Testing the abilities - Regence BlueShield

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Network Service Area - Definitions • Out of Area (OOA) or Outside the Service Area - is outside the specific counties that RealValue is available • Out of Network (OON) is when we do not have a contracted provider providing the service © 2012 Regence. Private and Confidential. 24
Emergency, Urgent Care and Preventive Services Out of Network In Service Area Out of Area Emergency Covered Covered Urgent Care Not Covered Covered Preventive Service Not Covered Not Covered • Urgent Care Services • Outside-the-service-area is covered regardless of where it is provided • Within the service area members must obtain urgent care from a RealValue contracted facility • Preventive Services (PPACA and non-PPACA Preventive) • Outside-the-service-area is not covered • Within the service area members must obtain preventive care from a RealValue contracted facility © 2012 Regence. Private and Confidential. 25
Page 1 and 2: Regence RealValue SM Producer Train
Page 3 and 4: New WA Products • Quote date 4/15
Page 6 and 7: Regence RealValue BENEFIT DESIGN ©
Page 8 and 9: Regence RealValue In-Network Upfron
Page 10 and 11: Regence RealValue Exclusions • Ac
Page 12 and 13: Outside the Service Area • Outsid
Page 14 and 15: Dental Options As with the Evolve s
Page 16 and 17: Regence RealValue Network • The R
Page 18 and 19: King County Hospital Participation
Page 20 and 21: Snohomish County Hospital Participa
Page 22 and 23: Kitsap and Thurston Counties Hospit
Page 26 and 27: Covered services received Within- T
Page 28 and 29: Referral to an Out-of-Network Provi
Page 30 and 31: Pricing Rates • Approved Annual r
Page 32 and 33: Member Card © 2012 Regence. Privat
Page 34 and 35: RealValue EOB © 2012 Regence. Priv
Page 36 and 37: Regence RealValue MARKETING © 2012
Page 38 and 39: Key Messages • More of what you n
Page 40: Questions Q&A Producer Support 800-

Testing the abilities - Regence BlueShield

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