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PAY BILLS ONLINE
Payment Processing Center. PO Box 644366. Pittsburgh, PA 15264-4366. Our records indicate you are a Child Health Plus Member. To make a payment, please visit https://www.mybcbswny.com or call (844)885-1004. This online payment form is for individual members only. To make a payment for your employer group, please use eBilling.THE GOOD LIFE
The Good Life is a comprehensive program that works in conjunction with your health plan. By completing the steps of the program including the biometric screening, online health assessment, and if required, speaking with one of our certified health coaches - you can learn about areas of your health that can improve with our support. PROVIDER POLICIES & GUIDELINES We also understand how that complexity can impact patient care, as well as your bottom line. That's why we're offering all of our policies and guidelines in one, easy-to-access section. Here you'll find all you need to know about our products, services, claims and reimbursement process, drug therapy guidelines, and patient safetyresources.
OVER THE COUNTER (OTC) BENEFIT Over-the-Counter Benefit. As a BlueCross BlueShield Medicare Advantage member, you have an over-the-counter (OTC) benefit of one $25 purchase every quarter* to get the products you need conveniently delivered right to your door. Using your OTC benefit you can shop for a wide range of items including vitamins, allergy care, and first aidproducts.
WELLNESS DEBIT CARD
The following outlets do not participate in our wellness debit card program: Pharmacies, sporting goods stores, grocery stores, doctor's offices, optometrists, salons, and department stores. At BlueCross BlueShield of Western New York, we do our best to ensure members have the best wellness options available to get and stay healthy.DESTINATION 65
Introducing our newest individual plans – Destination 65. Designed for our early retiree members who need coverage while waiting to age into Medicare. These plans are carefully constructed to mirror our most popular Medicare Advantage plans, ultimately making the transition to Medicare that much easier. 7521 CHIRO GUIDE FEBRUARY 2021 UPDATED 22521 MASTER 7521_Chiro Guide _February 2021 Updated_22521 Master Chiropractic, acupuncture and massage therapy programs overview The goals of the chiropractic, acupuncture and massage therapy programs are to ensureour members receive
CAVE ANALYTICS
Cave Consulting Group is an independent and nationally recognized healthcare analytic software company focused on improving effectiveness (quality-of-care) and efficiency (cost-of-care). Used nationally, their practice-level reports offer insights to specialists about their quality and cost by comparing their performance with peersin the same
CARDIAC REHABILITATION IN THE OUTPATIENT SETTING Protocol Cardiac Rehabilitation in the Outpatient Setting Last Review Date: 05/20 Page 3 of 6. Intensive cardiac rehabilitation with the Ornish Program for Reversing Heart Disease or Pritikin Program is con- BLUECROSS BLUESHIELD OF WESTERN NEW YORK Coronavirus, Stay Up To Date. As individuals in the United States are being diagnosed with COVID-19 (Coronavirus), we recognize BlueCross BlueShield of Western New York members may have concerns. While the situation is fluid and information is being updated daily, one thing that will remain constant is our commitment to connecting our membersPAY BILLS ONLINE
Payment Processing Center. PO Box 644366. Pittsburgh, PA 15264-4366. Our records indicate you are a Child Health Plus Member. To make a payment, please visit https://www.mybcbswny.com or call (844)885-1004. This online payment form is for individual members only. To make a payment for your employer group, please use eBilling.THE GOOD LIFE
The Good Life is a comprehensive program that works in conjunction with your health plan. By completing the steps of the program including the biometric screening, online health assessment, and if required, speaking with one of our certified health coaches - you can learn about areas of your health that can improve with our support. PROVIDER POLICIES & GUIDELINES We also understand how that complexity can impact patient care, as well as your bottom line. That's why we're offering all of our policies and guidelines in one, easy-to-access section. Here you'll find all you need to know about our products, services, claims and reimbursement process, drug therapy guidelines, and patient safetyresources.
OVER THE COUNTER (OTC) BENEFIT Over-the-Counter Benefit. As a BlueCross BlueShield Medicare Advantage member, you have an over-the-counter (OTC) benefit of one $25 purchase every quarter* to get the products you need conveniently delivered right to your door. Using your OTC benefit you can shop for a wide range of items including vitamins, allergy care, and first aidproducts.
