Blue Cross Blue Shield of Illinois: UVT: Anthem BCBS of Virginia: UVU: Blue Cross Blue Shield of Alabama: UVV: Wellmark BCBS: UVW: Empire Blue Cross Blue Shield: UVX: CareFirst BCBS: UVY: Blue Cross of California: UVZ: Blue Cross Blue Shield of Texas: UWA: Blue Cross Blue Shield of Michigan: UWB: Anthem BCBS of …Blue Cross and Blue Shield of Illinois has what you need to successfully sell to and service your clients: Quality health care plans and networks across group, Medicare, and individual markets. A service and technology infrastructure built to support you and your clients. Marketing materials, online quoting, enrollment tools, secure messaging ...How To Submit An Anthem Claim Yourself. Typically, your doctor or provider, especially if they’re in your plan, will submit the claim for you. In some cases when you visit a doctor outside your plan, you may have to do this yourself. You can access claim forms in our Forms Library. Here are some steps to make sure your claim is processed ... Prescription drugs are a vital part of your health care coverage. If you have prescription drug coverage through Blue Cross and Blue Shield of Illinois (BCBSIL), this information can help you and your doctor get the most from your prescription drug coverage. If you are a BCBSIL member, log in to Blue Access for Members SM (BAM SM) to check your ... 5253 W Roosevelt Rd. Cicero, IL 60804. 10. Blue Cross Blue Shield Of Illinois. Health Insurance Insurance. Website Services. 23 Years. in Business.A drug list is a list of drugs available to Blue Cross and Blue Shield of Illinois members. How much you pay out-of-pocket for prescription drugs is determined by whether your medication is on the list. These prescription drug lists have different levels of coverage, which are called "tiers". Generally, if you choose a drug that is a lower tier ...When you look at your paycheck, you likely see less than you expected, especially if your wages are already low. That's because taxes are taken out of your earnings. This is for So...Blue Cross Blue Shield Association. / 41.8864516; -87.6239771. Blue Cross Blue Shield Association, also known as BCBS, BCBSA, or The Blues, is a United States -based federation with 34 independent and locally-operated BCBSA companies that provide health insurance in the United States to more than 115 million people as of 2022. These tools and services can help you use your Blue Cross and Blue Shield of Illinois (BCBSIL) membership. Log in to Blue Access for Members SM (BAM SM) Log in to your account to access your health plan information: Find an in-network doctor, hospital or other provider; Pay your bill; Review benefits, account balances, claims status and more A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association 226920.1118 Provider must call . BCBSIL at 800-851-7498. to check the member’s benefits. Print and fax the completed form to BCBSIL at . 877-361-7656.Anthem Blue-Cross: UTN: Illinois: Blue-Cross Blue-Shield of Illinois: UTO: California: Blue-Shield of California: UTP-Unallocated/Not Assigned: UTQ: Pennsylvania: Independence Blue-Cross of Philadelphia and Southeastern Pennsylvania: UTR: Pennsylvania: Independence Blue-Cross of Philadelphia …Online. Compare BCBSIL health plan options online. Agent. A licensed BCBSIL authorized health plan specialist can answer questions and help you with your 2024 health care coverage. Request a health plan specialist if you don’t have one. Phone. You can call 1-866-514-8044 to speak with a BCBSIL licensed health plan specialist.Anthem Blue Cross Blue Shield is located at 225 North Michigan Ave. Chicago, IL and Anthem Blue Cross Blue Shield operates in the Insurance industry. These Medical Policies serve as guidelines for health care benefit coverage decisions, which may vary according to the different products and benefit plans offered by BCBSIL. In addition to the active and pending Medical Policies, BCBSIL has included policies which are under development or being revised. Providers have the opportunity to review ... Anthem Blue-Cross: KNS: Illinois: Blue-Cross Blue-Shield of Illinois: KNT: Pennsylvania: Independence Blue-Cross of Philadelphia and Southeastern Pennsylvania: KNU: Ohio: Anthem Blue-Cross Blue-Shield of Ohio: KNV: Maryland/District of Columbia/Northern Virginia: Carefirst Blue-Cross Blue … Bus passes can be provided to get you to and from your doctor’s appointment. Call ModivCare at 1-877-831-3148 (TTY/TDD: 1-866-288-3133) at least two weeks before your appointment. Bus passes will