506 Amita Health Cin (2024)

FAQs

What is IL Blue Precision HMO? ›

Key Blue Precision HMO® Plan features include:

Lower out-of-pocket costs and monthly premiums than PPO plans. May help keep your costs lower and more predictable. You must select a network primary care physician (PCP), who coordinates your care within the network. Referral required to see a specialist.

To change your PCP or medical group (HMO members only), sign in to your BAM account and click on Find Care. Use our Provider Finder tool to find network provider options in your area. Once you're ready to make your selection, click the Change MG or Change PCP option and follow the prompts to choose your new provider.

Payer ID: NAING

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HMO plans are generally less expensive than PPO plans, with lower monthly payments, making them ideal if your favorite doctors are already in the network, or if you receive most of your care close to home.

HMOs don't offer coverage for care from out-of-network healthcare providers. The only exception is for true medical emergencies. With a PPO, you have the flexibility to visit providers outside of your network. However, visiting an out-of-network provider will include a higher fee and a separate deductible.

The Payer ID or EDI is a unique ID assigned to each insurance company. It allows provider and payer systems to talk to one another to verify eligibility, benefits and submit claims. The payer ID is generally five (5) characters but it may be longer. It may also be alpha, numeric or a combination.

The Payer ID number assigned by the clearinghouse to the payer.

United Health Care (UHC), Optum, and United Behavioral Health (UBH) are all “Optum” companies which handle mental health claims. All of these companies use the same Payer ID to file claims (87726), so they all end up in the same place at the end of the day.

Blue Cross Blue Shield of Illinois offers many different HMO plans, all with different premiums, deductibles, copays, and coinsurance rates.

Most HMOs provide care through a network of doctors, hospitals and other medical professionals that you must use to be covered for your care. With an HMO-POS you can go outside of the network for care, but you'll pay more.

What is the meaning of HMO in Humana? ›

HMO stands for health maintenance organization. HMOs have their own network of doctors, hospitals and other healthcare providers who have agreed to accept payment at a certain level for any services they provide. This allows the HMO to keep costs in check for its members.

A type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO. It generally won't cover out-of-network care except in an emergency.