Member: Blue Cross recently asked me about a medical condition I saw my doctor about. I’m curious — why does Blue Cross need to know this information? —Bob, Little Falls
Dr. Fendrich: Thanks for the question, Bob. The quick answer is that Blue Cross works alongside your physician to support your health care team.
One way that Blue Cross supports the care of your health and wellness is to ensure they have a good understanding of any medical conditions you might have. This might be done through an in-home or virtual wellness visit. Once Blue Cross gets to know your health care needs, they can help you feel sure that you have all the essential resources to navigate your provider’s treatment plan and to live your healthiest life.
Here are some more specific reasons Blue Cross might inquire about your conditions:
1. To help you understand your benefits
The main reason Blue Cross might ask you for information about your medical condition is to help you to locate any in-network specialists or to answer questions about your benefits. Ensuring that you understand all the pieces to complete your treatment plan is the main way Blue Cross can support your provider.
2. To connect you to programs or services
If you have a major medical condition, such as cancer, Blue Cross might refer you or a caregiver for information and resources from the American Cancer Society. Similarly, Blue Cross might ask you about a medical condition in order to help you navigate one of their own programs that could help.
3. To improve benefit offerings
Blue Cross might inquire about your medical conditions so that they can define existing benefits, or explore new benefit options.
Remember, you have multiple people on your health care team. Talk to your doctor if something new comes up, and make sure to schedule regular preventive care visits to reduce potential health problems. Reach out to Blue Cross by calling the number on the back of your member ID card when you have questions about your benefits or need assistance locating an in-network doctor, specialist, care provider or program.
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