be mailed to your home. For more information about transportation services, check your Member Handbook or visit the FAQs page. Blue Cross Blue Shield. Plans we accept from. Blue Cross Blue Shield. Visit Website ... Blue Cross and Blue Shield of Illinois... Blue Cross and Blue Shield ...IAR. Alabama. Blue-Cross Blue-Shield of Alabama. IAS. Massachusetts. Blue-Cross Blue-Shield of Massachusetts. IAT BCBS Prefix. New York. Empire Blue-Cross Blue-Shield of New York.Download the BCBSIL mobile app to conveniently access your member information, anytime you need it. With the mobile app you can: Find care. Access your Medicare coverage information. Access your temporary digital member ID card, and more. The mobile app is available for iPhone and Android users. To download the app, text* BCBSILAPP … Medicare Advantage Plans (Medicare Part C) From Anthem. An Anthem Medicare Advantage plan can help you and your budget stay healthy. You’ll get doctor, hospital, and prescription drug coverage, plus a prepaid benefits card, 1 dental, vision, and hearing – all in one plan. A ZIP code helps us find plans in your area. Stay on top of your health with Individual and Family health insurance plans designed to fit your budget. Anthem health plans include coverage for doctor visits, hospital care, and mental health benefits, plus: $0 virtual care, 24/7 †. $0 preventive care §. Prescription drug coverage, with some commonly-used drugs as low as $0 ¶. Americans place their hands over their hearts during the national anthem because it is the customary salute to the flag and anthem suggested by the country’s flag code. The flag co...Blue Cross and Blue Shield companies in Illinois, Montana, New Mexico, Oklahoma and Texas offer access to Benefits Value Advisor. This live advocate helps individuals as they consider treatment options by easily enabling them to identify in-network providers and locate the best value through cost and …Blue Cross Blue Shield: 5.0 rating, 1.7M+ providers, all metal tiers. Positive experiences, higher complaints, ACA premiums. Bronze plan: $458 avg. cost, $7,173 ...Insurance Basics. Shop Plans & Products. Find a Doctor or Hospital. Shop Plans and Products. 2021 Individual and Family Health Insurance Plans. Special Enrollment. Student Health …IAR. Alabama. Blue-Cross Blue-Shield of Alabama. IAS. Massachusetts. Blue-Cross Blue-Shield of Massachusetts. IAT BCBS Prefix. New York. Empire Blue-Cross Blue-Shield of New York. Blue Cross Medicare Advantage SM – 877-774-8592. For out-of-state Blue Cross and Blue Shield members, call the BlueCard® Eligibility Line at 800-676-BLUE (2583) for eligibility and benefit verifications. Learn more about BlueCard. For Federal Employee Program® (FEP) members, eligibility and benefits can be obtained by calling 800-972-8382. Credentialing is the process by which BCBSIL reviews and validates the professional qualifications of physicians and certain other providers who apply for participation in the BCBSIL HMO, PPO, Blue Choice PPO SM, Blue Cross Medicare Advantage (PPO) SM and Blue Cross Medicare Advantage (HMO) SM, ensuring they meet our professional …Quality Care That’s Right for YouWhether you need a routine check-up or a specialty procedure, you want the best care you can find.BCBS recognizes doctors and hospitals for their expertise and exceptional quality in delivering care. Learn more about our Total Care and Blue Distinction® Specialty Care designation programs … These Medical Policies serve as guidelines for health care benefit coverage decisions, which may vary according to the different products and benefit plans offered by BCBSIL. In addition to the active and pending Medical Policies, BCBSIL has included policies which are under development or being revised. Providers have the opportunity to review ... Blue Cross Blue Shield of Illinois: RZV: Anthem BCBS of Ohio: RZW: BCBS of Western New York: RZX: Premera Blue Cross: RZY: BCBS of Western New York: RZZ: Anthem BCBS of Missouri: VW: Blue Cross Blue Shield of Massachusetts: Sep 3, 2020 Payer Goddess. Subscribe to our mailing list and have all of the latest updates and …Contact Information for Blue Cross and Blue Shield of Illinois. This link will take you to a new site not affiliated with BCBSIL. It will open in a new window. To return to our website, simply close the new window. ... Blue Cross Community Health Plans SM (BCCHP SM) Blue Cross Community MMAI (Medicare-Medicaid Plan) SM. ... AIM Specialty Health …Anthem Blue-Cross: KNS: Illinois: Blue-Cross Blue-Shield