27 de agosto de 2020
Starting Sept. 1, 2020, the Availity Eligibility and Benefits Inquiry results will include informational Blue Distinction® Center (BDC) messaging for the below specialty care categories when the patient’s policy has a Blue Distinction component. The Availity benefit response will include applicable coverage for the service selected. However, if you need to confirm the specific BDC benefit differential, you will need to call the Customer Service phone number found on the back of the member’s Blue Cross and Blue Shield of New Mexico (BCBSNM) identification card.
BDCs offer quality care, treatment expertise and better overall patient results. A Blue Distinction® Center+ (BDC+) offers more affordable care in addition to quality, care, cost, treatment expertise, and better overall patient results.
La atención especializada de Blue Distinction incluye las siguientes categorías:
- Bariatric (weight-loss) surgery
- Atención cardiovascular
- Reemplazo de rodilla y cadera
- Atención durante la maternidad
- Cirugía de la columna vertebral
- Trasplantes
Para Más Información
Find facilities recognized for expertise in bariatric surgery, cardiac care, knee and hip replacement, maternity, spine surgery and transplants on the Blue Distinction® Specialty Care page.
Refer to the Availity Eligibility and Benefits user guide for navigational assistance. If you need further assistance or customized training, contact our Provider Education Consultants.
This information in this notice is not applicable to Medicare Advantage members.
A Local Blue Plan may require additional criteria for providers located in its own service area; for details, contact your Local Blue Plan. Blue Distinction® National criteria for BDC and BDC+ are displayed on www.bcbs.com. Los resultados individuales pueden variar. Neither Blue Cross and Blue Shield Association nor any Blue Plans are responsible for non-covered charges or other losses or damages resulting from Blue Distinction or other provider finder information or care received from Blue Distinction® or other providers.
Trademarks are the property of their respective owners.
Availity es una marca registrada de Availity, LLC, una compañía aparte que opera una red de información de salud para prestar servicios de intercambio de información electrónica a profesionales médicos. Availity presta servicios administrativos a BCBSNM. BCBSNM makes no endorsement, representations or warranties regarding any products or services provided by third party vendors such as Availity. Si tiene alguna pregunta acerca de los productos o servicios ofrecidos por estos proveedores, debe comunicarse con el proveedor directamente.
The information in this article is being provided for educational purposes only and is not the provision of medical care or advice. Physicians and other health care providers are to their own best medical judgment based upon all available information and the condition of the patient in determining the best course of treatment. La descripción de un servicio o tratamiento en este material no garantiza que el servicio o tratamiento sea un beneficio con cobertura, y los asegurados deben consultar su certificado de cobertura para obtener más detalles sobre los beneficios, las limitaciones y las exclusiones. Independientemente de los beneficios, la decisión final sobre cualquier servicio o tratamiento la toman el asegurado y su médico.