Is the billing and payment process the same for a non-network hospital?
No. When you use a network hospital, the hospital submits a claim to the local Blue Cross plan and Blue Cross reimburses the hospital. Claims for services performed at a non-network hospital must be submitted to Empire BCBS. A non-network hospital may or may not submit a claim to Empire BCBS. If a non-network hospital will not bill Empire BCBS directly, the enrollee must submit an itemized bill to Empire BCBS. Once the bill is submitted to Empire BCBS, benefits will be determined and a check will be mailed to the enrollee. It is then the enrollees responsibility to reimburse the hospital.
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