Common use of Second Medical Opinion Policy Clause in Contracts

Second Medical Opinion Policy. If you have a question about your diagnosis, or believe that additional information concerning your condition would be helpful in determining the most appropriate plan of treatment, you may make an appointment with another physician for a second medical opinion. Your attending physician may also offer to refer you to another physician for a second opinion. Remember that the second opinion visit is subject to all Plan contract benefit limitations and exclusions. Additionally, please see the section entitled "Your Blue Shield of Califor- nia Shield Spectrum PPO Plan and How to Use It" regarding advantages from selecting a Preferred Physician for these services. Utilization Review State law requires that health plans disclose to Members and health plan providers the process used to authorize or deny health care services under the plan. Blue Shield of California has completed documentation of this as required under Sec- tion 1363.5 of the California Health and Safety Code. The document describing Blue Shield’s Utilization Management Program is available online at xxx.xxxxxxxxxxxx.xxx or Member’s may call the Customer Service Department at the telephone number provided on the back page of this Evidence of Coverage to request a copy. Health Education and Health Promotion Health education and health promotion services provided by Blue Shield of California include the Blue Shield of Califor- nia Member Newsletter. Additionally, Blue Shield of Cali- fornia's Internet site is located at xxxx://xxx.xxxxxxxxxxxx.xxx. Subscribers using a personal computer and modem with World Wide Web access may view and download healthcare information. Retail-Based Health Clinics Retail-based health clinics are Outpatient facilities, usually attached or adjacent to retail stores, pharmacies, etc…, which provide limited, basic medical treatment for minor health issues. They are staffed by nurse practitioners under the di- rection of a Physician and offer services on a walk-in basis. Covered Services received from retail-based health clinics will be paid on the same basis and at the same Benefit levels as other covered Services shown in the Summary of Benefits. Retail-based health clinics may be found in the Preferred Provider Directory or the Online Physician Directory located at xxxx://xxx.xxxxxxxxxxxx.xxx. See the Blue Shield of Cali- fornia Preferred Providers section for information on the ad- vantages of choosing a Preferred Provider. NurseHelp 24/7 If you are unsure about what care you need, you should con- tact your physician’s office. In addition, your Plan includes a service, NurseHelp 24/7, which provides licensed health care professionals available to assist you by phone 24 hours a day, seven days a week. You can call NurseHelp 24/7 for imme- diate answers to your health questions. Registered nurses are available 24 hours a day to answer any of your health ques- tions, including concerns about:

Second Medical Opinion Policy. If you have a question about your diagnosis, or believe that additional information concerning your condition would be helpful in determining the most appropriate plan of treatment, you may make an appointment with another physician for a second medical opinion. Your attending physician may also offer to refer you to another physician for a second opinion. Remember that the second opinion visit is subject to all Plan contract benefit limitations and exclusions. Additionally, please see the section entitled "Your Blue Shield of Califor- nia Shield Spectrum PPO Plan and How to Use It" regarding advantages from selecting a Preferred Physician for these services. Utilization Review State law requires that health plans disclose to Members and health plan providers the process used to authorize or deny health care services under the plan. Blue Shield of California has completed documentation of this as required under Sec- tion 1363.5 of the California Health and Safety Code. The document describing Blue Shield’s Utilization Management Program is available online at xxx.xxxxxxxxxxxx.xxx or Member’s Members may call the Customer Service Department at the telephone number provided on the back page of this Evidence of Coverage to request a copy. Health Education and Health Promotion Health education and health promotion services provided by Blue Shield of California include the Blue Shield of Califor- nia Member Newsletter. Additionally, Blue Shield of Cali- fornia's Internet site is located at xxxx://xxx.xxxxxxxxxxxx.xxx. Subscribers using a personal computer and modem with World Wide Web access may view and download healthcare information. Retail-Based Health Clinics Retail-based health clinics are Outpatient facilities, usually attached or adjacent