Urgent Services Benefits Sample Clauses

Urgent Services Benefits. To receive urgent care within your Primary Care Physician Service Area, call your Primary Care Physician’s office or follow instructions given by your assigned Medical Group/IPA in accordance with the How to Use This Health Plan section. When outside the Plan Service Area, Members may receive care for Urgent Services as follows: Inside California For Urgent Services within California but outside the Member’s Primary Care Physician Service Area, the Member should, if possible, contact Blue Shield Member Services at the number provided on the back page of this booklet in accordance with the How to Use This Health Plan section. Member Services will assist Members in receiving Urgent Services through a Blue Shield of California Provider. Mem- bers may also locate a Blue Shield Provider by vis- iting Blue Shield’s internet site at xxx.xxxxxxxxxxxx.xxx. You are not required to use a Blue Shield of California provider to receive Ur- gent Services; you may use any provider. However, the services will be reviewed retrospectively by Blue Shield to determine whether the services were Ur- gent Services. Outside California or the United States When temporarily traveling outside California, call the 24-hour toll-free number 1-800-810-BLUE (2583) to obtain information about the nearest Blue- Card or Blue Shield Global Core participating provider. When a BlueCard or Blue Shield Global Core participating provider is available, you should obtain Urgent Services and Out-of-Area Follow-up Care from a participating provider whenever possi- ble, but you may also receive care from a non-par- ticipating provider. The services will be reviewed retrospectively by Blue Shield to determine whether the services were Urgent Services. For information on Urgent Services received outside of California see the Inter-Plan Arrangements section of the EOC. Up to two Medically Necessary Out-of-Area Fol- low-up Care outpatient visits are covered. Authoriza- tion by Blue Shield is required for more than two fol- low-up outpatient visits. Blue Shield may direct the Member to receive the additional follow-up care from their Primary Care Physician. Principal Limitations, Exceptions, Exclusions and Reductions General Exclusions and Limitations No Benefits are provided for the following:

Urgent Services Benefits. To receive urgent care within your Primary Care Physician Service Area, call your Primary Care Physician’s office or follow instructions given by your assigned Medical Group/IPA in accordance tion by Blue Shield is required for more than two fol- low-up outpatient visits. Blue Shield may direct the Member to receive the additional follow-up care from their Primary Care Physician.