Chapter 13 Blue Cross Blue Shield . Introduction. Blue Cross and Blue Shield Perhaps the best known plans of medical insurance in the United States. Origin of Blue Cross Blue Shield. Blue Cross,1929 Baylor University hospital in Dallas, Texas
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Blue Cross Blue Shield
BCBS plans, in exchange for tax relief for their nonprofit status, are forbidden by state law from canceling coverage for an individual because he or she is in poor health or BCBS payments to providers have far exceeded the average.
– Assistant surgeon fees
– Obstetric care
– Intensive care
– Newborn care
– Chemotherapy for cancer
– Purchase of durable medical equipment
– Mental health visits
– Allergy testing and injections
– Prescription drugs
– Private duty nursing
– Dental care required as a result of a covered accidental injury
The insurance claim is submitted to the BC/BS plan in the state where services were rendered. That local plan forwards the claim to the home plan for adjudication.