September 2019
Are you familiar with BluePrint PPOSM?
BluePrint PPO is a product offered by Blue Cross and Blue Shield of Illinois (BCBSIL). You may be an in-network provider through your PPO contract for BCBSIL members with this product.
BCBSIL members may refer to their benefit booklet for more details. As always, it is important to check eligibility and benefits for each patient before every scheduled appointment. The best way to check eligibility and benefits is electronically through the Availity® Provider Portal or your preferred vendor portal.
Eligibility and benefit quotes include important information about BluePrint PPO patients’ benefits, such as membership verification, coverage status and applicable copayment, coinsurance and deductible amounts. Also, the benefit quote may include information on applicable benefit preauthorization/pre-renotification requirements. When services may not be covered, you should let the BluePrint PPO member know that they may be billed directly.
Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSIL. BCBSIL makes no endorsement, representations or warranties regarding any products or services provided by third party vendors such as Availity. If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly.
Checking eligibility and benefits and/or obtaining preauthorization is not a guarantee of payment of benefits. Payment of benefits is subject to several factors, including, but not limited to, eligibility at the time of service, payment of premiums/contributions, amounts allowable for services, supporting medical documentation, and other terms, conditions, limitations, and exclusions set forth in the member’s policy certificate and/or benefits booklet and or summary plan description. Regardless of any preauthorization or benefit determination, the final decision regarding any treatment or service is between the patient and their health care provider.