Host Blue definition

Host Blue means the local Blue Cross and/or Blue Shield plan or licensee in a geographic area outside of the Wellmark service area.

Host Blue means the independent Blue Cross and/or Blue Shield Licensees (Plans and certain Plan affiliates) that participate in Inter-Plan Programs and provide PROVIDER network access and claim pricing for other independent Blue Cross and/or Blue Shield Licensees (Plans and certain Plan affiliates), including BCBSNC, when Members receive medical services in that Host Blue's service area.

Host Blue means a local Blue Cross and/or Blue Shield licensee outside the geographic area that Claim Administrator serves.

Examples of Host Blue in a sentence

• However, the Host Blue is responsible for contracting with and generally handling all interactions with its participating providers.

• This excess amount reflects an amount that may be necessary to secure (a) the Provider’s participation in the network and/or (b) the overall discount negotiated by the Host Blue.

• Some providers (“nonparticipating providers”) don’t contract with the Host Blue.

• Often, this “negotiated price” will be a simple discount that reflects an actual price that the Host Blue pays to your healthcare provider.

• In some cases, the Host Blue will engage a third party to assist in identification or collection of recovery amounts.

• Group understands and agrees to reimburse BCBSM for certain fees and compensation which we are obligated under applicable Inter-Plan Arrangement requirements to pay to the Host Blue, to the Blue Cross and Blue Shield Association, and/or to vendors of Inter-Plan Arrangement-related services.

• Sometimes, this negotiated price may be greater for a given service or services than the billed charge in accordance with how the Host Blue has negotiated with its Participating Provider(s) for specific healthcare services.

• Under the BlueCard® Program, when you receive covered healthcare services within the geographic area served by a Host Blue, we will remain responsible for doing what we agreed to in the contract.

• The Host Blue will not receive compensation from how the estimated price or average price methods, described above, are calculated.

• A Host Blue may include all provider reimbursement obligations in Claims or may, at its election, collect some or all of its value-based provider (VBP) reimbursement obligations through a per attributed member per month (PaMPM) benefit expense, as in, for example, the Blue Distinction Total Care (BDTC) Program.

More Definitions of Host Blue

Host Blue means a local Blue Cross and Blue Shield licensee outside the geographic area that Claim Administrator serves.

Host Blue means the independent Blue Cross and/or Blue Shield Licensees (Plans and certain Plan affiliates) that participate in Inter-Plan Programs and provide Provider network access and claim pricing for other independent Blue Cross and/or Blue Shield Licensees (Plans and certain Plan affiliates), including BCBSNC, when Members receive medical services in that Host Blue’s service area.