How do I get another ID card?
Contact Allied at 800-288-2078.
How do I answer the question, "WHAT INSURANCE DO YOU HAVE?"
The doctor, hospital or provider is really asking you where do I send claims
and who is paying the bill? The best answer is - Allied is the payor so
send claims to the Allied address located on the ID card. BCHP contracts
with Allied to process all medical and dental claims. The real payor is
you, the employees of the Butler County Health Plan. Our premium dollars pay
each claim-medical, prescription and dental.
What is a Preferred Provider Organization (PPO)?
A PPO is a large network of doctors and hospitals that agree to discount its
fees in exchange for a high volume of patients.
BCHP offers the HealthSpan Preferred Network and the Emerald Health Network as our
statewide wrap around PPO. The blended PPO provides employees and their
families protection from health care costs. The PPO allows for discounted
prices; you pay less, and are protected from "balance billing" when you use
an In-Network provider. Multiplan is the national PPO network available to you when traveling or for
students attending college out of state.
Is my doctor or hospital In-Network or Out-of-Network?
Please call HealthSpan at 1-888-914-7726 or 513-551-1400 to verify
In-Network Providers. If your provider is not in HealthSpan, call Multiplan
at 800-672-2140.
Although on-line directories are provided by HealthSpan and Multiplan,
the most current information is available by calling the PPOs. It is the
member's responsibility to verify that the provider is in the network before
the appointment is made.
Do I need a referral to see a Specialist?
No. You may self refer to any physician in the network.
My child attends a college out of the PPO Network region.
How will the plan pay for medical, dental and prescription services?
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Emergency or Urgent Care claims away from home for
college students are paid at the IN- NETWORK benefit level. Other
non-urgent services like check ups or non-emergency surgery are paid at
the out of network benefit level unless you find a provider in the
Multiplan national PPO network which is listed on the back of
your I.D. card. If you cannot find a provider in the national network,
you may schedule the non-urgent services with the local in-network
provider over the summer, semester breaks or times when the student is
home.
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There is no dental network so claims are paid at the
current benefit level.
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Caremark is a national company with pharmacies in
every state. If your drug card was not accepted, you may send in for
reimbursement consideration on a Caremark form with an attached
receipt.
What is the Multiplan Network?
This nationwide network of hospitals and doctors is offered
in 50 states. When you are out of the tri-state region, call the Multiplan
number on your ID card to locate a provider to get a discount on
out-of-network claims and avoid the usual and customary charge.
What is the Labcard Program?
A total voluntary benefit of free outpatient laboratory
testing is available to you. You may request that your doctor's office
collect your specimen and send them to Labcard for testing. When your
specimens are sent to Labcard, BCHP pays the full cost of outpatient
laboratory work covered by the Plan. If you do not request Labcard, your
regular benefits will apply.
Who do I notify for emergency admission or inpatient
hospital stays?
The provider must call the HealthSpan number
on the back of the ID card to pre-certify a hospital admission. Your plan
has a non-compliance penalty so be certain a call is made. Notify within 2
working days of emergency or urgent admissions. When the office is closed,
you may leave a message and a Registered Nurse will return your call.
