New Mexico Plan Participation Agreement between Blue Cross Blue Shield Assoc. and Blue Cross Blue Shield of MO regarding healthcare benefit provisions

• Category: Corporations - Public - Participation
• State: Multi-State
• Control #: US-EG-9383
• Format: Word; Rich Text

Description

Plan Participation Agreement between Blue Cross and Blue Shield Association and Blue Cross and Blue Shield of Missouri regarding health care benefit provisions (Federal Employee Program) dated January 1, 1995. 13 pages. The New Mexico Plan Participation Agreement between Blue Cross Blue Shield Association (BC BSA) and Blue Cross Blue Shield of Missouri (BCBS) encompasses various healthcare benefit provisions aimed at ensuring quality healthcare services for New Mexico residents. This agreement outlines the terms and conditions under which BCBS will provide healthcare benefits to its members in New Mexico, in partnership with BC BSA. The agreement includes detailed provisions regarding the coverage and reimbursement of medical, hospital, and pharmaceutical services. It establishes a comprehensive network of healthcare providers, ensuring that BCBS members have access to a wide range of healthcare professionals and facilities. The agreement also specifies the cost-sharing arrangements, such as deductibles, co-payments, and coinsurance, to be implemented for different healthcare services. One key aspect of the agreement is the provision for preventive care, which focuses on promoting wellness and early detection of illnesses. It outlines the specific preventive services that BCBS will cover, such as immunizations, screenings, and annual check-ups, emphasizing the importance of proactive healthcare management. Another significant provision relates to the management of chronic conditions. The agreement recognizes the need for specialized care and tailored treatment plans for individuals with chronic illnesses. It includes provisions for disease management programs, coordination of care, and access to necessary medications, aimed at improving health outcomes and reducing hospitalizations. Furthermore, the New Mexico Plan Participation Agreement addresses the availability of mental health and substance abuse services. It ensures that BCBS members have access to an extensive network of mental health providers and that coverage is provided for necessary treatment and counseling services. In addition, the agreement covers emergency medical services, including ambulance transportation and emergency room visits, outlining the conditions under which these services will be covered. It also details the process for member grievances and appeals, ensuring that BCBS members have a mechanism to voice their concerns and seek resolution. It is important to note that the specific types of New Mexico Plan Participation Agreements between BC BSA and BCBS may vary based on factors such as employer groups, individual plans, or government programs. These agreements may have different provisions and coverage options tailored to the needs of specific groups or programs. In summary, the New Mexico Plan Participation Agreement between BC BSA and BCBS is a comprehensive document outlining the healthcare benefit provisions for BCBS members in New Mexico. It covers various aspects of healthcare, including preventive care, chronic disease management, mental health services, emergency care, and member support. The specific types of agreements may differ based on different plans or programs.

The New Mexico Plan Participation Agreement between Blue Cross Blue Shield Association (BC BSA) and Blue Cross Blue Shield of Missouri (BCBS) encompasses various healthcare benefit provisions aimed at ensuring quality healthcare services for New Mexico residents. This agreement outlines the terms and conditions under which BCBS will provide healthcare benefits to its members in New Mexico, in partnership with BC BSA. The agreement includes detailed provisions regarding the coverage and reimbursement of medical, hospital, and pharmaceutical services. It establishes a comprehensive network of healthcare providers, ensuring that BCBS members have access to a wide range of healthcare professionals and facilities. The agreement also specifies the cost-sharing arrangements, such as deductibles, co-payments, and coinsurance, to be implemented for different healthcare services. One key aspect of the agreement is the provision for preventive care, which focuses on promoting wellness and early detection of illnesses. It outlines the specific preventive services that BCBS will cover, such as immunizations, screenings, and annual check-ups, emphasizing the importance of proactive healthcare management. Another significant provision relates to the management of chronic conditions. The agreement recognizes the need for specialized care and tailored treatment plans for individuals with chronic illnesses. It includes provisions for disease management programs, coordination of care, and access to necessary medications, aimed at improving health outcomes and reducing hospitalizations. Furthermore, the New Mexico Plan Participation Agreement addresses the availability of mental health and substance abuse services. It ensures that BCBS members have access to an extensive network of mental health providers and that coverage is provided for necessary treatment and counseling services. In addition, the agreement covers emergency medical services, including ambulance transportation and emergency room visits, outlining the conditions under which these services will be covered. It also details the process for member grievances and appeals, ensuring that BCBS members have a mechanism to voice their concerns and seek resolution. It is important to note that the specific types of New Mexico Plan Participation Agreements between BC BSA and BCBS may vary based on factors such as employer groups, individual plans, or government programs. These agreements may have different provisions and coverage options tailored to the needs of specific groups or programs. In summary, the New Mexico Plan Participation Agreement between BC BSA and BCBS is a comprehensive document outlining the healthcare benefit provisions for BCBS members in New Mexico. It covers various aspects of healthcare, including preventive care, chronic disease management, mental health services, emergency care, and member support. The specific types of agreements may differ based on different plans or programs.