Who is responsible for getting prior plan approval from BCBSF?
• If your doctor is part of the BCBSF network, he or she is responsible for obtaining prior plan approval and should contact BCBSF for you. If an in-network doctor fails to get a required prior plan approval for a non-emergency scan, you won’t be held responsible for paying. • If your doctor is NOT part of the network or is located outside of Florida, it’s your responsibility to tell your doctor to get prior plan approval for you. It’s easy to initiate: Simply have your non-network or out-of-state doctor call the number on your ID card. If prior plan approval is not obtained, BCBSF will not pay for the scan and you will be responsible for the bill. • Remember that prior plan approval is not necessary if you’re being treated in a hospital emergency room or as a hospital inpatient.
