Deeming

It's easy to become deemed

With our private fee-for-service plan, there's no need for a signed participation agreement. If you have an opportunity to review our terms and conditions and you treat a Medicare Plus Blue member, you are "deemed to have a contract with us."

 

How to become a deemed health care provider

• Know before providing services that the patient is a Medicare Plus Blue PFFS^SM member.


• Have reasonable access to our terms and conditions.


• Provide covered services to the member.

You can decide whether to accept our terms and conditions each time you see a Medicare Plus Blue member. Treating one plan member does not obligate you to treat other Medicare Plus Blue members, and you are not obligated to accept the same member for a future treatment.

Once you meet these conditions and treat the member, you are a deemed provider for that episode of care.

If you don't accept our terms and conditions

If you don't want to accept our terms and conditions, you should not treat a Medicare Plus Blue member, except for emergency services.

If you provide non-emergency services, you are considered deemed and subject to our terms and conditions.