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Copays/Deductibles
Q: Will co-payments still need to be collected if BC+ members are in an
HMO? Currently they are not always collected depending on the HMO.
A: In most cases, yes, the provider will have to collect co-pays from members.
Each HMO will have their own internal procedures and arrangements with providers
for collecting co-pays from members in the Standard and Benchmark Plans.
Most HMOs will be administering copays for members in the Standard Plan with
three exceptions to date. Abri, GHC-EC, and Compcare will not be requiring
co-pays for members in the Standard Plan.
Q: How will the financial counselors know if someone is in the benchmark
plan or the standard plan? This is important for them to know which co-pays that
the member needs to be charged.
A: The recipients will be told in their Notices of Decision what plan is
covering them. The Medical Status Codes will tell providers whether someone is
in the standard or benchmark plan.
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