Blue advantage louisiana 2020. Blue Advantage (HMO) is a product of HMO Louisiana, Inc.

Blue advantage louisiana 2020. Access Blue Advantage manuals, speed guides, tidbits, workshop and webinar presentations, tutorials and forms. Blue Cross and Blue Shield of Louisiana, an independent licensee of the Blue Cross Blue Shield Ass Phone Number Fax Number Addition Information: Blue Advantage from Blue Cross and Blue Shield of Louisiana HMO is an HMO plan with a Medicare contract. Our credentialing program is accredited by the Utilization Review Accreditation Commission (URAC). https://providers. HMO Louisiana plan = HMO Louisiana HMO/POS network Pick a Primary Care Physician You must pick a primary care provider in the HMO network to handle most of your medical needs when you are sick or injured. COM Sep 17, 2025 · Blue Cross and Blue Shield (BCBS) companies are committed to ensuring access to vaccines that protect individuals and communities from serious illness. Blue Advantage follows the policies and procedures outlined by the Centers for Medicare and Medicaid Services (CMS). Your feedback is important to us and will help us improve our plan to better serve you. Blue Cross and Blue Shield of Louisiana and its subsidiaries, HMO Louisiana, Inc. Providers have the capability to get immediate approvals using our online BCBSLA Authorization tool, which does not require Blue Cross personnel intervention. Blue Advantage from Blue Blue Advantage from Blue Cross and Blue Shield of Louisiana is a PPO plan with a Medicare contract. To activate your MyLABlue account, powered by MyChart, press the MyLABlue Account Activation button below. Both are independent licensees of the lue Cross and Blue Shield Association. Here is where you can get all the information and answers you need to make the most of the many benefits available to you as a Blue Advantage member. If you receive a survey, we hope you will complete it so we can continue to improve our service. Blue Advantage from Blue Cross and Blue Shield of Louisiana is an HMO plan with a Medicare contract. The Blue Advantage Flex Card MasterCard® Prepaid Card is issued by Stride Bank, N. This directory is for the state of Louisiana service area. Blue Advantage values you as a member and wants to hear from you! You may receive a survey between March and June asking about your experience with Blue Advantage. Next year, there will be some changes to the plan’s costs and benefits This booklet tells about the Effective for dates of service on and after April 15, 2020, Blue Cross is waiving all member cost shares (deductible, coinsurance and copayment) for telehealth services rendered by an eligible Blue Cross-credentialed, Louisiana participating provider for our individual members who buy their own healthcare coverage and those who are covered Blue Advantage (HMO) is a product of HMO Louisiana, Inc. This is a summary of drug and health services covered by Blue Advantage (PPO) from January 1, 2020 – December 31, 2020. The purpose of this guide is to help Blue Advantage network providers reach the appropriate areas of service for our Blue Advantage (HMO) and Blue Advantage (PPO) members. Medicare Advantage plans usually include prescription drug coverage (Part D), as well as extra benefits such as fitness benefits, vision, hearing and dental services. Sep 1, 2025 · Learn about your benefits, which include pharmacy, flex card, over-the-counter benefit, dental, vision, telehealth, fitness and healthy rewards. This manual contains policies, procedures and general reference information, including minimum standards of care, which are required of Blue Advantage providers and govern the administration of the Medicare Advantage and Prescription A partner is a person or group contracted with the Louisiana Department of Health to perform a specific role such as assisting with Medicaid applications. Blue Advantage (HMO) is a product of HMO Louisiana, Inc. Blue Advantage refers to Blue Cross and Blue Shield of Louisiana’s Medicare Advantage products and provider networks exclusively available to Medicare Advantage-eligible customers. Express Scripts is an independent company that serves as the pharmacy benefit manager for Blue Cross and Blue Shield of Louisiana. 