2025 Blue Cross and Blue Shield Service Benefit Plan - FEP Blue Focus
Index
Page 141
Index
Page 141
National Doctor & Hospital Finder - 104
Neurological testing - 38, 68-71
Never Events - 6-8, 135
Newborn care - 27, 37-38, 43-44, 66-68
No Surprises Act (NSA) - 30-31
NON-CORE benefits - 35, 135
Non-member facilities - 14-15, 17-18
Non-participating providers - 30, 136-137
Non-preferred providers - 14-15, 17, 30
Non-PSHB benefits - 110
Nurse - 52-53, 72-74, 103
Nutritional counseling - 37-43, 65-66, 105
Observation care - 135
Obstetrical care - 43-44, 66-68
Occupational therapy - 48, 68-72
Office visits - 37-38, 80-81
Oral surgery - 58
Organ/tissue transplants - 54-63
Orthopedic devices - 50, 68-71
Osteoporosis screening - 138
Ostomy and catheter supplies - 52
Out-of-pocket expenses - 31-32
Outpatient facility services - 68-71, 102
Outpatient professional services - 37-38, 80-81
Overpayments - 32
Overseas Assistance Center - 107
Overseas services, drugs, supplies and claims - 107-109
Oxygen - 51-52, 72-74
Pap tests - 39-43
Participating providers - 30, 136-137
Patient Safety and Quality Monitoring (PSQM) program - 86-87
Personal Health Record - 103
PET scans - 38, 68-71
Pharmacotherapy - 37-38, 47
Physical examinations - 39-43, 68-71, 111-112
Physical therapy - 48, 68-74
Physician - 14-15, 124, 128-129, 133
Plan allowance - 136-137
PPO - 14-15, 17-18, 137
Pre-admission testing - 65-66
Precertification - 20, 137
Preferred providers - 14-15, 17, 104
Pregnancy (see: Maternity care)
Prescription drugs
Prior approval - 20-23, 25-26, 138
Professional providers - 14-15, 17
Prostate cancer - 39-41
Prosthetic devices - 50, 65-66, 68-71
Psychotherapy - 80-83
Pulmonary rehabilitation - 47, 68-71
Radiation therapy - 47, 68-71
Reconsiderations - 27-28, 116-118
Replacement coverage - 13
Reproductive services - 45-46, 131Residential treatment center (RTC) - 17-18, 71-72, 82
Rights and responsibilities - 14-15
Room and board - 65-68, 71-72, 82
Routine Annual Physical Incentive Program - 106
Screening services - 39-41, 138
Second surgical opinion - 37-38
Self-injectable drugs - 84
Skilled nursing facility (SNF) care - 72
Smoking cessation - 53, 96-99
Social worker - 104-105
Specialty Drug Pharmacy Program - 84-89, 114
Specialty drugs - 84-86, 88-89, 94-95, 138
Speech therapy - 48, 68-74
Speech-generating devices - 51-52
Stem cell transplants - 59-62
Sterilization procedures - 44-45
Subrogation - 121-122, 138
Substance use disorder - 80-83, 139
Surgery - 54-63
Tobacco cessation - 53, 96-99
Transplants - 54-63
Travel benefit - 62, 103
Treatment therapies - 47
TRICARE - 120-121
Ultrasounds - 38, 68-71
Urgent care center - 76-79
Urgent care claims - 26, 139
VA facility - 32, 129
Vaccines - 39-43, 96-99
Verbal statements - 28, 104-105
Vision services - 49, 122
Waivers - 30
Weight control - 20-23, 103
Wheelchairs - 51-52
Wigs - 50
WRAP benefits - 35, 139
X-rays - 38, 68-71
Neurological testing - 38, 68-71
Never Events - 6-8, 135
Newborn care - 27, 37-38, 43-44, 66-68
No Surprises Act (NSA) - 30-31
NON-CORE benefits - 35, 135
Non-member facilities - 14-15, 17-18
Non-participating providers - 30, 136-137
Non-preferred providers - 14-15, 17, 30
Non-PSHB benefits - 110
Nurse - 52-53, 72-74, 103
Nutritional counseling - 37-43, 65-66, 105
Observation care - 135
Obstetrical care - 43-44, 66-68
Occupational therapy - 48, 68-72
Office visits - 37-38, 80-81
Oral surgery - 58
Organ/tissue transplants - 54-63
Orthopedic devices - 50, 68-71
Osteoporosis screening - 138
Ostomy and catheter supplies - 52
Out-of-pocket expenses - 31-32
Outpatient facility services - 68-71, 102
