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Changes to referral requirements for certain nutrition counseling services

November 1, 2011

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Our commercial managed care members have benefits for up to six fully covered nutrition counseling visits per year and for medically necessary diabetic education. Currently, a referral is required for HMO members to use these benefits.

Effective December 1, 2011, however, HMO members will no longer need a referral for these services. This change is an effort to make it easier for all of our members to use their nutrition counseling and diabetic education benefits.

For all members, copayments do not apply when using an in-network provider for these nutritional counseling services. HMO members must use an in-network provider to take advantage of these benefits; PPO and POS members may use an out-of-network provider subject to applicable deductibles and coinsurance.

In order to schedule an appointment for nutrition counseling, members should contact their primary physician or a participating registered dietitian. To locate a network provider, members can log on to ibxpress.com or call Customer Service at 1-800-ASK-BLUE.

Note: Only certain providers (i.e., primary care physicians or registered dietitians) are eligible to provide nutrition counseling services. Appointments with nutritionists are not a covered benefit.

This is not a statement of benefits. Benefits may vary based on state requirements, benefits program (HMO, PPO, etc.), and/or employer groups. Providers should call Customer Service for the member?s applicable benefits information. Members should be instructed to call the Customer Service telephone number listed on their ID card.


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