It's easy to provide services with BlueMedicare PFFS.
With BlueMedicare PFFS, there is no physician, hospital or other health care provider network so there's no requirement of a signed participation agreement. Instead, you become a Deemed Provider when you agree to accept a BlueMedicare PFFS member.
How do you become a Deemed Provider?
When the following conditions are met, you will be considered a Deemed Provider.
- You have a valid Medicare billing number.
- You know before providing services that the patient is a Blue Cross and Blue Shield of Florida (BCBSF) BlueMedicare PFFS member (the member's health insurance ID card will convey this information).
- You agree to accept the BlueMedicare PFFS Terms and Conditions of Payment (PDF)
- You subsequently provide services to the patient.
Once you meet these conditions and render service, you are considered a Deemed Provider. Health care providers choose whether they are Deemed Providers, on a member-by-member, visit-by-visit basis.
N0TE: Having reasonable access to a PFFS plan's terms and conditions combined with providing services to a PFFS plan member represent acceptance of the plan's Terms and Conditions. The Centers for Medicare & Medicaid Services (CMS)
consider there is reasonable access when a PFFS plan's terms and conditions' access information is printed on the member's insurance ID card and the terms and conditions are available on the plan's website, via fax and by phone.
BlueMedicare PFFS has a Medicare Advantage contract approved by the Centers for Medicare & Medicaid Services. Contracts are renewed annually and availability of coverage beyond the end of the current contract year is not guaranteed. A Medicare Advantage Private Fee-for-Service plan works differently than a Medicare supplement plan. A doctor or hospital must agree to accept the plan's terms and conditions prior to providing health care services to a member, with the exception of emergencies. If a doctor or hospital does not agree to accept our payment terms and conditions, they may not provide health care services to the member, except in emergencies.
Terms of Use
