My.capbluecross.com
Capital Blue Cross
WebHealthcare benefit programs issued or administered by Capital Blue Cross and/or its subsidiaries, Capital Advantage Insurance Company ®, Capital Advantage Assurance Company ® and Keystone Health Plan ® Central. Independent licensees of the Blue Cross Blue Shield Association serving 21 counties in Central Pennsylvania and the Lehigh Valley.
Actived: 8 days ago
Drug Infusion Site of Service
WebMEDICAL POLICY POLICY TITLE DRUG INFUSION SITE OF SERVICE POLICY NUMBER MP 3.016 1 Effective 1/1/2024 Effective Date: 1/1/2024 I. POLICY Note: An injectable medication must meet applicable medical necessity criteria for coverage. When coverage criteria are met for the injectable medication, this policy is used to determine
Pharmacy Benefit Claim Form
WebUse a separate claim form for each member and prescription. Complete Section 1 and Section 2 on the front of this form and Section 4 below if applicable. All information provided on or attached to this claim form must be for the same person/prescription. 2. Attach original itemized pharmacy receipts provided with your prescription.
Capital Blue Cross Value Formulary Update
Web2nd & 3rd Quarter 2023 (effective January 1, 2024) The Capital BlueCross formulary is a reference list of prescription drugs that contains a wide range of generic and brand drugs that have been approved by the U.S. Food and Drug Administration (FDA). The formulary is updated on a quarterly basis or when new generic or brand-name …
Out-of-Network Facility Reimbursement QRG
WebOut-of-Network Facility Reimbursement Quick Reference Guide Healthcare benefit programs issued or administered by Capital Blue Cross and/or its subsidiaries, Capital Advantage Insurance Company®, Capital Advantage Assurance Company®, and Keystone Health Plan® Central. Independent licensees of the Blue Cross Blue Shield Association …
P TITLE Services In Addition To A Basic Service
WebPROFESSIONAL NETWORK REIMBURSEMENT POLICY POLICY TITLE Services In Addition To A Basic Service POLICY NUMBER NR-09.902 Page 1 of 5 Health care benefit programs issued or administered by Capital Blue Cross and/or its subsidiaries, Capital Advantage Insurance Company®, Capital Advantage Assurance Company® and …
BH-140: Substance Use Disorder Presentation
WebWhat is substance use disorder? •Substance use disorder: a medical condition that is defined by the inability to control the use of a particular substance (or substances) despite harmful consequences. •Substances can be prescribed medications being improperly used or illicit narcotics/drugs obtained illegally for consumption.
Improving member health outcomes through effective …
WebAgenda 1 1 The role of providers in relation to behavioral health. 2 A strong foundation for care and coordination. 3 Communication responsibilities to other providers. Improving care and coordination between medical and behavioral health. 4 5 Final thoughts and resources.
P TITLE General Coding Guidelines
WebPROFESSIONAL NETWORK REIMBURSEMENT POLICY POLICY TITLE General Coding Guidelines POLICY NUMBER NR- 30.001 Page 1 of 6 Health care benefit programs issued or administered by Capital Blue Cross and/or its subsidiaries, Capital Advantage Insurance Company®, Capital Advantage Assurance Company® and Keystone Health Plan® …
ROFESSIONAL ETWORK EIMBURSEMENT POLICY
WebPROFESSIONAL NETWORK REIMBURSEMENT POLICY POLICY TITLE Correct Coding and Reimbursement Methodology POLICY NUMBER NR- 30.019 Page 1 of 5 Health care benefit programs issued or administered by Capital Blue Cross and/or its subsidiaries, Capital Advantage Insurance Company®, Capital Advantage Assurance Company® and …
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