Members

Members

www.deltadentalma.com (Delta Dental MA)

Additional Links: www.webmdhealth.com (How healthy are you? Take WebMD’s Health Assessment)

SP576 Member Guide NO ROM 5.11

Helpful Member Information:

Anthem Blue Cross & Blue Shield / Member Services
800-327-9232
To request ID Cards
To ask questions relative to Benefits and Claims
To change Primary Care Physician (PCP)

Anthem Prescription Management
800-455-5949
To request ID Cards
To ask general prescription questions
To utilize the mail order RX Program ($10/25/40 co-pay for three month supply)

Anthem Behavioral Health (Mental Health/Substance Abuse)
800-441-6613
To obtain pre-certification (necessary for all treatment)
To find a qualified provider in your area

KGA (Employee Assistance Program)
800-648-9557
www.kgreer.com
“Your EAP and work life program – free, confidential assistance for you and your household members”

Fallon Community Health Plan / Member Services 800-868-5200
To request ID Cards
To ask questions relative to Benefits and Claims
To change Primary Care Physician (PCP)

General Information
A referral id required for all non primary care physician (specialist) visits

You must contact your PCP within 48 hours of an emergency room visit

When visiting an In-Network Provider, patient is only responsible for office co-pay (There should be no balance billing from the Provider), assuming a referral is obtained if services are rendered by a provider other than the patient’s PCP.

The patient is not responsible for any bills received for anesthesia, radiology, or pathology if incurred in conjunction with an in-network hospitalization. Most times the company billing for those charges has not been notified of your coverage. If bills are received, contact your provider with your ID number and ask them to submit to Blue Cross.

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