of Illinois: KNT: Pennsylvania: Independence Blue-Cross of Philadelphia and Southeastern Pennsylvania: KNU: Ohio: Anthem Blue-Cross Blue-Shield of Ohio: KNV: Maryland/District of Columbia/Northern Virginia: Carefirst Blue-Cross Blue …For other EDI transactions, you will need to enlist the services of a third-party electronic business vendor, such as Availity ® Essentials. Availity Essentials – To register with Availity or learn more about services available to BCBSIL providers, visit the Availity website, or call Availity Client Services at 800-AVAILITY (282-4548).To calculate your total monthly COBRA premium, add a 2% service charge to the $650 for a grand total of $663 per month. Here's a sample calculation: Your contribution: $125 per paycheck X 2 = $250 per month. Your employer's contribution: $400 per month. Total contribution: $250 + $400 = $650 per month. Official Site of Anthem Blue Cross Blue Shield, a trusted health insurance plan provider. Shop plans for Medicare, Medical, Dental, Vision & Employers. EFT is a direct deposit of your claim payment from BCBSIL to your designated bank account. The ERA or ANSI 835 transaction is a HIPAA-compliant method of receiving claim payment and remittance details. The ERA can be automatically posted to your patient accounting system. When you enroll for the ERA, you are automatically enrolled for the …Anthem Blue-Cross: J2F: Illinois: Blue-Cross Blue-Shield of Illinois: J2G: Illinois: Blue-Cross Blue-Shield of Illinois: J2H: New Hampshire: Anthem Blue-Cross Blue-Shield of New Hampshire: J2I-Unallocated/Not Assigned: J2J-Unallocated/Not Assigned: J2K: California: Anthem Blue-Cross: J2L: …We’re committed to maintaining an environment of Equal Opportunity and Affirmative Action. If you need accommodation to see the information provided on this web site, please call us at tel: 1-866-977-7378 . EEO AA Statement. Illinois Federal State Wage and Labor Laws. Federal Contractors.BCBS Prefix List 2024 - Alpha. State Lookup. BCBS Company. SAA. South Dakota/Iowa. Wellmark Blue-Cross Blue-Shield. SAB. Ohio. Anthem Blue-Cross Blue-Shield of Ohio.Correct BCBS home plan can easily be identified using our BCBS prefix lookup directory. We update BCBS prefix list data on daily basis to provide latest BCBS prefix home plan information. Have a look at our BCBS alpha prefix and BCBS alpha numeric prefix directory below. In case, you need any additional information related to BCBS prefix then ...Correct BCBS home plan can easily be identified using our BCBS prefix lookup directory. We update BCBS prefix list data on daily basis to provide latest BCBS prefix home plan information. Have a look at our BCBS alpha prefix and BCBS alpha numeric prefix directory below. In case, you need any additional information related to BCBS prefix then ...Logging into your Anthem account is an easy process that can be completed in just a few steps. Whether you’re a new or existing customer, this guide will help you access your accou...Visit Premera Facebook page Visit Premera Twitter page Visit Premera Youtube page Visit Premera LinkedIn pageA drug list is a list of drugs available to Blue Cross and Blue Shield of Illinois members. How much you pay out-of-pocket for prescription drugs is determined by whether your medication is on the list. These prescription drug lists have different levels of coverage, which are called "tiers". Generally, if you choose a drug that is a lower tier ...Starting January 1, 2025, the PSHB Program will offer health insurance to USPS employees, retirees and eligible family members. The Office of Personnel Management (OPM) recently announced that the Blue Cross and Blue Shield Federal Employee Program (FEP) is a conditionally approved carrier. Learn More. Welcome to the Blue Cross Blue Shield Association Job Center, where you can view our current job openings and apply for positions to join the team that supports the nation’s largest health care network, providing coverage to nearly one in three Americans. Current BCBSA employees: Please search opportunities and apply in Workday via the ... Anthem Blue-Cross: K2F: Illinois: Blue-Cross Blue-Shield of Illinois: K2G: Oklahoma: Blue-Cross Blue-Shield of Oklahoma: K2H: New York (Western) Blue-Cross Blue-Shield of Western New York: K2I-Unallocated/Not Assigned: K2J: Pennsylvania: Highmark Blue-Cross Blue-Shield of Pennsylvania: K2K: Pennsylvania: …October 2019 Understanding Tiered Products: Are you an in-network PPO provider? Tiered products – such as Blue Options PPO SM and Blue Choice Options PPO SM – are designed to give the employer and the member the opportunity to help them self-manage their health care spending. With a tiered product, the member’s benefit level of cost …Physicians Immediate Care is in-network with all BCBSIL PPO plans, including Medicare Advantage and BCBS HMO, select plans only.200 E. Randolph. Chicago, IL 60601. 