Blue Choice is a preferred provider organization (PPO) network. With Blue Choice members have freedom of choice. Not only can they select their personal doctor; they also may go directly to specialists without a referral from another doctor.
Other advantages of Blue Choice:
By using Blue Choice network providers and obtaining pre-admission certification before any planned admission, maximum benefits are available.
If services are not received from Blue Choice network providers payment will be reduced and the member will be responsible for any additional out-of-pocket expense. Benefits will be paid according to the maximum Competitive Allowance Program (CAP) allowance, subject to an additional 20 percent coinsurance amount up to an additional $2,000. Members also will be responsible for any deductible, coinsurance or shared payment of the program and any non-covered services. In addition, members also may be responsible for any difference between our allowance and the provider’s charge.
Blue Choice also offers the convenience of toll-free telephone numbers members can call for pre-admission certification. This 24 hours a day, 7 days a week cost-savings feature is needed for all planned inpatient care, including care for nervous and mental or substance abuse services.
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