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Agenda - 10-02-1995 - IX-C
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Agenda - 10-02-1995 - IX-C
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1/7/2015 2:47:05 PM
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1/7/2015 2:46:47 PM
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BOCC
Date
10/2/1995
Meeting Type
Regular Meeting
Document Type
Agenda
Agenda Item
IX-C
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Minutes - 19951002
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\Board of County Commissioners\Minutes - Approved\1990's\1995
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12 <br /> ADDITIONAL INFORMATION ABOUT PREFERRED CARE SELECT <br /> FROM BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA <br /> Provider's Reasonable Charge (PRC). <br /> The charge that Blue Cross and Blue Shield of North Carolina determines is reasonable for covered services <br /> provided to a member. <br /> Special Services/Providers Deductible. <br /> Special services and services of special providers are amount each calendar year All covered services under <br /> subject to the$200 preferred benefits calendar year this option apply toward meeting the calendar year <br /> deductible. You will pay only one maximum deductible deductible. <br /> Admission Certification. <br /> Many medical and surgical procedures that were hospital admissions must be certified prior to the <br /> previously performed on an inpatient basis can now be hospitalization.Approval for emergency and maternity <br /> done safely in a less costly outpatient setting.Admission admissions should be requested within two days or on <br /> certification is a program designed to make sure that the first business day after the admission. <br /> your care is given in a cost effective setting and an If the admission is not certified,charges for room and <br /> efficient manner board will not be covered by Blue Cross and Blue Shield <br /> If you need to be hospitalized, you must obtain of North Carolina. <br /> admission certification.'Nonemergency and nonmaternity <br /> Length of Stay Assignment. <br /> When Preferred Care Select subscribers are admitted help avoid unnecessary and costly hospital days to keep <br /> to a nonpreferred hospital, the doctor must obtain a costs to a minimum. If a longer stay is needed, the <br /> length of stay assignment as well as admission certification. doctor should contact Blue Cross and Blue Shield of <br /> With a length of stay assignment,a certain number of North Carolina. <br /> days will be approved for the hospital stay.The length of If a Preferred Care Select subscriber is admitted to a <br /> stay assignment reflects the number of inpatient days that nonpreferred hospital and does not obtain a length of <br /> are normally necessary to treat the patient's condition. stay assignment, room and board charges will not be <br /> The length of stay assignment program is designed to covered by Blue Cross and Blue Shield of North Carolina. <br /> Emergency Care. <br /> During an emergency, the initial visit or admission will preferred hospital.The preferred level of benefits includes <br /> be paid at the preferred level of benefits even when the$200 preferred deductible(with a maximum of$600 <br /> services are not provided by a preferred doctor or in a per family)and the preferred copayment of 10 percent. <br /> Chemical Dependency. <br /> All chemical dependency benefits are subject to the lifetime and calendar year chemical dependency maximums. <br /> Preferred Care Providers. <br /> A directory of doctors who participate in our Preferred Care Select program, the preferred hospitals and the <br /> preferred ambulatory surgical facilities will be included in your employee information. <br /> Facility Providers. <br /> Private duty nursing is covered for agencies only; it is not covered for individual facilities. <br /> Carry Over Credit. <br /> Expenses incurred for covered services in the last that calendar year deductible will be applied to the <br /> three months of a calendar year which were applied to deductible of the next calendar year. <br /> This fact sheet is a summary of Preferred Care Select limitations and exclusions of Preferred Care Select are <br /> benefits Plan S3.This is meant only to be a summary. found in and governed by the group contract. <br /> Final interpretation and a complete listing of benefits, <br /> L901 5,95 0� <br />
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