750 9th St. NW. Washington, DC 20001. For BCBS customer service, call the toll-free number on the back of your member ID card. This is the customer service number for questions about your health insurance coverage, benefits or treatment. Maybe the best way to put it is they are separate companies under a similar umbrella. BCBS of IL focuses on IL (of course) New Mexico, Texas, Montana, and Oklahoma, while Anthem covers quite a large amount of states. I tend to see a lot of California plans, Indiana plans, and Georgia plans from Anthem. Logging into your Anthem account is an easy process that can be completed in just a few steps. Whether you’re a new or existing customer, this guide will help you access your accou...Posted Jan. 11, 2021. Prior authorization to confirm medical necessity is required for certain services and benefit plans as part of our commitment to help ensure all Blue Cross and Blue Shield of Illinois (BCBSIL) members get the right care, at the right time, in the right setting.Utilization management review requirements and recommendations are in place to help ensure our members get the right care, at the right time, in the right setting. Types of utilization management review that may be conducted before services are rendered include prior authorization, recommended clinical review (predetermination), and pre …Logging into your Anthem account is an easy process that can be completed in just a few steps. Whether you’re a new or existing customer, this guide will help you access your accou...Get a Quote. Why Choose Us. Find a Doctor or Hospital. Search for doctors, hospitals, pharmacies, urgent care and more. Member Login. Log in to your account to get the most …About Anthem. At Anthem Blue Cross and Blue Shield we understand our health connects us to each other. What we all do impacts those around us. So Anthem is dedicated to delivering better care to our members, providing greater value to our customers and helping improve the health of our communities. Anthem Blue Cross and Blue …Getting Started with Anthem; Credentialing; Employee Assistance Program (EAP) COVID-19 Info. COVID-19 Resource Center; Main Content. Where do you have or need coverage? Select a state for information that's relevant to you. Information for . Select a State. Forms Library Members can log in to view forms that are specific … Official Site of Anthem Blue Cross Blue Shield, a trusted health insurance plan provider. Shop plans for Medicare, Medical, Dental, Vision & Employers. We’re committed to maintaining an environment of Equal Opportunity and Affirmative Action. If you need accommodation to see the information provided on this web site, please call us at tel: 1-866-977-7378 . EEO AA Statement. Illinois Federal State Wage and Labor Laws. Federal Contractors. Blue Cross and Blue Shield of Illinois is proud to be the state’s only statewide, customer-owned health insurer. We are also the largest provider of health benefits in Illinois, serving more than 8.9 million members in all 102 counties across the state. For more than 85 years, we’ve provided our members with comprehensive, … More About Consumer-Driven Health Plans. A consumer-driven health plan (CDHP) is a high-deductible health insurance plan that allows individuals and families to set aside pre-tax money to help pay for qualified medical expenses. CDHPs are HDHPs paired with HSAs. Members may use the pre-tax funds from their HSA to pay for medical expenses, like ... Please contact your appropriate state below for further information. For Illinois - Contact your network representative or click here: https://www.bcbsil.com/ ...Blue-Cross Blue-Shield of Illinois: EOA: Ohio: Anthem Blue-Cross Blue-Shield of Ohio: EOB: Maryland/District of Columbia/Northern Virginia: Carefirst Blue-Cross Blue-Shield: EOC: California: Blue-Shield of California: EOD: Pennsylvania: Highmark Blue-Cross Blue-Shield of Pennsylvania: EOE: Idaho: Blue-Cross of Idaho: EOF: …Blue Cross Blue Shield. Plans we accept from. Blue Cross Blue Shield. Visit Website ... Blue Cross and Blue Shield of Illinois... Blue Cross and Blue Shield ...120 Days. Reconsideration: 180 