BlueCard Program definition

BlueCard Program means the program in which all Blue Cross and Blue Shield Plans participate. This program benefits Blue Cross and Blue Shield members who receive Covered Services outside the geographic area that Blue Cross and Blue Shield of South Carolina serves. The Blue Cross and Blue Shield Plan where you are is treated is the “Host Plan”.
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BlueCard Program means the national program established by BCBSA under which Enrollee Claims are processed by BCBS Plans when Enrollees receive health care services outside of the geographic area that BCBSM serves. BCBSA mandates the policies, procedures and disclosures of the BlueCard Program and amends them from time to time. Schedule B sets forth BCBSA's required disclosures for the BlueCard Program and is incorporated into this Contract. If BCBSA amends the disclosures, such amendments shall automatically become a part of this Contract upon BCBSM giving 60 days prior written notice to Group.
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BlueCard Program means the program governed by BCBSA that requires Blue Cross and/or Blue Shield Plans to use certain policies, procedures and/or technology to service Blue Cross and/or Blue Shield members located outside of a Blue Cross and/or Blue Shield Plan’s service area.
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Examples of BlueCard Program in a sentence

  • The Blue Cross Blue Shield Global Core is unlike the BlueCard Program available in the BlueCard service area in certain ways.

  • Negotiated (non–BlueCard Program) Arrangements With respect to one or more Host Blues, in certain instances, instead of using the BlueCard Program, we may process your claims for covered healthcare services through Negotiated Arrangements for National Accounts.

  • Value-Based Programs may be delivered either through the BlueCard Program or a Negotiated Arrangement.

  • When you receive covered health care services outside our service area and the claim is processed through the BlueCard Program, the amount you pay for covered health care services is calculated based on the lower of: • the billed covered charges for your covered services; or • the negotiated price that the Host Blue makes available to BCBSRI.

  • If BCBSNE has entered into a Negotiated Arrangement/Negotiated National Account Arrangement with a Host Blue to provide Value-Based Programs to THE GROUP’s Covered Persons, BCBSNE will follow the same procedures for Value-Based Programs administration and Care Coordination Fees as noted in the BlueCard Program section.

  • Note: BlueCard Program fees paid to HOST Blue Plans for claims incurred outside Nebraska are not included within the calculation of the provider savings discount nor are they part of the proposed Administrative Services fee.

  • An Administrative Expense Allowance (AEA) for each original claim processed through the BlueCard Program by the Host Blue, will be charged back to THE GROUP as an administrative expense, unless otherwise indicated in Attachment 1 and Section VI.A.1. An AEA Fee Report will be provided monthly with the Claims Analysis Report.

  • Blue Cross Blue Shield Global Core is unlike the BlueCard Program available in the BlueCard service area in certain ways.

  • BlueCard Program fees include per claim fees, percentage of savings fees, and/or Per Contract Per Month fees (if applicable).

  • The Blue Cross Blue Shield Global Core is unlike the BlueCard Program available in the United States, the Commonwealth of Puerto Rico and the U.S. Virgin Islands in certain ways.


More Definitions of BlueCard Program

BlueCard Program means the safety awareness program aligned to the Transport Industry National Competency Standard TDT F1 197B "Follow Occupational Health and Safety Procedures".
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BlueCard Program. The BlueCard® Program is an Inter-Plan Arrangement. Under this Arrangement, when members access covered healthcare services within the geographic area served by a Host Blue, the Host Blue will be responsible for contracting and handling all interactions with its participating healthcare providers. The financial terms of the BlueCard Program are described generally below.
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BlueCard Program a program in which all members of the BCBSA participate. Details of the BlueCard Program are more fully set forth in Article XII. Brand Name Drug: a Prescription Drug that is manufactured under a registered trade name or trademark. Care Coordination: organized, information-driven patient care activities intended to facilitate the appropriate responses to a Member's healthcare needs across the continuum of care. Care Coordinator: an individual within a Provider organization who facilitates Care Coordination for patients. Care Coordinator Fee: a fixed amount paid by a Blue Cross and/or Blue Shield Licensee to Providers periodically for Care Coordination under a VBP. Child: an Employee's child, whether a natural child, adopted child, xxxxxx child, stepchild or child for whom an Employee has custody or legal guardianship. The term “Child” also includes an Incapacitated Dependent, and a child of a divorced or divorcing Employee who, under a Qualified Medical Child Support Order, has a right to enroll under the Employer’s Group Health Plan. The term “Child” does not include the Spouse of an eligible child.
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BlueCard Program means an agreement among participating Blue Cross and Blue Shield Association affiliated plans pursuant to which enrollees of one such plan may access the provider network and financial terms of other such plans when they are away from the service area of their home plan.
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BlueCard Program means the national program established by BCBSA under which Member HRA Claims are processed by BCBS Plans when Members receive health care services outside of the geographic area that BCN serves. BCBSA mandates the policies, procedures and disclosures of the BlueCard Program and amends them from time to time. Exhibit B sets forth BCBSA’s required disclosures for the Blue Card Program and is incorporated into this Contract. If BCBSA amends the disclosures, such amendments shall automatically become a part of this Contract upon BCN giving 60 days prior written notice to Group.
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BlueCard Program means a national provider program offered by the Service Organization and other participating Blue Cross and/or Blue Shield Plans across the country.
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Related to BlueCard Program

