Verification of Benefits. Verification of Benefits is available for Members or authorized healthcare Providers on behalf of Members. You may call Customer Service with a medical benefits inquiry or Verification of Benefits during normal business hours (8:00 a.m. to 5:00 p.m. eastern time). Please remember that a benefits inquiry or Verification of Benefits is NOT a verification of coverage of a specific medical procedure. • Verification of Benefits is NOT a guarantee of payment. • If the verified service requires Prior Authorization, please call 0-000-000-0000. Prior Authorization – In-Network (also known as Pre-Certification) For Prior Authorization call 0-000-000-0000. • Required by your Physician or facility for ALL in-patient hospital admissions that are In- Network. • Please notify us by the next business day of an emergency or maternity admission; • Non-Urgent Care pre- certifications can be requested during normal business hours (8:30 a.m. – 5:00 p.m. eastern time). • Emergency services do NOT require Prior Authorization. Prior Authorization – Out-of-Network (also known as Pre-Certification) For Prior Authorization call 0-000-000-0000. • Required by YOU for ALL in-patient hospital admissions that are Outdo--Network. • YOU are responsible for notifying us within 1-business day of an emergency or maternity admission, or your claim may be denied. • Non-Urgent Care Prior Authorizations can be requested during normal business hours (8:30 a.m. – 5:00 p.m. eastern time). • Emergency services do NOT require Prior Authorization. Prior Authorization is a guarantee of payment f o r C o v e r e d S e r v i c e s ; as described in this section (and Alliant will pay up to the reimbursement level of this Contract when the Covered Services are performed within the time limits assigned through Coverage Certification) except for the following situations: • The Member is no longer covered under this Contract at the time the services are received; • The benefits under this Contract have been exhausted (examples of this include day limits); • In cases of fraud or misrepresentation. Prior Authorization approvals apply only to services which have been specified in the Prior Authorization and/or prior authorization list available on our website under provider resources. A Prior Authorization approval does not apply to any other services; other than the specific service being pre-certified. Payment or authorization of such a service does not require or apply to payment of claims at a later date rega...
Verification of Benefits. PROVIDER understands and acknowledges that any verification of benefits which PROVIDER may receive pursuant to access of myBlue, does not represent a guarantee of payment of such benefits by BCBSMS. Benefits are subject to the terms and conditions of the Benefit Plan.
Verification of Benefits. PHARMACY understands and acknowledges that any verification of benefits which PHARMACY may receive pursuant to access of myBlue, does not represent a guarantee of payment of such benefits by BCBSMS. Benefits are subject to the terms and conditions of the Benefit Plan.
Verification of Benefits. When We provide information about which health care services are covered under Your Plan that information is referred to as verification of benefits. When You or Your Provider call Our Customer Service Department at 000-000-0000 during regular business hours to request verification of benefits, a Health Plan representative will be immediately available to provide assistance. If the health care services are verified as a covered benefit, the Customer Service representative will advise whether Prior Authorization is required. Please be aware that verification of benefits is not a guarantee of payment for services. SECTION 2
Verification of Benefits. Verification of Eligibility (“VOB”) is undertaken only for appointments scheduled at less than 72 hours in advance of the Date of Service by Customer.
