blue cross blue shield covid test reimbursement form texas blue cross blue shield covid test reimbursement form texas

We have a nationwide network of providers that participate with Blue Cross Blue Shield of Michigan. If multiple tests are sold in one package, i.e., if one package includes two tests, it counts as two tests and not one test package toward the quantity limit. (To submit a single form for multiple members and/or receipts, use a mail-in form instead. endstream endobj 461 0 obj <>/ProcSet[/PDF]>>>>stream If you do not have an itemized receipt, you must send us the barcode (UPC code) from your test(s) packaging. W006259 COVID-19 Testing Member Reimbursement Form - Non-Medicare Advantage Please use this form to request reimbursement for COVID-19 tests you have paid for out of your own pocket. f/4kg>/ProcSet[/PDF]>>>>stream You can download the claim form hereor call the number on the back of your member ID card to receive one by mail. Online claim example 2: If you made two separate purchases and each purchase covered three members, you would need to submit six separate claim forms. Blue Shield and Blue Shield Promise cover these types of tests: 1Tests ordered by a healthcare provider means that a licensed and authorized healthcare provider has requested that you obtain a test for COVID-19. California Physicians Service DBA Blue Shield of California is an independent member of the Blue Shield Association. Insights, information and powerful stories on how Blue Cross Blue Shield companies are leading the way to better healthcare and health for America. We use cookies on this website to give you the best experience and measure website usage. If you have Medicare, you can go to www.empireblue.com/medicare for information about your plan. this.set=function(a,c){var b="",b=new Date;b.setTime(b.getTime()+6048E5);b="; expires="+b.toGMTString();document.cookie=a+"="+c+b+"; path=/; "}; We generally process claims within 30 days from receiving your completed claim form and receipts. Looking for COVID-19 coverage and benefit information? Centers for Disease Control and Prevention website: Test for Current Infection (accessed January 2022): cdc.gov. cRequired for employment purposes. All 35 Blue Cross and Blue Shield companies are fighting against COVID-19, investing more than $12.8 billion in the nation's recovery. Wu3B= e&gZ-h'BR$djC?Wn>2esFdUb'$K6Q endstream endobj 455 0 obj <>>>/EncryptMetadata false/Filter/Standard/Length 128/O(a;uY[7y\\ Y)/P -1036/R 4/StmF/StdCF/StrF/StdCF/U(6Tn= )/V 4>> endobj 456 0 obj <>>> endobj 457 0 obj <> endobj 458 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageC]/Properties<>/XObject<>>>/Rotate 0/StructParents 10/Tabs/W/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>> endobj 459 0 obj <>/ProcSet[/PDF]>>>>stream If you go to an out-of-state doctor or hospital that doesnt participate with Blue Cross Blue Shield, you may pay upfront for services. -60kWX6Ejr,@)wQGte^>2WUViq zn=`8REgLh`EsF53&5oc027R9 To be eligible for reimbursement, the purchased over-the-counter at-home COVID-19 tests: must be purchased on or after January 15, 2022 must be for personal diagnostic use used to identify the potential COVID-19 infection not be used for employment purposes not used for surveillance testing Health Insurance Providers Help Vaccinate More Than 2 Million Seniors Against COVID-19 in Underserved Communities, Blue Cross and Blue Shield Federal Employee Program (FEP) Joins White House Effort to Achieve National Vaccination Goal, Blue Cross Blue Shield Association Partners with Feeding America and its Network of 200 Food Banks to Drive Education of COVID-19 Vaccination, Blue Cross and Blue Shield Companies Join National Commitment to Protect Employees and Communities from COVID-19, Health Insurance Providers Commit to Help Millions of Seniors in Underserved Communities Receive COVID Vaccines, HPV vaccination rates low despite risks of related cancers, Infographic: COVID-19 patients with high-risk conditions 3x more likely to need the ICU, Why flu shots are so important during COVID-19 pandemic, Blue Cross Blue Shield Companies Invest in COVID-19 Relief, Frequently Asked Questions about COVID-19 Vaccination, Guidance for Communities, Workplaces and Schools. |X9GZaX~ Check your symptoms and risk for COVID-19 The CDC has a prevention tool you can use. Once you reach the limit of eight tests per member per calendar month, we will not reimburse claims for additional tests. We recognize the important role testing, along with vaccines and boosters, has played in the effort to battle the pandemic. Mail-in claim forms allow you to submit a claim for multiple members with one form. How can I resolve a problem with my PPO or HMO claim? To print and mail your claim, download theclaim form (PDF). this.check=function(){var a=this.get(f);if(a)a=a.split(":");else if(100!