Outpatient professional services - 37-38, 80-81
Overpayments - 32
Overseas Assistance Center - 107
Overseas services, drugs, supplies and claims - 107-109
Oxygen - 51-52, 72-74
Pap tests - 39-43
Participating providers - 30, 136-137
Patient Safety and Quality Monitoring (PSQM) program - 86-87
Personal Health Record - 103
PET scans - 38, 68-71
Pharmacotherapy - 37-38, 47
Physical examinations - 39-43, 68-71, 111-112
Physical therapy - 48, 68-74
Physician - 14-15, 124, 128-129, 133
Plan allowance - 136-137
PPO - 14-15, 17-18, 137
Pre-admission testing - 65-66
Precertification - 20, 137
Preferred providers - 14-15, 17, 104
Pregnancy (see: Maternity care)
Prescription drugs
Drugs from other sources - 100
Generic drugs - 84-89, 91-92, 94-95
Preferred retail pharmacies - 84-86, 88-89, 114
Retail Pharmacy Program - 84-86, 108-109
Self-injectable drugs - 84
Specialty Drug Pharmacy Program - 84-86, 88-89, 114
Specialty drugs - 84-86, 88-89, 91-92, 94-95, 138
Generic drugs - 84-89, 91-92, 94-95
Preferred retail pharmacies - 84-86, 88-89, 114
Retail Pharmacy Program - 84-86, 108-109
Self-injectable drugs - 84
Specialty Drug Pharmacy Program - 84-86, 88-89, 114
Specialty drugs - 84-86, 88-89, 91-92, 94-95, 138
Preventive care
Primary care provider (PCP) - 35Prior approval - 20-23, 25-26, 138
Professional providers - 14-15, 17
Prostate cancer - 39-41
Prosthetic devices - 50, 65-66, 68-71
Psychotherapy - 80-83
Pulmonary rehabilitation - 47, 68-71
Radiation therapy - 47, 68-71
Reconsiderations - 27-28, 116-118
Replacement coverage - 13
Reproductive services - 45-46, 131Residential treatment center (RTC) - 17-18, 71-72, 82
Rights and responsibilities - 14-15
Room and board - 65-68, 71-72, 82
Routine Annual Physical Incentive Program - 106
Screening services - 39-41, 138
Second surgical opinion - 37-38
Self-injectable drugs - 84
Skilled nursing facility (SNF) care - 72
Smoking cessation - 53, 96-99
Social worker - 104-105
Specialty Drug Pharmacy Program - 84-89, 114
Specialty drugs - 84-86, 88-89, 94-95, 138
Speech therapy - 48, 68-74
Speech-generating devices - 51-52
Stem cell transplants - 59-62
Sterilization procedures - 44-45
Subrogation - 121-122, 138
Substance use disorder - 80-83, 139
Surgery - 54-63
Assistant surgeon - 19, 36, 55-56
Eye: cataract, amblyopia, strabismus - 49, 55-56
Gender affirming - 54-57
Multiple procedures - 54-56
Oral and maxillofacial - 58
Outpatient - 68-71
Reconstructive - 56-57
Sterilization, reversal of voluntary - 44-45, 55-56
Surgical implants - 50, 68-71
Surgical treatment of morbid obesity - 20-23
Transplants - 20-23, 58-62
TelehealthEye: cataract, amblyopia, strabismus - 49, 55-56
Gender affirming - 54-57
Multiple procedures - 54-56
Oral and maxillofacial - 58
Outpatient - 68-71
Reconstructive - 56-57
Sterilization, reversal of voluntary - 44-45, 55-56
Surgical implants - 50, 68-71
Surgical treatment of morbid obesity - 20-23
Transplants - 20-23, 58-62
Dermatology - 37-38, 139
Mental health/substance use disorder - 105
Minor acute conditions - 17, 37-38, 105, 135
Nutritional counseling - 105
Temporary Continuation of Coverage (TCC) - 12-13Mental health/substance use disorder - 105
Minor acute conditions - 17, 37-38, 105, 135
Nutritional counseling - 105
Tobacco cessation - 53, 96-99
Transplants - 54-63
Travel benefit - 62, 103
Treatment therapies - 47
TRICARE - 120-121
Ultrasounds - 38, 68-71
Urgent care center - 76-79
Urgent care claims - 26, 139
VA facility - 32, 129
Vaccines - 39-43, 96-99
Verbal statements - 28, 104-105
Vision services - 49, 122
Waivers - 30
Weight control - 20-23, 103
Wheelchairs - 51-52
Wigs - 50
WRAP benefits - 35, 139
X-rays - 38, 68-71