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141

 
 
Document Number:
PSB25-141
Revision #:
v1.0
Date Published:
1/1/2025
 

 

2025 Blue Cross and Blue Shield Service Benefit Plan - Standard and Basic Option
Section 7. Filing a Claim for Covered Services

Page 141

 

Any notice of an adverse benefit determination or correspondence from us confirming an adverse benefit determination will include information sufficient to identify the claim involved (including the date of service, the healthcare provider, and the claim amount, if applicable), and a statement describing the availability, upon request, of the diagnosis code and its corresponding meaning, and the procedure or treatment code and its corresponding meaning.

 

Go to page 140.  Go to page 142.
 

Blue Cross Blue Shield Federal Employee Program
Confidential - Internal Plan use only