MONTEREY PARK (February 28, 2019) – Blue Shield of California Promise Health Plan (Blue Shield Promise) is closely monitoring the winter storm conditions in Los Angeles and San Diego counties in response to the Governor’s State of Emergency declaration. The nonprofit health plan has established, documented and implemented emergency response procedures to ensure that affected members had timely access to covered medical and behavioral health services.
Blue Shield Promise has confirmed that these emergency procedures have been adopted and have been implemented by its contracted health care service administrators.
These emergency response actions include, but are not limited to:
- Providing access to appropriate out-of-network providers when participating providers were displaced or unavailable due to the emergency.
- Extending the filing deadline for claims.
- Relaxing prior authorization standards, pre-certifications, and referrals as applicable for members affected by the emergency.
- Allowing members to replace medical equipment or supplies.
- Providing a toll-free number that affected members could call for answers to questions about access to health care.
- Beacon Health Strategies, Blue Shield Promise’s contracted managed care plan for behavioral health, has initiated an emergency triage workflow so that any calls coming in from Blue Shield Promise members can be triaged more quickly and Beacon may offer more hands-on support to help them link with a provider.
In response to the emergency, Blue Shield Promise may be conducting outreach to affected members who currently participate in a care/disease management programs to ensure continuity of care for these individuals. Blue Shield Promise will provide evacuation information for resources and care access support for any needed services to members who could be reached.
Blue Shield Promise members who need immediate assistance can contact customer service toll-free at 800-605-2556 (Medi-Cal); 800-544-0088 (Medicare); and 855-905-3825 (Cal MediConnect)
We will continue to monitor activity and may make further adjustments to continue to best serve our members.
About Blue Shield of California Promise Health Plan
Blue Shield of California Promise Health Plan is a managed care organization offering Medi-Cal, Cal MediConnect, Medicare Advantage HMO, and Dual Eligible Special Needs Plans. It is led by healthcare professionals with a “members-first” philosophy and committed to building a quality network of providers and partnering with community organizations for its nearly 500,000 members. For more information about Blue Shield of California Promise Health Plan, please visit www.blueshieldca.com/promise.
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