UC SHIP and Anthem Blue Cross: What's the Connection?
Table of Contents
- UC SHIP services provided by Anthem Blue Cross Prudent Buyer Providers
- The Student Health Insurance Office can help you select a Prudent Buyer Provider
- If you go to a non-Prudent Buyer Provider
- Anthem Blue Cross processes all claims
- The Anthem Blue Cross Card
| UC SHIP services provided by Anthem Blue Cross Prudent Buyer Providers | The UC Student Health Insurance Plan was created for University of California students. It is a non-profit plan administered by the University of California. In order to keep the cost of the plan low, UC has contracted with Anthem Blue Cross to provide medical and mental health services through Anthem Blue Cross' extensive network of providers and hospitals. These providers, called Prudent Buyer Providers, have agreed to charge lower fees to Anthem Blue Cross patients. |
| The SHIP Office will help you select a Prudent Buyer Provider | When you visit the Student Health Insurance Office to obtain authorization for off-campus services, a Benefits Representative will (a) determine if the provider to whom you have been referred by your clinician is a Prudent Buyer Provider, or (b) help you select an appropriate Prudent Buyer Provider if one is not specified on your referral. You may also visit the Anthem Blue Cross website at http://www.anthem.com/ for a complete list of Prudent Buyer Providers. |
| If you go to a non-Prudent Buyer Provider | If you receive care from a provider who is not a Prudent Buyer Provider, you will pay more. Providers who are not contracted with Anthem Blue Cross may charge patients more, and Anthem Blue Cross will pay up to a certain amount, known as the "limited fee schedule." You are responsible for the amount of charges above the limited fee schedule. |
| Anthem Blue Cross processes all claims | Anthem Blue Cross provides UC SHIP with another service: claims processing. Whenever a UC SHIP member receives a service covered by the plan, a claim is generated to pay the provider of the service. For example, when a UC SHIP member is seen at UHS and incurs fees, the patient pays only 10% of those fees, and UHS sends a claim to Anthem Blue Cross. Anthem Blue Cross processes the claim and reimburses UHS for the remaining 90% of the charges. Claims for services outside of UHS are handled in a similar way. Non-UHS providers may request payment of the patient's portion of fees at the time of the visit, or may send a bill later. For more on claims submission and payment, see How to Use SHIP. |
| The Anthem Blue Cross Card | See How do I obtain a Anthem Blue Cross insurance card? |
