Does BCBS follow Medicare guidelines?

Does BCBS follow Medicare guidelines? Yes, BCBS follows Medicare NCCI edits and the same has been incorporated into BCBS editing system. BCBS considers CMS NCCI edits are a recognized industry source for relationships between codes.

Is Blue Cross Blue Shield considered MassHealth?

If you see a doctor or other provider who is in the Blue Cross Blue Shield network but is NOT a MassHealth provider, as long as the service is a MassHealth covered service, MassHealth will reimburse you for your out-of-pocket costs up to what you would be responsible for under MassHealth.

Is Blue Cross Blue Shield of Massachusetts private insurance?

Blue Cross Blue Shield of Massachusetts (BCBSMA) is a state licensed nonprofit private health insurance company under the Blue Cross Blue Shield Association with headquarters in Boston.

How does Blue Cross Blue Shield medical policy work?

We strive to offer our members the latest in proven medical technologies by reviewing current scientific evidence and considering expert physician opinion when we develop our medical policies. Each month, our Medical Policy Group meets to review the policies for a specific specialty.

Who is involved in the Massachusetts Medical Society?

We incorporate input from the Massachusetts Medical Society, specialty societies, national technology review organizations and community physicians in the development and review of all policies. Searching for a medical policy?

What does it mean to have a medical policy?

Medical policies are scientific documents that define the technologies, procedures, and treatments that are considered medically necessary, not medically necessary, and investigational link to investigational policy. Our medical policies help us determine what technology, procedure, treatment, supply, equipment, drug, or other service we’ll cover.