Anthem blue cross blue shield prior rx authorization form. Claims administrator, po box 14053, lexington, ky 40512 account holder information last name first name id code day of birth dd and last 2 digits of ssn birth date mmdd employer name email address complete only if new. Mix more of these herbs and spices into your diet for added health benefits. Federal employee program fep basic option enrollment. This plans health coverage qualifies as minimum essential coverage. Basic i have been doing research to determine the best way forward for me with health care coverage when i am eligible for medicare and have found an interesting item. Blue cross and blue shields federal employee program.
Your blue cross and blue shield service benefit plan team. Similarly, under basic option you get two free dental cleanings a year when you combine. Our newest plan, fep blue focus, covers preferred providers with a low deductible. The best blue cross fep phone number with tools for skipping the wait on hold, the current wait time, tools for scheduling a time to talk with a blue cross fep rep, reminders when the call center opens, tips and shortcuts from other blue cross fep customers who called this number. A feeforservice plan fep blue focus with a preferred provider. Speak to a licensed doctor by phone or video in minutes. Basic option benefits chart blue cross and blue shields. Fep blue focus covers certain drugsmainly generics and some preferred brand name and specialty drugs.
Being able to get a visit wherever you are and whenever you need it is beyond convenient. Basic option and fep blue focus members can only use preferred providers. Ppo 1 of 7 the summary of benefits and coverage sbc document will help you choose a health plan. Fep bluevision is responsible for the selection of innetwork providers in your area. Spices like turmeric can pack serious health benefits. If you need help filing a grievance, our 1557 compliance coordinator is available to help you. Commercial members call 18003276716 or fax 18882820780 medicare hmo and ppo members call 18002227620 or fax 18004472994 federal employee program fep contact your local plan. For customer service assistance, visit our website. Find all the details and instructions on how to set up a medicare reimbursement account online here. Fep 5 tier managed rx drug formulary 807 basic option.
Updated august 28, 2019 a division of health care service corporation, a mutual legal reserve company, an independent licensee of the blue cross and blue shield association page 2 of 2. Complete and fax the appropriate prior approval request form to 8008431114. Basic option members are encouraged to seek care from preferred providers in cases of accidental injury or medical emergency. If a tasty meal makes you feel better, it might not be your imagination. This may be done by calling the fep bluedental customer service department at 855504blue or 8555042583 below is a generic sample of a fep bluedental id card. Enrollment in basic blue rx depends on contract renewal. Fep prior approval lists and forms fep premera blue cross. Blue cross and blue shield federal employee program home. Authorization to release information please read these instructions carefully before completing the form on page 2 when to use the form you must complete this form if you want fep bluedental to give protected health information phi about you to someone else for example. Discover the benefits and personalized services available to your family. The anthem blue cross blue shield prior authorization form is what physicians will use when requesting payment for a patients prescription cost. Certificationcertificationandcompliancdownloads approvedtransplantprograms. Is there some major reason i am not seeing and would regret going to the lower priced basic option.
In 2018, fep will continue to offer comprehensive benefitsincluding medical, dental and visionwhile. The nonformulary exception nfe process allows fep blue focus members to request coverage of a nonformulary drug if they have tried and failed a covered options. Precertification requirements for members covered under the federal employee benefit plan the federal employee benefit program fep requires precertification for the following services. You can fill the form in electronically or complete it by.
The protection of your privacy will be governed by the privacy policy of that site. Contact us blue cross and blue shields federal employee. I have had bcbs fep standard since the beginning of. Blue cross and blue shield service benefit plan fep. They are not intended to replace or substitute for the independent medical judgment of a practitioner or other. Blue cross and blue shield of alabama, compliance office, 450 riverchase parkway east, birmingham, alabama 35244, attn. Butthereismoreto healthinsurancethanjustbenefitsandpremiums. Your doctor can call us tollfree at 18777273784 between 7 a.
Fep 5 tier managed rx drug formulary 807 basic option effective april 7, 2020 v2. Ppo 1 of 6 the summary of benefits and coverage sbc document will help you choose a health plan. There are two covered drug tiers and the amount you pay for your drug depends on the tier its in. Federal employee program fep coverage of rehabilitation. The basic option covers preferred providers with no deductible. Federal employee program fep quick reference guide. Your doctor can submit an electronic prior approval. When a member provides your office with their fep bluedental id card, it is important to also ask. You may also request or view the most current directory via our website at continued participation of any specific. I am requesting reimbursement for medicare part b premium expenses i incurred while a member of the blue cross and blue shield service benefit plan.
Both provide preventive, diagnostic and other services without deductibles for innetwork care. Self only, self plus one or self and family plan type. Further details will be outlined in highmarks provider manual which is available on the. Basic option members get access to the mail service pharmacy and can get. Both standard and basic option have a great hearing aid benefit and provide you access to our blue365 discount program. This group number needs to be entered in block 62 on the ub 04 claim form. Fep bluedental recommends that you verify coverage for the date of service. Enrollment codes 104, 105, 106, 111, 112, 1 on the member. Prescriptions are not a better deal with basic, except for short term meds like antibiotics.
The sbc shows you how you and the plan would share the cost for covered health care services. Basic blue rx enhance your medicare coverage with basic. Schedule a doctor visit, manage your medical history, or even send a prescription to the nearest pharmacy all from the palm of your hand. In massachusetts, call 18006897219 or fax 88828215 behavioral health call 18005244010 or fax 18886415199 oral surgery call 180032767. Cross and blue shield service benefit plan brochure standard and basic option. Fep blue focus only provides you access to the blue365 discounts. Complete the form following the instructions on the back. The form contains important information regarding the patients medical history and requested medication which anthem will use to determine whether or not the prescription is included in the patients health care plan. Fep bluedental authorization to release information. Note federal employee program group number is 0feptx. Fep bluedental offers high option and standard option plans. Blue cross and blue shield service benefit plan fep blue.
In addition to the pdf brochure, we have interactive versions of each brochure. Get access to your statements, health records, provider. Basic claim adjudication policy concepts unbundled procedures incidental procedures integralincluded in procedures mutually exclusive procedures. Blue cross and blue shield federal employee program, washington d. With the app you can keep up with your benefits on the go, find preferred providers, call the nurse line and more. Standard option, basic option and fep blue focus premiums in 2019 standard option. Instructions do not fax these instructions with your claim. Precertification requirements federal employee benefit. If hearing aids are important to you, keep this in mind. A feeforservice plan fep blue standard and fep blue basic options.
Blue cross and blue shield service benefit plan opm. Fep blue cross blue shield out of pocket expenses pre. Opm has determined that the blue cross and blue shield service benefit plans prescription drug coverage is, on average, expected to pay out as much as the standard medicare prescription drug coverage will pay for all plan participants and is considered. However, if you need care immediately and cannot access a preferred provider, we will provide benefits for the initial treatment provided in the emergency room of any hospital even if the hospital is not a preferred facility. If you have only one ongoing prescription then basic will be cheaper. We now offer a high deductible health plan hdhp as a suboption called basic consumer option, for members who live in certain geographic service areas tennessee, ohio, minnesota, kansas and missouri. Blue cross and blue shield federal employee program. For services in hawaii, please submit claims on a cms1500 or ub04 form, as appropriate, to the federal employee program fep of blue cross blue shield of hawaii. Blue cross and blue shield federal employee program fep. Please see the 2014 blue cross and blue shield service benefit plan brochure for more information.
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