Q:

What are the benefits of BCBS Blue Choice PPO?

A:

Quick Answer

The BlueChoice PPO of BlueCross BlueShield of Texas features benefits such as receiving a higher level of in-network benefits when choosing from the company's network of preferred providers, not being balance billed and not being required to submit claim forms, states the company. Members who opt for preferred providers also do not have to worry about preauthorization, as network providers are responsible for it.

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Full Answer

Members who receive medical care from preferred providers are not balance billed, which means that the providers do not charge for expenses beyond BCBSTX's coverage limits, notes the company. Doctors, hospitals, specialty care providers and other health care professionals who belong to BCBSTX's network offer medical services at reduced rates. Members access a selection of more than 6,000 hospitals and 800,000 doctors throughout the United States, as of 2015.

Members who want to obtain medical care from non-network providers may select ParPlan providers, which participate in a direct-payment agreement with BCBSTX, or out-of-network providers, which are non-contracting providers, explains the company. They receive lower-level benefits when receiving health care services from these providers.

ParPlan providers are responsible for filing the claim forms of members, whereas non-contracting providers require members to file on their own, according to the company. Like network providers, ParPlan providers do not bill members for charges beyond the coverage limits. In comparison, non-contracting providers require members to pay for excess costs.

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