- Impacted insurer and plansSee the insurer name, plan names and product IDs.
- Out-of-network liability and balance billingUnderstand out-of-network costs, balance billing risks, and when we may apply in‑network benefits for non-preferred providers or emergency care.
- Medical member claims submissionA covered person or an authorized representative can submit written proof of any service, supply, prescription drug, test, equipment or other treatment up to 180 days after the service.
- Grace periods and claims pending policies during the grace periodLearn how health insurance grace periods work, how unpaid premiums affect claim processing, and what happens to pending claims during 30‑day and 3‑month grace periods.
- Retroactive denialsA retroactive denial occurs when it is discovered that a claim that was processed and paid, but which should not have been paid.
- Member recoupment of overpaymentsMembers are advised to contact customer service with any questions regarding premium overpayments.
- Medical necessity and prior authorization timeframes and member responsibilitiesLearn how we evaluate medical necessity, prior authorization requirements, denial reasons, and member responsibilities for approved services.
- Drug exceptions time frames and member responsibilitiesLearn how to request drug exceptions, required documentation, review timeframes, and member appeal and external review rights for non‑covered medications.
- Information on Explanation of BenefitsThe Explanation of Benefits is designed to make claims processing easier to understand.
- Coordination of benefitsCoordination of Benefits (COB) applies when an individual has coverage under more than one Health Benefit Plan.
Network status (Alert 1 of 1)
Support
Maybe one of these will help:
Sign in to Blueprint Portal
Blueprint Portal is a members-only website that will help you understand and manage your health plan so you’re able to find quality, patient-focused healthcare at the best possible price.
- Review claims history
- Check deductible and out-of-pocket totals
- View and order replacement ID cards
- Find a provider or hospital
- Estimate treatment costs
- View pharmacy information
- Review a recent doctor visit