Increase Blue Shield CA health plan reimbursement for out-of-network services
Use this step-by-step guidance to request network-level reimbursement when you see an out-of-network provider due to the fact that your Blue Shield CA health plan does not have an appropriate in-network provider.
Why
If the health plan is not contracted with a provider who can provide medically necessary services for your child within a reasonable distance from your home, you may have no choice but to see an out-of-network provider and pay higher costs. You can advocate for the health plan to reimburse you the difference for an in-network provider.
Guides
Curated by our research team, signed off by experts and parents alike, guides walk you through the entire process, step-by-step. They cover common pitfalls and how to navigate complexities in order to accomplish your goal.
If your child cannot access care because of your health plan’s lack of access to a qualified and available network-contracted provider, you can advocate for an authorization to increase health plan reimbursement for out-of-network intervention services to network-level coverage.
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Resources
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Increase Blue Shield CA health plan reimbursement for out-of-network services
Work with a Navigator to accomplish this goal
