claims processing. The claim form is available from Blue Shield Customer Service, the service center or online at ▇▇▇.▇▇▇▇▇▇▇▇▇▇▇▇▇▇.▇▇▇. If you need assistance with your claim submission, you should call the service center at (▇▇▇) ▇▇▇-▇▇▇▇ (2583) or call collect at (▇▇▇) ▇▇▇-▇▇▇▇, 24 hours a day, seven days a week. Blue Shield will provide Benefits before Medicare when: • You are eligible for Medicare due to age, if the Subscriber is actively working for a group that employs 20 or more employees (as defined by Medicare Secondary Payer laws); • You are eligible for Medicare due to disability, if the Subscriber is covered by a group that employs 100 or more employees (as defined by Medicare Secondary Payer laws); or • You are eligible for Medicare solely due to end-stage renal disease during the first 30 months you are eligible to receive benefits for end-stage renal disease from Medicare. Blue Shield will provide Benefits after Medicare when: • You are eligible for Medicare due to age, if the Subscriber is actively working for a group that employs less than 20 employees (as defined by Medicare Secondary Payer laws); • You are eligible for Medicare due to disability, if the Subscriber is covered by a group that employs less than 100 employees (as defined by Medicare Secondary Payer laws); • You are eligible for Medicare solely du...
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Blue Shield Global Core. If you are outside the United States, the Commonwealth of Puerto Rico and the U.S. Virgin Islands (BlueCard® Service Area), you may be able to take advantage of Blue Shield Global® Core when accessing Out-of-Area Covered Health Care Services. Blue Shield Global® Core is not served by a Host Blue. As such, you will typically have to pay the providers and submit the claims yourself to obtain reimbursement for these services.
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