WELLNESS DEBIT CARD
The following outlets do not participate in our wellness debit card program: Pharmacies, sporting goods stores, grocery stores, doctor's offices, optometrists, salons, and department stores. At BlueCross BlueShield of Western New York, we do our best to ensure members have the best wellness options available to get and stay healthy.DESTINATION 65
Introducing our newest individual plans – Destination 65. Designed for our early retiree members who need coverage while waiting to age into Medicare. These plans are carefully constructed to mirror our most popular Medicare Advantage plans, ultimately making the transition to Medicare that much easier. 7521 CHIRO GUIDE FEBRUARY 2021 UPDATED 22521 MASTER 7521_Chiro Guide _February 2021 Updated_22521 Master Chiropractic, acupuncture and massage therapy programs overview The goals of the chiropractic, acupuncture and massage therapy programs are to ensureour members receive
CAVE ANALYTICS
Cave Consulting Group is an independent and nationally recognized healthcare analytic software company focused on improving effectiveness (quality-of-care) and efficiency (cost-of-care). Used nationally, their practice-level reports offer insights to specialists about their quality and cost by comparing their performance with peersin the same
CARDIAC REHABILITATION IN THE OUTPATIENT SETTING Protocol Cardiac Rehabilitation in the Outpatient Setting Last Review Date: 05/20 Page 3 of 6. Intensive cardiac rehabilitation with the Ornish Program for Reversing Heart Disease or Pritikin Program is con-VISION PLANS
Blue Discount Vision Program. Adults in Standard plans, including Healthy NY; Essential Plans 1&2. Call Davis Vision for questions regarding plan details, 1 (800) 999-5431. View Benefit Summary.EVENTS NEAR YOU
View the complete list of activities! Chandler St. After Market. Come join us every Saturday, May 8 - November 20 from 3 – 8 p.m. at the Chandler St. After Market. A weekly event featuring a wide variety of local food producers and growers. Meet the suppliers, purchase locally made food items and support the Western New York community!PLATINUM PLANS
Platinum Plus. $794.99. $649.19. $622.80. N/A. $589.81. ** All plans include Affordable Care Act (ACA) preventive drug coverage. †For plans with a deductible, insulin is subject to cost-sharing but capped at $100 for a 30-day supply.DRUG THERAPY
Drug Therapy Guidelines. Our prescription drug and medical injectable policies promote safe and effective use by helping physicians select the drug product (s) considered most beneficial to their patients. In order to ensure thorough consideration of both quality-of-care and economic issues, some drugs require prior authorization to be covered WHERE TO USE YOUR WELLNESS DEBIT CARD BlueCross BlueShield of WNY offers all members a $250 Wellness Debit card that grants access to a wide range of gyms, fitness centers, fitness trackers, massage therapies, and more. Click to view a list of vendors, services and locations. 2019 PROVIDER AND FACILITY REFERENCE MANUAL 2019 Provider and Facility Reference Manual 2 Updated October 2019Purpose..54
CARDIAC REHABILITATION IN THE OUTPATIENT SETTING Protocol Cardiac Rehabilitation in the Outpatient Setting Last Review Date: 05/20 Page 3 of 6. Intensive cardiac rehabilitation with the Ornish Program for Reversing Heart Disease or Pritikin Program is con- UTILIZATION MANAGEMENT OUT-OF-PLAN REFERRAL REVIEW REQUEST Utilization Management Out-of-Plan Referral Review Request Form FAX to (716) 887-7913 Phone: 1-800-677-3086 In order to facilitate your request, this form must be completed in its entirety. Out of network referrals must be submitted prior to services being rendered. ENROLLMENT FORM CN9XAN0002 -over-PO Box 80, Buffalo, NY 14240-0080 Enrollment Application/Change Form — SMALL 1—Group Employer Information. This section should becompleted
BLUECROSS BLUESHIELD OF WESTERN NEW YORK BlueCross BlueShield of Western New York | Home BLUECROSS BLUESHIELD OF WESTERN NEW YORK Coronavirus, Stay Up To Date. As individuals in the United States are being diagnosed with COVID-19 (Coronavirus), we recognize BlueCross BlueShield of Western New York members may have concerns. While the situation is fluid and information is being updated daily, one thing that will remain constant is our commitment to connecting our membersPAY BILLS ONLINE
Payment Processing Center. PO Box 644366. Pittsburgh, PA 15264-4366. Our records indicate you are a Child Health Plus Member. To make a payment, please visit https://www.mybcbswny.com or call (844)885-1004. This online payment form is for individual members only. To make a payment for your employer group, please use eBilling.THE GOOD LIFE
The Good Life is a comprehensive program that works in conjunction with your health plan. By completing the steps of the program including the biometric screening, online health assessment, and if required, speaking with one of our certified health coaches - you can learn about areas of your health that can improve with our support. PROVIDER POLICIES & GUIDELINES We also understand how that complexity can impact patient care, as well as your bottom line. That's why we're offering all of our policies and guidelines in one, easy-to-access section. Here you'll find all you need to know about our products, services, claims and reimbursement process, drug therapy guidelines, and patient safetyresources.
