Provider Center Guide - Regence BlueShield

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How to find benefit informationSelecting the ‘View Coverage’ link (see page 1) will direct you to the Eligibility and Benefits Summaryscreen. The following pages show sample screenshots of the sections that will appear on this screen.Note: Please verify each patient’s information online.Expanded member infoThis section provides an overviewof the member’s information.Any information we have for themember’s primary insurancecarrier, including the name andeffective date will be shownhere. Any pre-existing credits willalso be shown with the originaleffective date.In the dark blue bar at the bottomof this section, you can search foreligibility and benefit informationfor a prior date of coverage byentering the date and selecting‘Submit New Date’.Benefit Summary As ofThis section includes theproduct name, effective dateand status.You can also view themember’s applicablecoinsurance andcopayment information.Information is shown for:• In- and out-of-networkproviders• Upfront benefits• Emergency room• Childhood immunizations• Office visitsPage 2 of 4
Download PDF BookletsSelecting the ‘Complete Plan Booklet’ opens a PDF of the member’sBenefit Booklet which outlines all of the members benefits in detail.(This document can be several hundred pages in length.)Selecting the ‘Summary of Plan’ opens a PDF document thatbriefly describes the member’s benefits and exclusions.(This document is usually just a few pages. See sample below.)Sample Summary of Plan documentView medical multi-year accumulatorsTo view your patient’s benefit maximums, how much he or she hasused to date, and how much of each benefit is remaining, selectthe service from the drop-down menu. Then select ‘Submit’. Themulti-year accumulator information will be displayed below.Page 3 of 4
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Provider Center Guide - Regence BlueShield

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