01MA1805 09/19 H1248_19-506_ENLU_M Blue Advantage (PPO) offered by Blue Cross and Blue Shield of Louisiana. Blue adVantage (HMO) | Blue adVantage (PPO) Contact Louisiana Relay Service (LRS) for assistance. , offers Blue Advantage (PPO). You will find a detailed list of topics at the beginning of each chapter. healthybluela. You also get extra benefits at no additional cost. 2025 Summary of Benefits Blue Advantage (HMO) Pine – Group Medicare Advantage Blue Advantage (HMO) is available statewide in Louisiana. 00 and includes a Part B premium discount of $0. Louisiana Blue’s prior authorization process ensures that members receive the highest level of benefits in the most appropriate setting and level of care for medical, prescription drugs and dental coverage. Blue Cross and Blue Shield of Louisiana HMO offers Blue Advantage (HMO). Details Drug Coverage for the Blue Cross and Blue Shield of Louisiana Blue adVantage Classic (HMO-POS) H6453-013 (HMO-POS). Blue Advantage became effective on January 1, 2016, and is available in Louisiana to members residing in the parishes of Ascension, East Baton Rouge, Jefferson, Lafayette, Livingston, Orleans, St. Blue Advantage is Blue Cross and Blue Shield of Louisiana’s Medicare Advantage products and provider networks that are exclusively for Medicare Advantage-eligible customers. H1248_19-507_ENLU_M OMB Approval 0938-1051 (Expires: December 31, 2021) Blue Advantage (PPO) offered by Blue Cross and Blue Shield of Louisiana Annual Notice of Changes for 2020 You are currently enrolled as a member of Blue Advantage (PPO). Find a Doctor or Drug Finding quality care is easier than you think. , Member FDIC, pursuant to license by MasterCard International. -- (BUSINESS WIRE)--Healthy Blue is introducing a new Medicare Advantage plan designed for individuals eligible for both Medicare and Medicaid in 27 Louisiana parishes. Blue Blue Advantage Provider Portal User Guide Y0132_24737PVLA_C C18100 013900 0224R Blue Cross and Blue Shield of Louisiana is an independent licensee of the Blue Cross Blue Shield Association. , a subsidiary of Blue Cosr s and Blue Shield of Louisiana, an independent licensee of the Blue Cross and Blue Shield Association and incorporated as Louisiana Health Service & Indemnity Co. Both companies are independent licensees of the Blue Cross and Blue Shield Association. This is a 3. Now is the perfect time to make the switch, and it couldn’t be easier or more convenient. HMO Louisiana, Inc. and Southern National Life Insurance Company, Inc. and Southern National Life Insurance Company, Inc, comply with applicable federal civil rights laws and do no exclude people or treat them differently on the basis of race, color, national origin, age, disability or sex. This Blue Advantage Provider Administrative Manual is intended to be used as a guide to assist providers in delivering covered services to Blue Advantage members. is a subsidiary of Blue Cross and Blue Shield of Louisiana. Oct 1, 2019 · BATON ROUGE, La. Blue Cross and Blue Shield of Louisiana encourages everyone to make plans and prepare for what they and their family will need before a storm hits. 01MA1430 R09/19 H1248_19-512_ENLU_C H1248_19-512_ENLU_C OMB Approval 0938-1051 (Expires: December 31, 2021) January 1 – December 31, 2020 Blue Advantage from Blue Cross and Blue Shield of Louisiana is a PPO plan with a Medicare contract. Prior authorization for requested services The primary coverage criteria of certain services must be established through a prior approval or pre-authorization process before they can be performed. Even better, the plan comes with the valuable extra benefits such as dental, vision, hearing and fitness coverage that helps save you even more. Apr 23, 2020 · BCBS Provider Phone Number April 23, 2020 Channagangaiah CMS 1500 blocks instructions in Medical Billing BCBS Federal Phone Number Blue Cross and Blue Shield of Louisiana and its subsidiaries, HMO Louisiana, Inc. Blue Cross and HMO Louisiana Medical Policies: Blue Cross and HMO Louisiana Medical Policies: Medicare Advantage Non-network Physician