10 Things You Swear CVT Never Told You....
 
1
To obtain the best benefit, you should stay within the preferred provider network. _If you go outside of the network, your PPO will pay the non-participating rate. _You will have out-of-pocket expense. _For example, an inpatient hospital stay and surgery in a non-participating facility will mean very large balance bills.
2
If it becomes medically necessary for you to receive care outside of the preferred provider network, have your referring physician call (or you can call) Health Care Management Systems in Blue Cross at 1-800-274-7767 to obtain an out-of-plan-referral. _Then call Blue Cross to determine exactly what your benefits will be.
3
CVT PPO plans do coordinate benefits. _If your spouse or other enrolled dependents have coverage other than CVT, that coverage must pay first. _The rule is: your coverage is primary for you, your spouse's coverage is primary for her/him and coverage for dependent children is determined by whichever parent has the birthday that falls first in the year.
4
If you are covered by a PPO plan and your spouse's primary coverage is an HMO, your spouse must use that HMO for medical care.
5
Pre-admission review is required for elective surgeries (inpatient or outpatient) and for hospitals stays. _It is also necessary for substance abuse treatment (inpatient or outpatient). _The number for pre-admission review (HCMS) is on the back of your card.
6
ALWAYS, ALWAYS, ALWAYS check with either Blue Cross, First Health, or CVT to verify the preferred provider status of any provider of medical service. _DO NOT take the well intentioned word of the provider's office. _Please take two minutes to call for verification. _It will save you balance bills.
7
CVT uses a chiropractic network. _If you go outside of the network, your coverage is limited to a maximum of $25 per day of medically necessary treatment. _Additional benefits may be available under certain circumstances.
8
All prescriptions are filled with a generic drug unless one is not available or if the prescribing physician requires the use of a name brand drug. This is true at the pharmacy or when using the mail order service. _IF YOU INSIST ON A NAME BRAND DRUG WHEN IT HAS NOT BEEN PRESCRIBED, YOU WILL PAY THE COPAY PLUS THE DIFFERENCE BETWEEN THE GENERIC AND NAME BRAND PRICE.
9
CVT has no pre-existing condition clauses.
10
If you have a claim problem or receive balance bills and you do not understand why or think that you should not owe anything, call Blue Cross, HealthComp, or the CVT office. _We will be happy to assist you.

Any Other Questions?
Call CVT's Member Services at 1-800-288-9870
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