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New Phone Number for Provider Use

Effective January 1, 2013, Blue Cross and Blue Shield of Louisiana now administers the PPO plan previously administered by OGB.

Provider questions regarding eligibility and claims for both PPO and HMO members should be directed to the Blue Cross Provider Customer Service team at 1-800-392-4089.

Special Instructions for Inpatient Claims that Begin in December 2012 and Continue into January 2013

Blue Cross is working with OGB to address continuity-of-care situations and pending authorizations for OGB members. In some cases, all claims should be submitted to a single carrier; in other cases, inpatient claims must be split and submitted to both carriers. Additional information is available by visiting the Blue Cross provider website (http://www.bcbsla.com/ogb > I’m a Provider > Office of Group Benefits) or by contacting Blue Cross Customer Service at 1-800-392-4089.

Coverage for Influenza Vaccinations

Immunization shots for influenza are covered by OGB health plans. Click here for more information.

Expanded Coverage

OGB offers expanded coverage in several key areas as mandated by federal law (the Affordable Care Act and the Mental Health Parity and Addiction Equity Act):

• The individual lifetime maximum for benefits was eliminated. Annual dollar limits on essential benefits were also eliminated.
  
  
• Preventive care (wellness) is paid at 100 percent (no deductibles, co-payments, coinsurance) if services are provided by a network provider. Preventive care benefit limits no longer apply. Click here for a complete list of covered preventive services.
  
  
• The plan member cost-share (deductible, coinsurance, or co-payment) for inpatient and outpatient medical care and surgery also applies to inpatient and outpatient mental health and substance abuse (MHSA) treatment benefits. There is no longer a separate plan member cost-share for MHSA treatment benefits.
  
  
• The pre-existing condition (PEC) exclusion no longer applies to any employee or dependent under age 19.
  
  
• OGB offers coverage for dependent children up to age 26, regardless of student, marital or tax status. A covered child under age 26 who is or becomes incapable of self-sustaining employment is eligible to continue coverage as an over-age dependent if OGB receives required medical documents verifying his or her incapacity before he or she reaches age 26. The definition of incapacity has been broadened to include mental and physical incapacity.