Notice Prior Authorizations Protecting Your Information Rate Justification Rights and Responsibilities Third-Party Apps Third-Party Policy Transparency in Coverage Transparency: HMOLA Transparency: LAHSIC Blue Cross and Blue Shield of Louisiana is an independent licensee of the Blue Cross Blue Shield Association. Healthy Blue Dual Advantage allows reimbursement for ambulance transport, and the services and supplies associated with the transportation, to the nearest facility equipped to treat the member. Jun 25, 2025 · Learn how to register for your online account and view your plan details. and Southern National Life, comply with applicable Federal civil rights laws and do not discriminate on the basis of race, color, national origin, age, disability or sex. The National Oceanic and Atmospheric Administration is predicting an “above-normal” hurricane season in 2020. Or learn more about prescription drugs, as well as finding helpful information and resources on providers, quality programs, and more. Prior Authorization Mandate Frequently Asked Questions Blue Cross and Blue Shield of Louisiana is streamlining its prior authorization processes. Enrollment in either Blue Advantage plan depends on contract renewal. Blue Advantage from Blue Cross and Blue Shield of Louisiana MO is an HMO plan with a Medicare contract. Blue Advantage (PPO) Annual Notice of Change 2020 H1248-006 Plan service area includes Caldwell, Catahoula, Concordia, East Carroll, Franklin, Jackson, LaSalle, Lincoln, Madison, Morehouse, Ouachita, Richland, Tensas, Union, West Carroll and Winn parishes. ). For more recent information or other questions, please contact the Blue Advantage Customer Service department toll-free at 1-866-508-7145. Plus, we ofer Group Medicare Advantage plans for employers. For the January 1, 2020, go-live of Healthy Blue Dual Advantage (HMO D-SNP), the dual-special needs Medicare Advantage plan offered by Healthy Blue, there are several useful links and phone numbers you can use to learn more. It has a monthly premium of $ 0. Blue Cross and Blue Shield of Louisiana, incorporated as Louisiana 20-107_ 132_C Health Service & Indemnity Co. Blue Advantage from Blue Cross and Blue Shield of Louisiana HMO is an HMO plan with a Medicare contract. The 2020 United States presidential election in Louisiana was held on Tuesday, November 3, 2020, as part of the 2020 United States presidential election in which all 50 states plus the District of Columbia participated. O. Blue Advantage from Blue Cross and Blue Shield of Louisiana is a PPO plan with a Medicare contract. Blue Cross and Blue Shield of Louisiana is an independent licensee of the Blue Cross Blue Shield Association. Oct 1, 2024 · Blue Cross and Blue Shield of Louisiana today announced it will be offering HMO-POS, PPO and Dual Eligible options for its 2025 Medicare Advantage plans. Blue Cross and Blue Shield of Louisiana HMO ofers Blue Advantage (HMO). Oct 10, 2024 · Every year, Medicare evaluates plans based on a 5-star rating system. Need health insurance in the New Orleans area? Louisiana Blue features Signature Blue, a plan with local doctors and hosptials to meets your family's needs. Blue Advantage requires prior authorization prior to coverage of certain durable medical equipment (DME), orthotics and prosthetics (O&P) items. BLACRPM-0008-20 515722MUPENMUB December 2020 Access the BCBSLA Provider Portal to manage your account, find resources, and handle provider-related tasks securely online. The HMO-POS plans allow out-of-network care in certain instances, while the D-SNP plan is for those eligible for both Medicare and Medicaid with cost Our new Blue adVantage Provider page is designed to give you access to the most current Blue adVantage resources. Hurricane season lasts until November 30, with the most storm activity typically happening during the summer months. Provider Directory H1248_19 -519_ENLU_C Blue Advantage (PPO) Stay home and get your medications delivered right to your door Don’t forget that your Blue Advantage plan comes with mail-order and 90-day-fill options for most drugs that we cover. We offer health insurance including medical, dental, Medicare