Don’t submit referrals for members with BCN point-of-service plans.
POS health plan referrals cannot be submitted via 3-referral
Blue Care Network POS health plans don’t require referrals. Beginning April 1, 2024, the e–referral system will reject all referrals submitted for BCN POS health plans.
Blue Care Network point-of-service health care plans allow members to receive covered services with any health care provider, in or out of network, with no referral required. Beginning in March 2024, the e-referral system will reject all referrals submitted for BCN POS health plans. How do you know which of your BCN patients don’t need a referral?
- BCN point-of-service health plan plastic member ID cards feature the BCN logo as well as the health plan name, which includes “POS” (for example, Blue Elect Plus POS, Healthy Blue Choices POS).
- The back of BCN point of service health plan plastic member ID cards have a statement saying the POS plan doesn’t require a referral.
- When you check member eligibility and benefits in our provider portal, through an electronic transaction or by calling Provider Inquiry, you’ll receive a message stating that the member can self-refer to any provider for covered services with no referral required. Although referrals aren’t required, BCN POS health plan members will have lower out-of-pocket costs when they receive services from an in-network provider. Note: Some services are only covered when performed by in-network providers, and some services require authorization by BCN. More information is available on the Blue Elect Plus POS webpage and the Healthy Blue Choices POS webpage.
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