Frequently Asked Questions about UT Select

Q. How do I locate a network provider or contracting facility?

A. Check your network provider directory, call Customer Service at 1-866-882-2034 or visit www.bcbstx.com/ut.

Q. What if I’m already in treatment when I enroll and my provider isn’t in the network?

A. We’ll work with you to provide the most appropriate care for your medical situation, especially if you are pregnant or receiving treatment for a serious illness. You may still be able to see your out-of-network provider for a period of time and receive network benefits. If you are not eligible for network benefits, you may continue to see your provider if you’re willing to pay more for your care. Ask your benefits office for a transition of care form to complete and return so your care can be coordinated.

Q. What if I want only one network provider to handle my care?

A. You are encouraged to use network providers so you will receive your plan’s highest level of benefits. If you want, you may choose a specific network provider, so he or she will know your medical history and can coordinate all your care. But you always have the freedom to choose your doctor each time you need care.

Q. What happens if I go to a ParPlan physician instead of a network provider?

A. Either way, you receive benefits for covered services. Participating physicians offer services plus cost advantages when you go out-of-network or are not in a service area. Participating physicians have agreed to accept an allowable amount for covered services and may file your claims. When going to a participating physician, you will receive out-of-network benefits.

Q. If I have to see an out-of-network provider, what should I do?

A. If your network provider wants you to see an out-of-network provider, Blue Cross and Blue Shield of Texas must be notified and must authorize care from an out-of-network provider in order for you to get network benefits. You will receive a notification letter indicating whether this request has been approved or denied. If you go out-of-network, you will receive out-of-network benefits. You will be responsible for filing claims. Also, you can be balance billed if you go to an out-of-network provider that has no contract with a Blue Cross and Blue Shield Plan.

Q. What happens if I need a hospital admission?

A. All hospital admissions and certain extended care services (such as home health care, home infusion therapy, etc.) must be precertified (refer to your Benefit Booklet). A network provider will precertify your network care, but you are generally responsible for precertifying any out-of-network care. To precertify services, call 1-800-441-9188. The phone number is also listed on your medical ID card.

Q. What happens if I need emergency care?

A. Get care immediately. Your coverage includes benefits for emergency care. Be sure to have someone call the precertification number on your medical ID card within 48 hours of any hospital admission.

Q. What is an emergency?

A. It’s a serious accident or a medical condition that, if not treated immediately, might result in a life-threatening situation. Some examples of a medical emergency are:

• unusual or excessive bleeding

• convulsions

• broken bones

• difficulty breathing

• loss of consciousness

• suspected heart attack or stroke

• acute abdominal or chest pain

• severe or multiple injuries or burns

• poisoning

• sudden, persistent pain

Remember: If an emergency occurs, call 911, your local ambulance, or go to the nearest emergency room.

Q. What coverage is available if my dependent child lives away from home?
What if something happens while I’m on vacation?

A. Your plan covers you whether you’re at home or away. If you are outside of the Texas service area, your UT SELECT ID card gives you access to network providers throughout the United States. The PPO-in-a-suitcase logo tells providers that you are part of the BlueCard PPO Program. Refer to your ID card and call BlueCard Access at 1-800-810-BLUE (2583) for information on the nearest BlueCard PPO doctors and hospitals.

Q. What if I need mental health care or chemical dependency treatment?

A. Benefits for these services can be obtained by calling the INROADS Behavioral Health Services at 1-800-528-7264.

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Source: http://www.bcbstx.com/ut/pdf/utselect_qa.pdf