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BCBS Pre-notification Requirement!

As a reminder, there is a pre-notification requirement for MRI and CT scans for all BCBS participants. If the covered participant (i.e. patient) does not complete the pre-notification process with BCBS before the imaging services take place, he/she will have to pay a $200 penalty. To give pre-notification, the covered participant must call BCBS at the number on the back of his/her medical plan ID card.

Why give pre-notification? The pre-notification requirement helps keep your costs lower. When you call BCBS to give pre-notification, they will provide you with the most cost-efficient location for the imaging services.

Who can give pre-notification? The pre-notification call to BCBS must be made by the covered participant. No one else — including the doctor’s office — can complete the pre-notification process with BCBS. This is solely the responsibility of the patient.

Who pays the penalty if no pre-notification? If the covered participant does not call BCBS and complete the pre-notification process before the imaging service is received, the covered participant will have to pay a penalty of $200. This is solely the responsibility of the covered participant.

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