to retail stores, pharmacies, etc…, which provide limited, basic medical treatment for minor health issues. They are staffed by nurse practitioners under the di- rection of a Physician and offer services on a walk-in basis. Covered Services received from retail-based health clinics will be paid on the same basis and at the same Benefit levels as other covered Services shown in the Summary of Benefits. Retail-based health clinics may be found in the Preferred Provider Directory or the Online Physician Directory located at xxxx://xxx.xxxxxxxxxxxx.xxx. See the Blue Shield of Cali- fornia Preferred Providers section for information on the ad- vantages of choosing a Preferred Provider. NurseHelp 24/7 If you are unsure about what care you need, you should con- tact your physician’s office. In addition, your Plan includes a service, NurseHelp 24/7, which provides licensed health care professionals available to assist you by phone 24 hours a day, seven days a week. You can call NurseHelp 24/7 for imme- diate answers to your health questions. Registered nurses are available 24 hours a day to answer any of your health ques- tions, including concerns about:

Second Medical Opinion Policy. If you have a question about your diagnosis, or believe that additional information concerning your condition would be helpful in determining the most appropriate plan of treatmenttreat- ment, you may make an appointment with another physician for a second medical opinion. Your attending physician may also offer to refer you to another physician for a second opinionopin- ion. Remember that the second opinion visit is subject to all Plan contract benefit limitations and exclusions. Additionally, please see the section entitled "Your Blue Shield of Califor- nia Shield Spectrum PPO Plan 5500 and How to Use It" regarding advantages from selecting a Preferred Physician for these services. Utilization Review State law requires that health plans disclose to Members and health plan providers the process used to authorize or deny health care services under the plan. Blue Shield of California has completed documentation of this as required under Sec- tion 1363.5 of the California Health and Safety Code. The document describing Blue Shield’s Utilization Management Program is available online at xxx.xxxxxxxxxxxx.xxx or Member’s Members may call the Customer Service Department at the telephone number provided on the back page of this Evidence Evi- dence of Coverage to request a copy. Health Education and Health Promotion Health education and health promotion services provided by Blue Shield of California include the Blue Shield of Califor- nia Member Newsletter. Additionally, Blue Shield of Cali- fornia's Internet site is located at xxxx://xxx.xxxxxxxxxxxx.xxx. Subscribers using a personal computer and modem with World Wide Web access may view and download healthcare information. Retail-Based Health Clinics Retail-based health clinics are Outpatient facilities, usually attached or adjacent to retail stores, pharmacies, etc…, which provide limited, basic medical treatment for minor health issues. They are staffed by nurse practitioners under the di- rection of a Physician and offer services on a walk-in basis. Covered Services received from retail-based health clinics will be paid on the same basis and at the same Benefit levels as other covered Services shown in the Summary of Benefits. Retail-based health clinics may be found in the Preferred Provider Directory or the Online Physician Directory located at xxxx://xxx.xxxxxxxxxxxx.xxx. See the Blue Shield of Cali- fornia Preferred Providers section for information on the ad- vantages of choosing a Preferred Provider. Health Education and Health Promotion Health education and health promotion services provided by Blue Shield of California include the Blue Shield of Califor- nia Member Newsletter. Additionally, Blue Shield of Cali- fornia's Internet site is located at xxxx://xxx.xxxxxxxxxxxx.xxx. Subscribers using a personal computer and modem with World Wide Web access may view and download healthcare information. NurseHelp 24/7 If you are unsure about what care you need, you should con- tact your physician’s office. In addition, your Plan includes a service, NurseHelp 24/7, which provides licensed health care professionals available to assist you by phone 24 hours a day, seven days a week. You can call NurseHelp 24/7 for imme- diate answers to your health questions. Registered nurses are available 24 hours a day to answer any of your health ques- tions, including concerns about:

Second Medical Opinion Policy. If you have a question about your diagnosis, or believe that additional information concerning your condition would be helpful in determining the most appropriate plan of treatmenttreat- ment, you may make an appointment with another physician for a second medical opinion. Your attending physician may also offer to refer you to another physician for a second opinion. Remember that the second opinion visit is subject to all Plan contract benefit limitations and exclusions. Additionally, please see the section entitled "Your Blue “The Shield of Califor- nia Shield Spectrum PPO Plan Savings – G and How to Use It" regarding advantages from selecting a Preferred Pre- ferred Physician for these services. Utilization Review State law requires that health plans disclose to Members and health plan providers the process used to authorize or deny health care services under the plan. Blue Shield of California Califor- nia has completed documentation of this as required under Sec- tion Section 1363.5 of the California Health and Safety Code. The document describing Blue Shield’s Utilization Management Man- agement Program is available online at xxx.xxxxxxxxxxxx.xxx or Member’s may call the Customer Service Department at the telephone number provided on the back page of this the Evidence of Coverage to request a copy. Health Education and Health Promotion Health education and health promotion services provided by Blue Shield of California include the Blue Shield of Califor- nia Cali- fornia Member Newsletter. Additionally, Blue Shield of Cali- forniaCalifornia's Internet site is located at xxxx://xxx.xxxxxxxxxxxx.xxx. Subscribers using a personal computer and modem with World Wide Web access may view and download healthcare information. Retail-Based Health Clinics Retail-based health clinics are Outpatient facilities, usually attached or adjacent to retail stores, pharmacies, etc…, which provide limited, basic medical treatment for minor health issues. They are staffed by nurse practitioners under the di- rection direction of a Physician and offer services on a walk-in basis. Covered Services received from retail-based health clinics will be paid on the same basis and at the same Benefit Bene- fit levels as other covered Services shown in the Summary of Benefits. Retail-based health clinics may be found in the Preferred Provider Directory or the Online Physician Directory Direc- tory located at xxxx://xxx.xxxxxxxxxxxx.xxx. See the Blue Shield of Cali- fornia California Preferred Providers section for information infor- mation on the ad- vantages advantages of choosing a Preferred Provider. NurseHelp 24/7 If you are unsure about what care you need, you should con- tact your physician’s office. In addition, your Plan includes a service, NurseHelp 24/7, which provides licensed health care professionals available to assist you by phone 24 hours a day, seven days a week. You can call NurseHelp 24/7 for imme- diate immediate answers to your health questions. Registered nurses are available 24 hours a day to answer any of your health ques- tionsquestions, including concerns about:

Second Medical Opinion Policy. If you have a question about your diagnosis, or believe that additional information concerning your condition would be helpful in determining the most appropriate plan of treatment, you may make an appointment with another physician for a second medical opinion. Your attending physician may also offer to refer you to another physician for a second opinion. Remember that the second opinion visit is subject to all Plan contract benefit limitations and exclusions. Additionally, please see the section entitled "Your Blue Shield of Califor- nia Shield Spectrum PPO Plan and How to Use It" regarding advantages from selecting a Preferred Physician for these services. Utilization Review State law requires that health plans disclose to Members and health plan providers the process used to authorize or deny health care services under the plan. Blue Shield of California has completed documentation of this as required under Sec- tion 1363.5 of the California Health and Safety Code. The document describing Blue Shield’s Utilization Management Program is available online at xxx.xxxxxxxxxxxx.xxx or Member’s may call the Customer Service Department at the telephone number provided on the back page of this Evidence of Coverage to request a copy. Health Education and Health Promotion Health education and health promotion services provided by Blue Shield of California include the Blue Shield of Califor- nia Member Newsletter. Additionally, Blue Shield of Cali- fornia's Internet site is located at xxxx://xxx.xxxxxxxxxxxx.xxx. Subscribers using a personal computer and modem with World Wide Web access may view and download healthcare information. Retail-Based Health Clinics Retail-based health clinics are Outpatient facilities, usually attached or adjacent to retail stores, pharmacies, etc…, which provide limited, basic medical treatment for minor health issues. They are staffed by nurse