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Name of Manual - Blue Cross and Blue Shield of Minnesota

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Referral Not Required<br />

(continued)<br />

<strong>Blue</strong> Plus<br />

• One postpartum home care visit, if the visit follows an early<br />

discharge. Early discharge for a vaginal delivery would be<br />

within 48 hours <strong>of</strong> delivery <strong>and</strong>, for C-section, within 96 hours<br />

<strong>of</strong> delivery<br />

• Oral <strong>and</strong> maxill<strong>of</strong>acial surgeons<br />

• Orthodontists<br />

• Outpatient emergency room services <strong>and</strong> associated services<br />

• Outpatient observation room<br />

• Prescription drug (pharmacy)<br />

• Services for the diagnosis <strong>of</strong> infertility<br />

• Testing <strong>and</strong> treatment <strong>of</strong> a sexually transmitted disease<br />

• Testing for AIDS or other HIV-related conditions<br />

• Voluntary planning <strong>of</strong> the conception <strong>and</strong> bearing <strong>of</strong> children<br />

PCCs can contact us to implement a PCC-specific referral bypass<br />

for their managed care members. This is beneficial when you<br />

continually refer to a specific provider.<br />

<strong>Blue</strong> <strong>Cross</strong> <strong>Blue</strong> <strong>Shield</strong> <strong>of</strong> <strong>Minnesota</strong> Provider Policy <strong>and</strong> Procedure <strong>Manual</strong> (12/27/10) 6-15

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