Within California. If you are temporarily traveling within California, but are outside of your Personal Physician Service Area, if possible you should call Blue Shield Member Services at the number provided on the last page of this booklet for assistance in re- ceiving Urgent Services through a Blue Shield of California Plan Provider. You may also locate a Plan Provider by visit- ing our web site at xxxx://xxx.xxxxxxxxxxxx.xxx. However, you are not required to use a Blue Shield of California Plan Provider to receive Urgent Services; you may use any provid- er. Note: Authorization by Blue Shield is required for care that involves a surgical or other procedure or inpatient stay. Follow-up care is also covered through a Blue Shield of Cali- fornia Plan Provider and may also be received from any pro- vider. However, when outside your Personal Physician Ser- vice Area authorization by Blue Shield is required for more than two Out-of-Area Follow-up Care outpatient visits. Blue Shield may direct the patient to receive the additional follow- up services from the Personal Physician. If services are not received from a Blue Shield of California Plan Provider, you may be required to pay the provider for the entire cost of the service and submit a claim to Blue Shield. Claims for Urgent Services obtained outside of your Personal Physician Service Area within California will be reviewed retrospectively for coverage. When you receive covered Urgent Services outside your Per- xxxxx Physician within California, the amount you pay, if not subject to a flat dollar copayment, is calculated on Blue Shield’s Allowed Charges. INTER-PLAN PROGRAMS Blue Shield has a variety of relationships with other Blue Cross and/or Blue Shield Plans and their Licensed Controlled Affiliates (“Licensees”) referred to generally as “Inter-Plan Programs.” Whenever you obtain healthcare services outside of California, the claims for these services may be processed through one of these Inter-Plan Programs. When you access Covered Services outside of California you may obtain care from healthcare providers that have a con- tractual agreement (i.e., are “participating providers”) with the local Blue Cross and/or Blue Shield Licensee in that other geographic area (“Host Plan”). In some instances, you may obtain care from non-participating healthcare providers. Blue Shield’s payment practices in both instances are described in this booklet. BLUECARD PROGRAM Under the BlueCard Program, when you obtain Covered Ser- vices wit...
Within California. If you are temporarily traveling within California, but are outside of your Primary Care Physician Service Area, if possible you should call Shield Concierge at the number provided on the back page of this booklet for assistance in receiving Ur- gent Services through a Blue Shield of California provider. You may also locate a Blue Shield provider by visiting our web site at xxx.xxxxxxxxxxxx.xxx. However, you are not re- quired to use a Blue Shield of California provider to receive Urgent Services; you may use any Cali- fornia provider. Out-of-Area Follow-up Care is also covered ately use the “911” emergency response system (where available) or seek immediate care from the nearest Hospital. Members should go to the closest Plan Hospital for Emergency Services whenever possible. The Member should notify their Primary Care Physi- cian within 24 hours of receiving Emergency Ser- vices or as soon as reasonably possible following medical stabilization. through a Blue Shield of California provider or from any California provider. Authorization by Blue Shield is required for more than two Out-of- Area Follow-up Care outpatient visits. Blue Shield may direct the patient to receive the additional fol- low-up services from their Primary Care Physi- cian. If services are not received from a Blue Shield of California provider, you may be required to pay the provider for the entire cost of the service and submit a claim to Blue Shield. Claims for Urgent Services obtained outside of your Primary Care Physician Service Area within California will be reviewed retrospectively for coverage. When you receive covered Urgent Services out- side your Primary Care Physician Service Area
Within California. If you are temporarily traveling within California, but are outside of your Personal Physician Service Area, if possible you should call Shield Concierge at the number provided on the back page of this booklet for assistance in receiving Urgent Services through a Blue Shield of California Plan Provider. You may also locate a Plan Provider by visiting our web site at xxx.xxxxxxxxxxxx.xxx. However, you are not required to use a Blue Shield of California Plan Provider to receive Urgent Services; you may use any provider. Note: Authorization by Blue Shield is required for care that involves a surgical or other procedure or inpatient stay. Follow-up care is also covered through a Blue Shield of California Plan Provider and may also be received from any provider. However, when outside your Personal Physician Service Area authorization by Blue Shield is required for more than two Out-of-Area Follow-up Care outpatient visits. Blue Shield may direct the patient to receive the additional follow-up services from the Personal Physician. If services are not received from a Blue Shield of California Plan Provider, you may be required to pay the provider for the entire cost of the service and submit a claim to Blue Shield. Claims for Urgent Services obtained outside of your Personal Physician Service Area within California will be reviewed retrospectively for coverage. When you receive covered Urgent Services outside your Personal Physician Service Area within California, the amount you pay, if not subject to a flat dollar Copayment, is calculated based on Blue Shield’s Allowed Charges.
Within California. The licenses granted above may be extended to new Designated Facilities within California only with the prior written approval of UNOCAL. Notwithstanding the foregoing, prior written approval of UNOCAL is not required if, after such extension of a license, the total number of NATIONAL Facilities within California does not exceed the total number of NATIONAL Facilities in California as of the Closing Date, provided that such new Designated Facility is not located within one (1) mile of a UNOCAL Facility then in existence, measured along the Interstate Highway or any street, highway or road upon which such UNOCAL Facility is located. Any and all contracts extending NATIONAL's license to use the Marks and/or Service Marks to its Resellers, shall be in writing and in a form which has first been approved by UNOCAL in writing, which approval shall not be unreasonably withheld. UNOCAL shall have the right, at its expense, upon reasonable notice, to inspect and copy all fully signed extensions or contracts. No other right or license, express or implied, is granted under this Agreement by either party hereto for the use of any trademark, service xxxx or trade name.