Days. Corrected Claim: 180 Days from denial. Appeal: 60 days from previous decision. Aetna Better Health TFL - Timely filing Limit. Initial Claims: 180 Days. Resubmission: 365 Days from date of Explanation of Benefits. Appeals: 60 days from date of denial. Anthem Blue …Please contact your appropriate state below for further information. For Illinois - Contact your network representative or click here: https://www.bcbsil.com/ ...Blue Cross Blue Shield Federal Phone Number. BCBS Prefix List 2024 - Alpha. State Lookup. BCBS Company. JAA. Minnesota. Blue-Cross Blue-Shield of Minnesota. JAB. Massachusetts.Our resources vary by state. Choose your location to get started. Select a State. Prior Authorization. Health insurance can be complicated—especially when it comes to prior …Blue-Cross Blue-Shield of Illinois: EOA: Ohio: Anthem Blue-Cross Blue-Shield of Ohio: EOB: Maryland/District of Columbia/Northern Virginia: Carefirst Blue-Cross Blue-Shield: EOC: California: Blue-Shield of California: EOD: Pennsylvania: Highmark Blue-Cross Blue-Shield of Pennsylvania: EOE: Idaho: Blue-Cross of Idaho: EOF: …The air ambulance claims filing rules apply regardless of the provider’s contracting status with the BCBS Plan where the claim is filed. Where possible, providers are encouraged to verify Member Eligibility and Benefits by contacting the phone number on the back of the Member ID card or calling 1.800.676.BLUE (2583).We have helped hundreds of Coverlipedema.com members with BCBS plans get fully covered for liposuction, any needed skin excisions, and even panniculectomy or abdominoplasty for lipedema, even when not explicitly covered in the BCBS plan’s lipedema coverage policy. Anthem Blue Cross Blue Shield, the largest BCBS insurer, …BlueCard is a national program that enables members of one Blue Cross and Blue Shield (BCBS) Plan to obtain health care services while traveling or living in another BCBS Plan’s service area. The program allows you to submit claims for members from other BCBS Plans to the Illinois Plan. The three-character prefix preceding the member’s ID ...The Clinical Practice Guidelines for Illinois Medicaid plans are adopted by BCBSIL through the Quality Assurance Committee. These guidelines are based on established evidence-based best practice standards of care, publicized by leading academic and national clinical organizations. BCBSIL uses evidence-based clinical guidelines from nationally ...Blue Cross and Blue Shield of Illinois P.O. Box 650774 Dallas, TX 75265-0774. Be sure you follow all instructions shown on your bill. In-Person. After making your first payment, payments can be made with cash at ...BCBS HMO (AMITA Health ONLY)*. * We are in-network with many BCBS HMO plans from AMITA Health. If you have one of the following plans from AMITA (or are unsure of the plan you have) please call 888.938.3838 to confirm if your plan is in-network. Blue Advantage HMO (AMITA Health)When you look at your paycheck, you likely see less than you expected, especially if your wages are already low. That's because taxes are taken out of your earnings. This is for So... Provider Finder - Anthem is a tool that helps you find doctors, hospitals, pharmacies, and other health care providers that are part of your Anthem plan. You can search by location, specialty, name, or network. You can also compare costs and quality ratings for different providers. Provider Finder - Anthem makes it easy to find the best care for your needs. Your Anthem Blue Cross Blue Shield insurance card contains all the essential information you need for using your health insurance. When you sign up for an Anthem plan, as a Medicare member, we will send you an Anthem ID card in the mail. For other types of members, we will send you an ID card unless you or your …To calculate your total monthly COBRA premium, add a 2% service charge to the $650 for a grand total of $663 per month. Here's a sample calculation: Your contribution: $125 per paycheck X 2 = $250 per month. Your employer's contribution: $400 per month. Total contribution: $250 + $400 = $650 per month.Anthem Blue Cross Blue Shield is located at 225 North Michigan Ave. Chicago, IL and Anthem Blue Cross Blue Shield operates in the Insurance industry.Anthem Blue Cross timely filing limit (Commercial and Medicare Advantage plan) Eff: October 1 2019: Anthem Blue Cross timely filing limit for Filing an Initial Claims: 90 Days from the DOS: ... Blue Cross Blue shield of Illinois timely filing limit for filing an claims: End of the calendar year following the year the service was rendered: BCBS …Machine Readable Files. A machine-readable file is defined as a digital representation of data or information in a file that can be imported or read by a computer system for further processing without human intervention, while ensuring no semantic meaning is lost. These files are in the Centers for Medicare & Medicaid Services (CMS) defined ...
