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12 11/2005
Eligibility & Benefits Verification
The following is a list of steps to take to verify eligibility and benefits of BCBSGa/
BCBSHP members.
• Capture the information listed on the member’s ID card for billing purposes.
Also, copy the front and back of the member’s ID card and file in the member’s
chart for future reference.
• Verify eligibility and benefits
before
rendering services via our web site or by
calling the appropriate telephone number based on the member’s benefit plan.
The telephone number can be found on the front of the member’s ID card.
• For the BCBSGa/BCBSHP plans listed below, verification of a member’s eligibility
and benefits can be conducted via the internet at www.bcbsga.com. Once you
have obtained the required logon ID and password, you may verify the
member’s eligibility and basic benefit information via the internet. Instructions
for requesting the required logon ID and password are found on the Provider
Corner of the web site.
• BlueChoice Healthcare Plan (HMO)
• BlueChoice Option (POS)
• Blue Direct
• BlueChoice PPO
• Traditional Health Plan (Indemnity)
• Hospital/Surgical
• Select self-funded groups
• Verification of a member’s eligibility and benefits can also be conducted via the
telephone Voice Response Unit (VRU) at 1-800-241-7475 24 hours, 7 days per
week.
• For all other plans, verification of a member’s eligibility and benefits can be
made directly to a customer service associate by telephone. Please refer to the
front of the member’s ID card for the appropriate customer service telephone
number.