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HorizonBlue-Logo-Updated-Jan15 2013
Horizon BCBS Brief Notes Out of Network Reimbursement Policy Change
Applies to: Small Employer Market - Changes Announced for Small Group Out-of-Network  reimbursement. The Small Employer Health Benefits (SEH) Program recently changed its regulations for the payment of out-of-network (OON) benefits accessed on a voluntary basis (non-emergent and non-urgent). Previously, insurance companies were required to pay covered charges for OON providers using either the allowed charge of 80 percent of Prevailing Healthcare Charges (PHCS) or the actual charges.