Blue Cross and Blue Shield of Illinois, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association . Web fire kirin
Blue Cross Blue Shield of Illinois Quality of Complaints & Occurrences Process Policy. QI 30. 4/1/2023. Blue Cross Blue Shield of Illinois Quality of Complaints & Occurrences Process Procedure. QI 30A. 4/1/2023. Member Communication. RR 5. 1/1/2022.The clinical payment and coding guidelines are not intended to provide billing or coding advice but to serve as a reference for facilities and providers. Certain policies may not be applicable to Self-Funded Members and certain insured products. Refer to the Member's plan of benefits or Certificate of Coverage to …The Clinical Practice Guidelines for Illinois Medicaid plans are adopted by BCBSIL through the Quality Assurance Committee. These guidelines are based on established evidence-based best practice standards of care, publicized by leading academic and national clinical organizations. BCBSIL uses evidence-based clinical guidelines from nationally ... Get a free instant rate quote and apply online today for Illinois health insurance plans including individual and family health insurance, Medicare supplement, short term health insurance and health savings account (HSA) compatible plans at www.bcbsil.com. Anthem Blue-Cross: U4M: Illinois: Blue-Cross Blue-Shield of Illinois: U4N: Indiana: Anthem Blue-Cross Blue-Shield of Indiana: U4O: Indiana: Anthem Blue-Cross Blue-Shield of Indiana: U4P: Illinois: Blue-Cross Blue-Shield of Illinois: U4Q-Prefix Unallocated/Not Assigned: U4R: Texas: Blue-Cross Blue …Blue Cross Blue Shield of Illinois: UVT: Anthem BCBS of Virginia: UVU: Blue Cross Blue Shield of Alabama: UVV: Wellmark BCBS: UVW: Empire Blue Cross Blue Shield: UVX: CareFirst BCBS: UVY: Blue Cross of California: UVZ: Blue Cross Blue Shield of Texas: UWA: Blue Cross Blue Shield of Michigan: UWB: Anthem BCBS of …Insurance Basics. Shop Plans & Products. Find a Doctor or Hospital. Shop Plans and Products. 2021 Individual and Family Health Insurance Plans. Special Enrollment. Student Health …Dental Provider Resources | Anthem.com. Find information that’s tailored for you. Our resources vary by state. Choose your location to get started. Select a State. Important Notice: Provider EFT Enrollments—Federal Mandate & Other Enhancements. Our EFT system is now available. Read more in the …2 Oct 2023 ... Q: When is the BCBSIL termination effective? A: Effective January 1, 2018, all OSF hospitals in Illinois, except for OSF HealthCare Saint ... STEP 1 – Complete an application. Individual and Medical Groups/Clinics to apply to join our networks, fill out the online Provider Onboarding Form . To add new network (s) to an existing contract, fill out the online Provider Onboarding Form for Contract as Solo or Add New Group/Clinic then select the new network (s) you wish to join. Blue Distinction ® Centers for Fertility Care focus on in vitro fertilization (IVF), which is the most common assisted reproductive technology (ART) treatment and is widely becoming the preferred option for fertility treatment. Blue Distinction ® Centers for Fertility Care, along with the Blue Distinction ® Centers for Bariatric Surgery ...BCBS HMO (AMITA Health ONLY)*. * We are in-network with many BCBS HMO plans from AMITA Health. If you have one of the following plans from AMITA (or are unsure of the plan you have) please call 888.938.3838 to confirm if your plan is in-network. Blue Advantage HMO (AMITA Health)Anthem Blue Cross and Blue Shield is a Qualified Health Plan that in certain geographic areas offer some health plans with a $0 premium option after subsidy is applied through the Health Insurance Marketplace or your state exchange. Anthem health plans with a $0 premium option are not available in all areas and eligibility …The clinical payment and coding guidelines are not intended to provide billing or coding advice but to serve as a reference for facilities and providers. Certain policies may not be applicable to Self-Funded Members and certain insured products. Refer to the Member's plan of benefits or Certificate of Coverage to ….