The provider of service must contact our Provider Customer Service Department by calling (800) 541-6652 to receive authorization before services are provided. Our representatives can help verify which health services are covered under your plan.
Please check the "Benefits Management Program" section of your Evidence of Coverage (EOC) or Certificate of Insurance (COI) for specific details. If you or your physician fails to contact Blue Shield as outlined in the "Benefits Management Program" section of your EOC/COI or fails to follow the recommendations given to you by program administrators, you may incur an additional fee beyond your deductibles and copayments for inpatient admissions and skilled nursing facilities.
Some services may not be covered or there may be a reduction in payment if certain review requirements are not met.