WELLNESS DEBIT CARD
The following outlets do not participate in our wellness debit card program: Pharmacies, sporting goods stores, grocery stores, doctor's offices, optometrists, salons, and department stores. At BlueCross BlueShield of Western New York, we do our best to ensure members have the best wellness options available to get and stay healthy. OVER THE COUNTER (OTC) BENEFIT Over-the-Counter Benefit. As a BlueCross BlueShield Medicare Advantage member, you have an over-the-counter (OTC) benefit of one $25 purchase every quarter* to get the products you need conveniently delivered right to your door. Using your OTC benefit you can shop for a wide range of items including vitamins, allergy care, and first aidproducts.
DESTINATION 65
Introducing our newest individual plans – Destination 65. Designed for our early retiree members who need coverage while waiting to age into Medicare. These plans are carefully constructed to mirror our most popular Medicare Advantage plans, ultimately making the transition to Medicare that much easier. 7521 CHIRO GUIDE FEBRUARY 2021 UPDATED 22521 MASTER 7521_Chiro Guide _February 2021 Updated_22521 Master Chiropractic, acupuncture and massage therapy programs overview The goals of the chiropractic, acupuncture and massage therapy programs are to ensureour members receive
CAVE ANALYTICS
Cave Consulting Group is an independent and nationally recognized healthcare analytic software company focused on improving effectiveness (quality-of-care) and efficiency (cost-of-care). Used nationally, their practice-level reports offer insights to specialists about their quality and cost by comparing their performance with peersin the same
CARDIAC REHABILITATION IN THE OUTPATIENT SETTING Protocol Cardiac Rehabilitation in the Outpatient Setting Last Review Date: 05/20 Page 3 of 6. Intensive cardiac rehabilitation with the Ornish Program for Reversing Heart Disease or Pritikin Program is con- BLUECROSS BLUESHIELD OF WESTERN NEW YORK Coronavirus, Stay Up To Date. As individuals in the United States are being diagnosed with COVID-19 (Coronavirus), we recognize BlueCross BlueShield of Western New York members may have concerns. While the situation is fluid and information is being updated daily, one thing that will remain constant is our commitment to connecting our membersPAY BILLS ONLINE
Payment Processing Center. PO Box 644366. Pittsburgh, PA 15264-4366. Our records indicate you are a Child Health Plus Member. To make a payment, please visit https://www.mybcbswny.com or call (844)885-1004. This online payment form is for individual members only. To make a payment for your employer group, please use eBilling.THE GOOD LIFE
The Good Life is a comprehensive program that works in conjunction with your health plan. By completing the steps of the program including the biometric screening, online health assessment, and if required, speaking with one of our certified health coaches - you can learn about areas of your health that can improve with our support. PROVIDER POLICIES & GUIDELINES We also understand how that complexity can impact patient care, as well as your bottom line. That's why we're offering all of our policies and guidelines in one, easy-to-access section. Here you'll find all you need to know about our products, services, claims and reimbursement process, drug therapy guidelines, and patient safetyresources.
