Blue Help
Medical Benefits
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General
100

What is the SOP # for DME Quick Reference Guide?

What is SOP 77?

100

Subscriber ID#15K009272
What is the OON urgent care benefits?

Deductible ($2700/$5400) then 20% coinsurance, OOP
(subject to R&C)

100

What system do you use to verify if an outpatient code requires prior authorization or not?

What is BQT?

100

What is the Blue Card ph#?

What is ph# 816-395-3686 or 800-32-09550?

100

Who & what ph# would the provider need to call for benefits on Subscriber ID# PFG 08JA03067?

What is Pipe Fitters ph# 816-361-0206?

200

What is the SOP # for Customer Service Injectable and Infusion Quick Reference Guide?

What is SOP 8488?

200

Subscriber ID# 05K218250

What is the in-ntwk benefits for OP 74182?

No Copayment 

Benefits for diagnostic services may vary based on where the services are rendered as indicated. 

(MRI bnf)

200

Provider would need to call who & what ph# for a member with group # 10025000?

What is Group 25 & ph# 816-395-3365?

200

What falls under Medicare Part A?

What is Inpatient hospital, skilled nursing, hospice &  home health? 

200

Would Dr Charles Beggs get the KCMO designated network benefits?

What is yes?

300

What is the SOP # for Blue KC 32-County Service Area and ZIP Code List?

What is SOP 3531?

300

Subscriber ID# 09K066321

What is the in-ntwk maternity bnf for a subscriber?

What is not covered?

300

What system do I use to verify if a group is full insured or self funded?

What is 360 Member View?

300

Is E-Stem covered on Dairy Farmers of America group policy?

What is yes?

300

Does BCBSKC use a third party vendor?

What is no?

400

What is the SOP # for High-Tech Radiology?

What is SOP 7779

400

Subscriber ID# 13H700148

What is the in-ntwk vasectomy benefits?

What is no copayment, covered @ 100%.

400

What type of codes are H0001-H2037?

What is Alcohol & Drug Abuse Treatment Services?

400

Who & what ph# would a provider call for vision benefits on an OEG member?

Who is Spectra & ph# 800-836-3242?

400

Name 1 group that covers Hyaluronan Injections?

What is Ash Grove, Barkley, Board of Public Utilities, Compass Health, Dairy Farmers of America, & Operating Engineers?

500

What is the SOP # for Hyaluronan Injections?

What is SOP 7833?

500

Subscriber ID# 10K054012

What is the in-ntwk benefits for code E0625?

What is not covered?
(see DME Quick Reference Guide SOP 77)

500

What is the phone system called?

What is Interaction Desktop?

500

What is the total # of cardiac rehab sessions a member can have during the 12-week period?

What is 36?

500

Where do you transfer to in facets to verify prior authorization status?

What is Prospective UM?

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