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11/2005
Table of Contents -
Continued
Claim Payment.......................................................................................46
Reimbursement .....................................................................................47
Fee Schedule Request Procedure....................................................48 - 50
Remittance Advice Reconciliation................................................... 51 - 54
Refund Recovery............................................................................ 55 - 58
Coordination of Benefits ................................................................59 - 60
Provider/Practitioner Complaint and Appeals Process ....................61 - 64
Member Appeal Process................................................................. 65 - 69
BlueCard Program..................................................................................70
EDI Services ...........................................................................................71
Preferred Drug List ................................................................................72
Mail Order Drug Program.......................................................................73
Glossary ........................................................................................ 74 - 83