=e)"v"==h&&(e=Math.random()>=e/100?0:100),a=[h,e,0],this.set(f,a.join(":"));else return!0;var c=a[1];if(100==c)return!0;switch(a[0]){case "v":return!1;case "r":return c=a[2]%Math.floor(100/c),a[2]++,this.set(f,a.join(":")),!c}return!0}; Commercial members may receive reimbursement for up to eight over-the-counter COVID-19 at-home tests per covered individual in the household per 30-days without a healthcare provider order or clinical assessment. The list will be updated as new FDA-authorized tests become available. Everyone qualifies. To qualify: . Required documentation for this medical claim includes: The attestation included in our claims process ensures our members comply with the spirit of this policyto ensure tests are accessible and affordable for those who need them. If you do not have an itemized receipt, you must send us the barcode (UPC code) from your test (s) packaging. Waiving cost-sharing for COVID-19 testing and treatment. Medicare Advantage COVID-19 Testing Member Reimbursement Form The Blue Cross Blue Shield Association is an association of independent, locally operated Blue Cross and Blue Shield companies. 2Some pharmacies may not be able to process claims for OTC tests at the pharmacy counter. CareFirst continues to cover the cost of COVID-19 tests administered by a healthcare provider for diagnostic purposes. 0 Here's how to get reimbursed: Submit a claim form Complete a Health Benefits Claim Form and submit it by mail to your local BCBS company. Throughout the COVID-19 pandemic, Independence Blue Cross (Independence) has been committed to helping you get the care you need. endstream endobj 471 0 obj <>/Subtype/Form/Type/XObject>>stream Medicare Advantage members: You will need an order for an OTC at-home test from an authorized healthcare provider to get reimbursed at this time. For example, one box containing two tests counts as two tests. Not Registered? New User? 454 0 obj <> endobj See below.). Each test within a package is counted individually. To be reimbursed for a COVID home test kit purchased at any pharmacy or retailer (e.g. You will be reimbursed up to $12 per test by submitting a claim. For additional COVID-19 information, visit the Blue Cross Blue Shield Coronavirus Resource Center. P/* ldF76Y*\v|*-9?S % COVID-19 Coverage for Members Your health is always our priority. endstream endobj startxref All Rights Reserved. One option is Adobe Reader which has a built-in screen reader. Starting February 1, 2022, Medi-Cal members should obtain OTC at-home tests through pharmacies enrolled as Medi-Cal providers. If you paid for a COVID-19 test and think you might qualify for reimbursement, read the COVID-19 Testing Member Reimbursement Form (PDF) to find out more. OTC tests, also known as self-tests, detect if you are currently infected with COVID-19. In addition, some sites may require you to agree to their terms of use and privacy policy. More than 140 million Americans have received a dose of the COVID-19 vaccine. If any information is missing from the invoice, contact the provider. 0 To access your member services, please visit your BCBS company. They are typically easy to use and produce rapid results. If a test is sold in a package of two, that is considered two tests, and you'll be reimbursed $24. endstream endobj 460 0 obj <>/ProcSet[/PDF]>>>>stream You can submit any number of receipts on a single claim form. at-home COVID-19 Test Reimbursement Claim form found here. SECTION 2 - PATIENT INFORMATION Reason for the test cI was exposed to someone with COVID-19. BCBS recognizes doctors and hospitals for their expertise and exceptional quality in delivering care. %PDF-1.7 % Please enter the NDC or UPC number from the cash register receipt or test package. this.start=function(){var t=this;"complete"!==document.readyState?window.addEventListener?window.addEventListener("load",function(){t.go()},!1):window.attachEvent&&window.attachEvent("onload",function(){t.go()}):t.go()};}; If you paid out of pocket for a test that was sent to a laboratory, follow the steps below to file a reimbursement claim. endstream endobj 470 0 obj <>/Subtype/Form/Type/XObject>>stream (To submit a single form for multiple members and/or receipts, use a mail-in form instead. The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies. ro?gu?"t6Vr K?K@n}r`TyEycB". s&jPDed The protection of your privacy will be governed by the privacy policy of that site. OTC tests purchased at retail locations cost, on average, $12 for a single test and $24 for a double test kit. If you recently visited a doctor outside of your network and you need to submit a claim, you can use one of these claim forms. Visit the Medi-Cal website for more details. This page may have documents that cant be read by screen reader software. Substance Use Treatment & ResourcesLearn more about substance use disorders and find a treatment provider that meets your needs. Substance Use Treatment & ResourcesLearn more about substance use disorders and find a treatment provider that meets your needs. You can also find an in-network doctor by. (function(){var g=function(e,h,f,g){ Your health plan covers FDA-authorized COVID-19diagnostic testingat no cost until the end of the public health emergency on May 11, 2023. Find out if the testing provider is in your health plans network. If you made two separate purchases and each purchase covered three members, you would need to submit six separate claim forms. CareFirst of Maryland, Inc. CareFirst Community Partners, Inc. and The Dental Network, Inc. underwrite products in Maryland only. Li@ c;8tH$0Neh,````1A88Co&) W e#f`lF|kQN2qC,`j` ` ;v window.CE_READY = function () { CE2.listen(window, 'click', function(evt) { if (evt.target.id=== 'QSIFeedbackButton-btn' || (evt.target.matches && evt.target.matches('#QSIFeedbackButton-btn *')) ) { CE2.set(1, 'feedback'); } }); } A nurse case manager with Blue Cross & Blue Shield of Rhode Island found that listening, without judgment, to one patients concerns made all the difference. State and Federal Privacy laws prohibit unauthorized access to Member's private information. Increasing access to prescription medications. Provide an itemized receipt that clearly shows that your purchase was for a COVID-19 test. Blue Cross and Blue Shield Companies Cover COVID-19 Testing and Treatment, I listened: A nurse case manager on addressing vaccine hesitancy, Meeting the challenge - BCBS companies are supporting Americans during COVID-19, COVID-19 vaccines: six ways were part of the solution, Blue Cross and Blue Shield of Kansas City, Horizon Blue CrossBlue Shield of New Jersey, Blue Cross and Blue Shield of North Carolina, Blue Cross and Blue Shield of North Dakota. California Physicians Service DBA Blue Shield of California is an independent member of the Blue Shield Association. Pickup cannot happen via drive-thru and tests will not be shipped. Leading the way in health insurance since 1929. If you purchased an OTC at-home test at the direction of your health care provider, please use this form: If you purchased an OTC at-home test for any other reason, please use this form: Send a copy of all your receipt(s) with the form. (function(){var g=function(e,h,f,g){ CVS Caremark is part of the CVS Health family of companies. If you need more space to include additional members, receipts, or healthcare providers, you may use a separate sheet of paper. Please call OptumRx customer service toll-free at (855) 828-9834 (TTY:711) or see the COVID-19 test kit FAQ under "Which tests are covered" for the most up to date list of covered tests. According to the Centers for Disease Control (CDC) recommendations, if your over-the-counter test has a positive result, you should follow the latest CDC guidance for isolation, wear a well-fitted mask if you have contact with others and call your healthcare provider. The Blue Cross Blue Shield System is made up of 34 independent and locally operated companies. try{(new g(100,"r","QSI_S_ZN_eQKLROMaB9E1yfz","https://zneqklromab9e1yfz-carefirst.siteintercept.qualtrics.com/SIE/?Q_ZID=ZN_eQKLROMaB9E1yfz&utm_source=Qualtrics")).start()}catch(i){}})(); In this case, you should fill out three claim forms one for each member. Your Blue Cross and Blue Shield of Texas (BCBSTX) health plan gives you access to the care you need during the COVID-19 pandemic. The Blue Cross Blue Shield Association is an association of independent, locally operated Blue Cross and Blue Shield companies. For help with these documents, please call 1-800-975-6314. 1To download the BCBSTX app, text BCBSTXAPP to 33633 or search for BCBSTX in the Apple App Store or Google Play. (For example, you can buy 4 boxes that include 2 over-the-counter COVID-19 tests.). Please mail completed form with copy of purchase receipt(s) to: Blue Shield of California P.O. In addition, some sites may require you to agree to their terms of use and privacy policy. You will be reimbursed for over-the-counter COVID-19 diagnostic tests purchased on or after January 15, 2022. Once we process your claim, well mail the contract holder a reimbursement check. You can use these claim forms to ask us for reimbursement. qO;,lH By continuing to use this website, you consent to these cookies. With each claim form, you should include the same receipt. 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