Inpatient Hospital Claims. Claims for Inpatient Hospital services arranged through the BlueCard Worldwide Service Center require Members to pay only the usual Cost-Sharing Amounts. The Hospital files the claim for the Member. Members who receive Inpatient Hospital care from a Non-Participating Hospital or services that were not coordinated through the BlueCard Worldwide Service Center may have to pay the Hospital and submit the claim to the BlueCard Worldwide Service Center at X.X. Xxx 000000, Xxxxx, XX 00000. For all outpatient and professional medical care, the Member pays the Provider and then submits the claim to the BlueCard Worldwide Service Center at X.X. Xxx 000000, Xxxxx, XX 00000. The claim should be submitted showing the currency used to pay for the services. There is a specific claim form that must be used to submit international claims. Itemized bills must be submitted with the claim form. The international claim form can be accessed at xxxxxxxxxxxx.xxx. All claims must be submitted within twelve (12) months from the date of service with the exception of claims from certain State and Federal agencies.
Appears in 4 contracts
Samples: Individual Hmo Subscriber Agreement, Hmo Subscriber Agreement, Hmo Subscriber Agreement