Advantage and prescription drug coverage to individuals, families and employers. A list of services that require prior authorization can be found in the Provider Quick Reference Guide on the Blue Advantage Provider Portal accessed through iLinkBlue (www. lablue. A Louisiana Blue Medicare Advantage plan combines medical, hospital and prescription drug coverage in one convenient and affordable plan. Blue Cross Blue Shield of Louisiana and its subsidiary, HMO Louisiana, Inc. Enrollment in Blue Advantage depends on contract renewal. (collectively referred to as "Louisiana Blue") have developed these medical policies to serve as general coverage guidelines for determining if a particular Blue Advantage from Blue Cross and Blue Shield of Louisiana is a PPO plan with a Medicare contract. BLUE ADVANTAGE HMO With Blue Advantage, you don’t need to buy a separate Medicare supplement or Part D prescription drug plan. 101. If the requested services are to treat a condition due to a complication of a non-covered Blue Cross and HMO Louisiana Medical Policies: Blue Cross and HMO Louisiana Medical Policies: Medicare Advantage Non-network Physician Notice Prior Authorizations Protecting Your Information Rate Justification Rights and Responsibilities Third-Party Apps Third-Party Policy Transparency in Coverage Transparency: HMOLA Transparency: LAHSIC OUR Blue Cross and Blue Shield of Louisiana is an independent licensee of the Blue Cross Blue Shield Association. 2025 BLUE ADVANTAGE (H MO/PPO) PLANS Provider/Pharmacy Directory This directory provides a list of Blue Advantage’s current network providers and pharmacies. Plan members with Qualified Medicare Beneficiary (QMB) status are eligible for the LOUISIANABLUEADVANTAGE. Louisiana Blue Medical Policy Coverage Guidelines By clicking on "I Accept" below, I acknowledge that I can read and that I have read and accept the following. [1] Louisiana voters chose electors to represent them in the Electoral College via a popular vote, pitting the Republican Party 's nominee, incumbent President Donald Trump BCBSLA Provider Portal Blue Cross and Blue Shield of Louisiana is an independent licensee of the Blue Cross and Blue Shield Association and is incorporated as Louisiana Health Service & Indemnity Co. Details of Blue adVantage Liberty (PPO), a Louisiana Medicare Advantage Plan (2025 Plan) offered by Blue Cross and Blue Shield of Louisiana. com Healthy Blue is the trade name of Community Care Health Plan of Louisiana, Inc. . Provide LRS with the Louisiana Blue toll-free number (1-800-495-2583) to direct your call to the correct department. Complete details are in the member’s Evidence of Coverage. Helena, St Learn More about Healthy Blue Healthy Blue Dual Advantage 2 (HMO D-SNP) Plan Details, including how much you can expect to pay for coinsurance, deductibles, premiums and copays for various services covered by the plan. Blue Advantage from Blue Cross and Blue Shield of Louisiana is a PPO plan with Louisiana Blue is an independent licensee of the Blue Cross and Blue Shield Association and incorporated as Louisiana Health Service & Indemnity Company. The following is a summary of these changes. When it says “plan” or “our plan,” it means Blue Advantage (PPO). Look for a doctor, hospital, laboratory, or any other medical provider by name, specialty or location anywhere in Louisiana, and print directory results for your search. Box 98045 Baton Rouge, LA 70898-9045 A list of services that require prior authorization can be found in the Provider Quick Reference Guide on the Blue Advantage Provider Portal accessed through iLinkBlue (www. More Information Oct 10, 2024 · Medicare Advantage can be confusing. Oct 10, 2024 · Our Medicare Advantage plans combine medical, hospital and prescription drug coverage in one convenient and affordable plan. LAHB-CR-RP-067630-24-CPN67048 November 2024 and/or requirements indicate otherwise. Blue Cross and Blue Shield of Louisiana has a contract with Medicare to offer Blue adVantage (HMO) | Blue adVantage (PPO). 