Slide 1

Claims Flow, Responsibilities, and Tools Scenarios Claims Flow, Responsibilities, and Tools Scenarios 1 Slide 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? 2 Slide 3 Sally should call BlueCard Access at 1-800-810-BLUE. She can also use http://www.bcbs.com/healthtravel/finder.html if she has access to the internet. http://www.bcbs.com/healthtravel/finder.html Sally should call BlueCard Access at 1-800-810-BLUE. She can also use http://www.bcbs.com/healthtravel/finder.html if she has access to the internet. http://www.bcbs.com/healthtravel/finder.html 3 Slide 4 Which Plan (TN or AR) would be Sallys HOME PLAN? 4 Slide 5 Which Plan (TN or AR) would be Sallys HOST PLAN? 5 Slide 6 Which Plan (TN or AR) is the LOCAL BLUE? 6 Slide 7 Betty hands her Alabama Blue Cross Blue Shield ID card to the intake specialist at a California physicians office. The specialist reviews the ID card and notices that Betty has BlueCard coverage. How does the specialist know that Betty has BlueCard coverage? 7 Slide 8 Bettys ID Card has the suitcase logo, identifying her as a BlueCard member. 8