Question

Case 8.2 Applying Insurance Rules

Jan Wommelsdorf, of Fargo, North Dakota, was on vacation in Portland, Oregon, when she became ill. She has BCBS BlueCard insurance, so she telephoned the BlueCard toll-free number to find a provider near her in Portland. She was examined by Dr. Vijay Sundaram and provided a special diet to follow until she returns home and visits her regular physician.

A. Who submits the claim, Jan Wommelsdorf or Dr. Sundaram?


B. Is the claim submitted to Jan’s local BCBS plan in North Dakota or to Dr. Sundaram’s local plan in Oregon?

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Answer #1

A. Dr. Sundaram submits the claim.

B. The claim is submitted to Dr. Sundaram's local plan in Portland, Oregon.

answered by: Nonsandez
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