5-star Medicare Advantage plan. H1248_19-504_ENLU_M OMB Approval 0938-1051 (Expires: December 31, 2021) Blue Advantage (PPO) offered by Blue Cross and Blue Shield of Louisiana Annual Notice of Changes for 2020 You are currently enrolled as a member of Blue Advantage (PPO). All provider information obtained during the credentialing process is considered highly confidential. Blue Cross and Blue Shield of Louisiana is an independent licensee of the Blue Cross and Blue Shield Association and is incorporated as Louisiana Health Service & Indemnity Co. Dec 1, 2024 · If you meet Medicare coverage requirements, your drugs will still be covered under Medicare Part A or Part B even though you are enrolled in a Blue Advantage plan. com/ilinkblue). These members are also eligible to receive the additional Medicaid benefits described in the plan Evidence of Coverage. John the Baptist, St. Y0132_23-431_PVLA_C 18NW2266 R12/22 ht 2023 American Med iana HMO offers Blue Advantage (HMO). Find a provider or facility and check to see if they are in-network. It is the responsibility of the provider to secure a prior authorization before delivery of items requiring a prior authorization. An example of a partner is an Application Center. Our resources help you find a doctor and while logged in, get cost estimates. Medical Appeal Request Form 04HQ1563 R12/24 Blue Cross and Blue Shield of Louisiana is an independent licensee of the Blue Cross and Blue Shield Association. ADMINISTRATIVE APPEAL REQUEST FORM Please submit this form and supporting information to: Blue Cross and Blue Shield of Louisiana Appeals and Grievance Coordinator P. For more help in finding information you need, go to the first page of a chapter. Certain DME and O&P items are not covered by Medicare and therefore not covered by Blue Advantage. Feb 1, 2025 · Blue Cross and Blue Shield of Louisiana is an independent licensee of the Blue Cross Blue Shield Association. When this booklet says “we,” “us,” or “our,” it means Blue Cross and Blue Shield of Louisiana. TTY users should call 711. Access the BCBSLA Provider Portal for resources, tools, and services to support healthcare providers in Louisiana. Pick a primary care provider by logging into your account or by calling Blue Cross Customer Service at the number on the back of your ID card. These members are also eligible to receive the full Medicaid benefits. Healthy Blue Dual Advantage (HMO D-SNP) Plan members with full Medicaid coverage (Full Benefit Dual Eligible (FBDE)) status are eligible for the Louisiana Medicaid program, which may be responsible for payment of their Medicare cost sharing. , an independent licensee of the Blue Cross Blue Shield Association. That is why we created resources to answer some of our members' most common Medicare questions. 2025 Blue adVantage Liberty (PPO) H1248 — 007 — 0 is a PPO offered in State of Louisiana by Louisiana Health Service & Indemnity Company. Blue Advantage believes that practicing physicians must be actively involved in all aspects of healthcare improvement and cost control. Blue Advantage Resources | Providers | Louisiana Blue: By clicking on "I Accept" below, I acknowledge that I can read and that I have read and accept the following. Next year, there will be some changes to the plan’s costs and benefits This booklet tells about the What Is Blue Advantage? Blue Advantage is the product and provider network developed to serve and support our Medicare Advantage population. SAMPLE For 2025, Louisiana Blue ofers the Medicare Advantage plans Blue adVantage (HMO-POS), Blue adVantage (HMO-POS D-SNP) and Blue adVantage (PPO) to individuals across the state. This Provider/Pharmacy Directory was updated on 12/1/2024. Apr 4, 2025 · See what CMS finalized for 2026 Medicare Advantage & Part D—from prior auth and appeals fixes to the $2,100 drug cap—plus 2025 costs and steps to prepare before Oct 15–Dec 7. Medicare Advantage plan information for 2025 Blue adVantage Premier (PPO) H1248 - 004 - 0 by Louisiana Health Service & Indemnity Company. This page is intentionally left blank. This manual contains policies, procedures and general reference information, including minimum standards of care, which are required of Blue Advantage providers and govern the administration of the Medicare Advantage and