Host Blue definition

Host Blue means the local Blue Cross and/or Blue Shield plan or licensee in a geographic area outside of the Wellmark service area.

Host Blue means the independent Blue Cross and/or Blue Shield Licensees (Plans and certain Plan affiliates) that participate in Inter-Plan Programs and provide PROVIDER network access and claim pricing for other independent Blue Cross and/or Blue Shield Licensees (Plans and certain Plan affiliates), including BCBSNC, when Members receive medical services in that Host Blue's service area.

Host Blue means a local Blue Cross and/or Blue Shield licensee outside the geographic area that Claim Administrator serves.

Examples of Host Blue in a sentence

• Often, this “negotiated price” will be a simple discount that reflects an actual price that the Host Blue pays to your healthcare provider.

• However, the Host Blue is responsible for contracting with and generally handling all interactions with its participating providers.

• For instance, although the Blue Cross Blue Shield Global Core assists you with accessing a network of inpatient, outpatient and professional providers, the network is not served by a Host Blue.

• Some providers (“nonparticipating providers”) don’t contract with the Host Blue.

• If you receive covered healthcare services under a Value-Based Program inside a Host Blue’s service area, you will not be responsible for paying any of the Provider Incentives, risk-sharing, and/or Care Coordinator Fees that are a part of such an arrangement, except when a Host Blue passes these fees to us through average pricing or fee schedule adjustments.

• The amount you pay for covered healthcare services under this arrangement will be calculated based on the negotiated price (refer to the description of negotiated price in the BlueCard® Program section above) made available to us by the Host Blue.

• In some cases, the Host Blue will engage a third party to assist in identification or collection of recovery amounts.

• Under the BlueCard® Program, when you receive covered healthcare services within the geographic area served by a Host Blue, we will remain responsible for doing what we agreed to in the contract.

• Under the BlueCard® Program, when you access covered healthcare services within the geographic area served by a Host Blue, we will remain responsible for fulfilling our contractual obligations.

• Under the BlueCard® Program, when You receive Covered Services within the geographic area served by a Host Blue, the Claims Administrator will still fulfill its contractual obligations.

More Definitions of Host Blue

Host Blue means a local Blue Cross and Blue Shield licensee outside the geographic area that Claim Administrator serves.

Host Blue means the independent Blue Cross and/or Blue Shield Licensees (Plans and certain Plan affiliates) that participate in Inter-Plan Programs and provide Provider network access and claim pricing for other independent Blue Cross and/or Blue Shield Licensees (Plans and certain Plan affiliates), including BCBSNC, when Members receive medical services in that Host Blue’s service area.