  • Educational program means a program for educating and preparing physician assistants which is approved by the board.

  • Program means the statutorily authorized activities of the System Agency under which this Contract has been awarded.

  • Electronic Programme Guide or “EPG” means a program guide maintained by the IPTV Operator that lists television channels and programmes, and scheduling and programming information therein and includes any enhanced guide that allows subscribers to navigate and select such available channels and programmes.

  • WOSB Program Repository means a secure, Web-based application that collects, stores, and disseminates documents to the contracting community and SBA, which verify the eligibility of a business concern for a contract to be awarded under the WOSB Program.

  • Cardholder Agreement means the agreement between Bank and a Cardholder governing the terms and use of a Card.

  • Retailer means every person engaged in the business of making sales at retail, or for distribution,

  • Master distributor means a wholesaler who acts in the same or similar capacity as a brewer or outstate seller of beer for a brand or brands of beer to other wholesalers on a regular basis in the normal course of business.

  • Training program means an NCA-approved Iowa college, the Iowa law enforcement academy or an Iowa hospital approved by the department to conduct emergency medical care training.

  • Alliance means the Public Service Alliance of Canada;

  • Program services means services that include all of the following provided they are pursuant to a program agreement: program needs assessment and development, job task analysis, curriculum development and revision, instruction, instructional materials and supplies, computer software and upgrades, instructional support, administrative and student services, related school to career training programs, skill or career interest assessment services and testing and contracted services.

  • Participating Hospice Care Program Provider means a Hospice Care Program Provider that either: (i) has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield to provide services to participants in this benefits program, or; (ii) a Hospice Care Program Provider which has been designated by a Blue Cross and/or Blue Shield Plan as a Participating Provider Option program.

  • Reseller Agreement means the separate agreement between Customer and Reseller regarding the Services. The Reseller Agreement is independent of and outside the scope of This Agreement.

  • Database Management System (DBMS) A system of manual procedures and computer programs used to create, store and update the data required to provide Selective Routing and/or Automatic Location Identification for 911 systems. Day: A calendar day unless otherwise specified. Dedicated Transport: UNE transmission path between one of CenturyLink’s Wire Centers or switches and another of CenturyLink’s Wire Centers or switches within the same LATA and State that are dedicated to a particular customer or carrier. Default: A Party’s violation of any material term or condition of the Agreement, or refusal or failure in any material respect to properly perform its obligations under this Agreement, including the failure to make any undisputed payment when due. A Party shall also be deemed in Default upon such Party’s insolvency or the initiation of bankruptcy or receivership proceedings by or against the Party or the failure to obtain or maintain any certification(s) or authorization(s) from the Commission which are necessary or appropriate for a Party to exchange traffic or order any service, facility or arrangement under this Agreement, or notice from the Party that it has ceased doing business in this State or receipt of publicly available information that signifies the Party is no longer doing business in this State.

  • Non-Administrator Coordinated Home Care Program means a Coordinated Home Care Program which does not have an agreement with the Claim Administrator or a Blue Cross Plan but has been certified as a home health agency in accordance with the guidelines established by Medicare.

  • Procurement Plan means the Recipient’s procurement plan for the Project, dated April 2, 2010, and referred to in paragraph 1.16 of the Procurement Guidelines and paragraph 1.24 of the Consultant Guidelines, as the same shall be updated from time to time in accordance with the provisions of said paragraphs.

  • Network plan means a policy of group health insurance offered by an insurer under which the financing and delivery of medical care, including items and services paid for as medical care, are provided, in whole or in part, through a defined set of providers under contract with the insurer. The term does not include an arrangement for the financing of premiums.

  • Custom program means a computer program which is specifically designed and developed only for