Prescription Healthy Blue Dual Advantage (HMO D-SNP) Plan members with full Medicaid coverage (Full Benefit Dual Eligible (FBDE)) status are eligible for the Louisiana Medicaid program, which may be responsible for payment of their Medicare cost sharing. Blue adVantage (HMO) | Blue adVantage (PPO) Medicare Advantage Coverage Backed by Blue! With Blue adVantage (HMO) | Blue adVantage (PPO), you get Medicare coverage, plus so much more. 50. Jan 5, 2024 · You can use this insurance payer id lookup tool to search the verified latest payer ID information of all insurances in USA. Our new Blue adVantage Provider page is designed to give you access to the most current Blue adVantage resources. The Medicare Advantage (MA) Plan must follow all traditional Medicare NCDs and LCDs applicable to the MA Plan’s service area per 42 CFR § 422. Both are independent licensees of the Blue Cross and Blue Shield Association. Provider Directory H6453_19 -529_ENLU_C Blue Advantage (HMO) Blue Advantage (HMO) is a product of HMO Louisiana, Inc. Welcome to Blue Advantage! Here is where you can get all the information and answers you need to make the most of the many benefits available to you as a Blue Advantage member. BCBSLA. Blue Advantage follows the policies and procedures outlined by the Centers for Medicare & Medicaid Services (CMS). Please refer to Availity Essentials portal, Blue Advantage Coverage Policy or the member’s benefit certificate to determine which services need prior authorization. Jan 31, 2024 · Blue adVantage PCP Incentives: Rewarding Quality Care For the listening benefit of webinar attendees, we have muted all lines and will be starting our presentation shortly. , a subsidiary of Blue Cross and Blue Shield of Louisiana, an independent licensee of the Blue Cross and Blue Shield Association and incorporated as Louisiana Health Service & Indemnity Co. We've put together the most common documents and forms you might while having a BlueAdvantage plan and need for things like filing claims or reviewing your coverage. , ofers Blue Advantage (PPO). Louisiana 2021 Dual Advantage plan changes Annual benefit changes for Medicare Advantage plan members under Healthy Blue will be effective January 1, 2021. Blue Cross and Blue Shield of Louisiana and its subsidiary, HMO Louisiana, Inc. Charles, St. Here are the 10 Steps to be Blue Approved/Ready to Sell Medicare Advantage products for Louisiana Health Service & Indemnity Company d/b/a Blue Cross and Blue Shield of Louisiana and HMO Louisiana. Reimbursement is based on the guidelines in this policy. Welcome to Blue Cross and Blue Shield of Louisiana Provider Credentialing Since 1996, we have been dedicated to fully credentialing providers who apply for network participation. PayForward LLC is an independent company that administers the prepaid Flex Card benefits for Blue Cross and Blue Shield of Louisiana and Blue Cross and Blue Shield of Louisiana HMO. James, St. Blue Cross and Blue Shield of Louisiana, incorporated as Louisiana Health Service & Indemnity Co. Contact Louisiana Relay Service (LRS) for assistance. Aug 1, 2025 · This manual is designed to provide information you will need as a participant in a Blue Cross and Blue Shield of Louisiana provider network—it is an extension of your agreement(s). A. 2020 Evidence of Coverage for Blue Advantage (HMO) 1 Table of Contents 2020 Evidence of Coverage Table of Contents This list of chapters and page numbers is your starting point. This plan The purpose of this guide is to help Blue Advantage network providers reach the appropriate areas of service for our Blue Advantage (HMO) and Blue Advantage (PPO) members. Blue Cross and Blue Shield of Louisiana, an independent licensee of the Blue Cross and Blue Shield Association, ofers Blue Advantage (PPO). Blue Advantage Provider Administrative Manual 21-103_Y0132_C 18NW2234 R08/20 Blue Cross and Blue Shield of Louisiana HMO ofers Blue Advantage (HMO). , comply with applicable federal civil rights laws and do not exclude people or treat them differently on the basis of race, color, national origin, age, disability or sex. jyivt ravnj viyrn eslcdo usepj gnk wfndah kwkgtmh bxoal kvxjo