practitioners under the di- rection of a Physician and offer services on a walk-in basis. Covered Services received from retail-based health clinics will be paid on the same basis and at the same Benefit levels as other covered Services shown in the Summary of Benefits. Retail-based health clinics may be found in the Preferred Provider Directory or the Online Physician Directory located at xxxx://xxx.xxxxxxxxxxxx.xxx. See the Blue Shield of Cali- fornia Preferred Providers section for information on the ad- vantages of choosing a Preferred Provider. Health Education and Health Promotion Health education and health promotion services provided by Blue Shield of California include the Blue Shield of Califor- nia Member Newsletter. Additionally, Blue Shield of Cali- fornia's Internet site is located at xxxx://xxx.xxxxxxxxxxxx.xxx. Subscribers using a personal computer and modem with World Wide Web access may view and download healthcare information. NurseHelp 24/7 If you are unsure about what care you need, you should con- tact your physician’s office. In addition, your Plan includes a service, NurseHelp 24/7, which provides licensed health care professionals available to assist you by phone 24 hours a day, seven days a week. You can call NurseHelp 24/7 for imme- diate answers to your health questions. Registered nurses are available 24 hours a day to answer any of your health ques- tions, including concerns about:

Second Medical Opinion Policy. If you have a question about your diagnosis, or believe that additional information concerning your condition would be helpful in determining the most appropriate plan of treatmenttreat- ment, you may make an appointment with another physician for a second medical opinion. Your attending physician may also offer to refer you to another physician for a second opinionopin- ion. Remember that the second opinion visit is subject to all Plan contract benefit limitations and exclusions. Additionally, please see the section entitled "Your Blue Shield of Califor- nia Shield Spectrum PPO Plan 5500 and How to Use It" regarding advantages from selecting a Preferred Physician for these services. Utilization Review State law requires that health plans disclose to Members and health plan providers the process used to authorize or deny health care services under the plan. Blue Shield of California has completed documentation of this as required under Sec- tion 1363.5 of the California Health and Safety Code. The document describing Blue Shield’s Utilization Management Program is available online at xxx.xxxxxxxxxxxx.xxx or Member’s may call the Customer Service Department at the telephone number provided on the back page of this the Evidence of Coverage to request a copy. Health Education and Health Promotion Health education and health promotion services provided by Blue Shield of California include the Blue Shield of Califor- nia Member Newsletter. Additionally, Blue Shield of Cali- fornia's Internet site is located at xxxx://xxx.xxxxxxxxxxxx.xxx. Subscribers using a personal computer and modem with World Wide Web access may view and download healthcare information. Retail-Based Health Clinics Retail-based health clinics are Outpatient facilities, usually attached or adjacent to retail stores, pharmacies, etc…, which provide limited, basic medical treatment for minor health issues. They are staffed by nurse practitioners under the di- rection of a Physician and offer services on a walk-in basis. Covered Services received from retail-based health clinics will be paid on the same basis and at the same Benefit levels as other covered Services shown in the Summary of Benefits. Retail-based health clinics may be found in the Preferred Provider Directory or the Online Physician Directory located at xxxx://xxx.xxxxxxxxxxxx.xxx. See the Blue Shield of Cali- fornia Preferred Providers section for information on the ad- vantages of choosing a Preferred Provider. Health Education and Health Promotion Health education and health promotion services provided by Blue Shield of California include the Blue Shield of Califor- nia Member Newsletter. Additionally, Blue Shield of Cali- fornia's Internet site is located at xxxx://xxx.xxxxxxxxxxxx.xxx. Subscribers using a personal computer and modem with World Wide Web access may view and download healthcare information. NurseHelp 24/7 If you are unsure about what care you need, you should con- tact your physician’s office. In addition, your Plan includes a service, NurseHelp 24/7, which provides licensed health care professionals available to assist you by phone 24 hours a day, seven days a week. You can call NurseHelp 24/7 for imme- diate answers to your health questions. Registered nurses are available 24 hours a day to answer any of your health ques- tions, including concerns about: