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What is the timely filing limit for BCBS of Illinois?

BCBSIL Facility Providers Claims must be filed with BCBSIL on or before December 31 of the calendar year following the year in which the services were rendered.

What is a predetermination attachment?

A predetermination of benefits is a voluntary request for written verification of benefits prior to rendering services. BCBSNM recommends submitting a predetermination of benefits request if the service may be considered experimental, investigational or unproven, as specified within the BCBSNM Medical Policy.

What does predetermination mean for insurance?

A predetermination of benefits is a review by your insurers medical staff. They decide if they agree that the treatment is right for your health needs. Predeterminations are done before you get care, so you will know early if it is covered by your health insurance plan.

Can I use BCBS of Illinois out of state?

Most Blue Cross Blue Shield members can rest easy since Blue Cross Blue Shield coverage opens doors in all 50 states and is accepted by over 90 percent of doctors and specialists. And if your extended travel plans take you abroad, you can ensure you have access to quality care through GeoBlue.

What is the difference between precertification and preauthorization?

Prior authorization, also known as preauthorization, prior approval, or precertification, is a process that insurance companies use to determine whether a patient is eligible to receive certain procedures, medications, or tests, except in an emergency.

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How to do a predetermination?

There are four steps to creating a predetermination: Select the participating insurer and service provider. Select or create the patient. Enter the service information. Verify and submit the predetermination.

What is predetermination authorization?

Predetermination for benefits of your health insurance plan is a process through which your insurers medical staff reviews the recommended treatment. If they agree with your doctors and specialists that you need the health treatment and that it is right for you, your predetermination is approved.

Is Blue Shield of Illinois the same as Blue Cross Blue Shield?

About Blue Cross and Blue Shield of Illinois BCBSIL is a division of Health Care Service Corporation, a Mutual Legal Reserve Company and an Independent Licensee of the Blue Cross and Blue Shield Association.

What is included in predetermination?

Predetermination confirms the amount that the insurer will reimburse for the service. If a medical procedure, treatment or test is not covered, the in-network ordering or servicing provider or the member will be responsible for paying the bill.

What type of insurance is Blue Cross Blue Shield of Illinois?

Blue Cross and Blue Shield of Illinois (BCBSIL) is a customer-owned health insurance company serving Illinois residents. The company offers individuals and families healthcare and prescription drug coverage through its Blue Choice Preferred PPO, Blue Precision HMO, and BlueCare Direct HMO plans.

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What is the timely filing limit for BCBS of Illinois?

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