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Claims Flow, Responsibilities, and Tools Scenarios

Claims Flow, Responsibilities, and Tools Scenarios. Sally is a Little Rock resident and a BlueAdvantage member. She and her family go on vacation to the Smoky Mountains in eastern Tennessee. She and her children all develop a rash after a day of hiking and need to see a doctor.

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Claims Flow, Responsibilities, and Tools Scenarios

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  1. Claims Flow, Responsibilities, and Tools Scenarios

  2. Sally is a Little Rock resident and a BlueAdvantage member. She and her family go on vacation to the Smoky Mountains in eastern Tennessee. She and her children all develop a rash after a day of hiking and need to see a doctor. What tool can Sally use to assist her in locating a participating Blue Cross Blue Shield service provider in that area?

  3. Sally should call BlueCard Access at 1-800-810-BLUE. She can also use http://www.bcbs.com/healthtravel/finder.htmlif she has access to the internet.

  4. Which Plan (TN or AR) would be Sally’s HOME PLAN?

  5. Which Plan (TN or AR) would be Sally’s HOST PLAN?

  6. Which Plan (TN or AR) is the “LOCAL BLUE?”

  7. Betty hands her Alabama Blue Cross Blue Shield ID card to the intake specialist at a California physician’s office. The specialist reviews the ID card and notices that Betty has BlueCard coverage. How does the specialist know that Betty has BlueCard coverage?

  8. Betty’s ID Card has the suitcase logo, identifying her as a BlueCard member.

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