Submitting a Blue Cross Blue Shield Global® Core claim When you pay for covered health care services outside the BlueCard® service area, you must submit a claim to obtain reimbursement. For institutional and professional claims, complete a Blue Cross Blue Shield Global® Core claim form and send the claim form with the provider's itemized bill(s) to the service center (the address is on the form) to initiate claims processing. Following the instructions on the claim form will help ensure timely processing of your claim. The claim form is available from the claims administrator, the service center, or online at the Blue Cross Blue Shield Global Core® website at bcbsglobalcore.com. If you need assistance with your claim submission, you should call the service center at 1-800-810-BLUE (2583) or call collect at 1-804-673-1177, 24 hours a day, 7 days a week. When services received outside the U.S. are covered The plan covers the same benefits as described in this COC if the services received outside the U.S.: • Are appropriate for the condition being treated; • Are covered by the plan; • Are medically necessary; • Are not considered to be experimental or investigational by U.S. standards; and • Have met all medical policy criteria. Important tips for receiving care outside the U.S. • Always carry your UMP member ID card. • If you need emergency medical care, go to the nearest hospital. • If you need urgent medical care, contact the Blue Cross Blue Shield Global® Core Service Center for help finding a network provider. • If you are admitted to the hospital, contact the Blue Cross Blue Shield Global® Core Service Center to notify the plan of your admission. Blue Cross Blue Shield Global® Core contact and online information Contact Blue Cross Blue Shield Global® Core to learn about services received outside the U.S., find a provider outside the U.S., or submit a claim for medical care provided outside the U.S. • Call the Blue Cross Blue Shield Global® Core Service Center at 1-800-810-BLUE (2583), or call collect 1-804-673-1177 (available 24 hours a day, 7 days a week). • To use the online provider search tool, register and sign in on the Blue Cross Blue Shield Global® Core website at bcbsglobalcore.com. • Visit the Blue Cross Blue Shield Global® Core website on the Blue Cross Blue Shield Global® Core website at bcbsglobalcore.com. After you create an account, you may find Blue Cross Blue Shield Global® Core information, get an international claim form, and submit claims electronically. Finding a network provider outside the U.S. Under Blue Cross Blue Shield Global® Core, you have access to network providers outside the U.S., including hospital care (inpatient and outpatient) and professional provider services at network rates. To find a contracted provider outside the U.S., register and sign in on the Blue Cross Blue Shield Global® Core website at bcbsglobalcore.com or call the Blue Cross Blue Shield Global® Core Service Center: 1- 800-810-BLUE (2583) or collect at 1-804-673-1177. 28 2024 UMP Plus–PSHVN (PEBB) Certificate of Coverage