WELLNESS DEBIT CARD
The following outlets do not participate in our wellness debit card program: Pharmacies, sporting goods stores, grocery stores, doctor's offices, optometrists, salons, and department stores. At BlueCross BlueShield of Western New York, we do our best to ensure members have the best wellness options available to get and stay healthy. OVER THE COUNTER (OTC) BENEFIT Over-the-Counter Benefit. As a BlueCross BlueShield Medicare Advantage member, you have an over-the-counter (OTC) benefit of one $25 purchase every quarter* to get the products you need conveniently delivered right to your door. Using your OTC benefit you can shop for a wide range of items including vitamins, allergy care, and first aidproducts.
DESTINATION 65
Introducing our newest individual plans – Destination 65. Designed for our early retiree members who need coverage while waiting to age into Medicare. These plans are carefully constructed to mirror our most popular Medicare Advantage plans, ultimately making the transition to Medicare that much easier. 7521 CHIRO GUIDE FEBRUARY 2021 UPDATED 22521 MASTER 7521_Chiro Guide _February 2021 Updated_22521 Master Chiropractic, acupuncture and massage therapy programs overview The goals of the chiropractic, acupuncture and massage therapy programs are to ensureour members receive
CAVE ANALYTICS
Cave Consulting Group is an independent and nationally recognized healthcare analytic software company focused on improving effectiveness (quality-of-care) and efficiency (cost-of-care). Used nationally, their practice-level reports offer insights to specialists about their quality and cost by comparing their performance with peersin the same
CARDIAC REHABILITATION IN THE OUTPATIENT SETTING Protocol Cardiac Rehabilitation in the Outpatient Setting Last Review Date: 05/20 Page 3 of 6. Intensive cardiac rehabilitation with the Ornish Program for Reversing Heart Disease or Pritikin Program is con-VISION PLANS
Blue Discount Vision Program. Adults in Standard plans, including Healthy NY; Essential Plans 1&2. Call Davis Vision for questions regarding plan details, 1 (800) 999-5431. View Benefit Summary.EVENTS NEAR YOU
View the complete list of activities! Chandler St. After Market. Come join us every Saturday, May 8 - November 20 from 3 – 8 p.m. at the Chandler St. After Market. A weekly event featuring a wide variety of local food producers and growers. Meet the suppliers, purchase locally made food items and support the Western New York community!PLATINUM PLANS
Platinum Plus. $794.99. $649.19. $622.80. N/A. $589.81. ** All plans include Affordable Care Act (ACA) preventive drug coverage. †For plans with a deductible, insulin is subject to cost-sharing but capped at $100 for a 30-day supply.DRUG THERAPY
Drug Therapy Guidelines. Our prescription drug and medical injectable policies promote safe and effective use by helping physicians select the drug product (s) considered most beneficial to their patients. In order to ensure thorough consideration of both quality-of-care and economic issues, some drugs require prior authorization to be covered WHERE TO USE YOUR WELLNESS DEBIT CARD BlueCross BlueShield of WNY offers all members a $250 Wellness Debit card that grants access to a wide range of gyms, fitness centers, fitness trackers, massage therapies, and more. Click to view a list of vendors, services and locations. 2019 PROVIDER AND FACILITY REFERENCE MANUAL 2019 Provider and Facility Reference Manual 2 Updated October 2019Purpose..54
CARDIAC REHABILITATION IN THE OUTPATIENT SETTING Protocol Cardiac Rehabilitation in the Outpatient Setting Last Review Date: 05/20 Page 3 of 6. Intensive cardiac rehabilitation with the Ornish Program for Reversing Heart Disease or Pritikin Program is con- UTILIZATION MANAGEMENT OUT-OF-PLAN REFERRAL REVIEW REQUEST Utilization Management Out-of-Plan Referral Review Request Form FAX to (716) 887-7913 Phone: 1-800-677-3086 In order to facilitate your request, this form must be completed in its entirety. Out of network referrals must be submitted prior to services being rendered. ENROLLMENT FORM CN9XAN0002 -over-PO Box 80, Buffalo, NY 14240-0080 Enrollment Application/Change Form — SMALL 1—Group Employer Information. This section should becompleted
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