What is a ParPlan provider?
ParPlan providers have agreed to accept the Blue Cross and Blue Shield of Texas allowed amount and/or negotiated rates for covered services. When using ParPlan providers, you are covered at the non-network level and, in most cases, will not have to file your own claims. However, you will also not be responsible for any billed amount that exceeds the allowable amount unless you make a special agreement with your provider for non-covered services.
What happens if a non-network provider is used?
When you seek care from a network doctor or hospital, your UT SELECT PPO plan pays a larger portion of your health care costs than it pays for services by a non-network provider. When you receive care outside the network, you still have coverage, but you may pay more of the cost, including any charges exceeding the Blue Cross and Blue Shield of Texas allowed amount.
What happens if care is not available from a network provider?
If care is not available from a network provider as determined by Blue Cross and Blue Shield of Texas, and Blue Cross and Blue Shield of Texas preauthorizes your visit to a non-network provider prior to the visit, network benefits will be paid. Otherwise, non-network benefits will be paid, and the claim will have to be resubmitted for review and adjustment, if appropriate. Note: Even if approved by Blue Cross and Blue Shield of Texas, non-network providers paid at the network level may bill you for any charges exceeding the Blue Cross and Blue Shield of Texas allowable amount for covered services. You are responsible for these charges.