Frequently Asked Questions

A PPO, or Participating Provider Option, is a network of doctors and hospitals who have contracted with Blue Cross and Blue Shield of Illinois. When you use a PPO doctor or hospital you will receive a higher benefit than if you receive care outside of the PPO network.

No, but remember, you get the greatest benefits if you use a doctor or hospital from the Blue Cross and Blue Shield of Illinois PPO network.

It's possible your doctor is already a member of the PPO network. To confirm that your doctor is already a member of the BCBSIL PPO network, contact your doctor or call the Robert Bosch Customer Service Center at 1-866-540-2130. If your doctor is not a member of the BCBSIL PPO network, you may continue seeing that doctor but your benefits will be covered at a lower non-network level.

No. You do not need a referral to see a specialist, but your regular doctor may be an excellent resource for advice and guidance when you need to select a specialist.

Blue Cross and Blue Shield of Illinois (BCBSIL) has a large network of doctors, hospitals and outpatient facilities. You can ask your doctor if he or she is in the BCBSIL PPO network, or you can call 1-800-810-2583 to find a doctor in your area or an area where you will be traveling. You can also search the online list of Doctors and Hospitals.

No. You can select a PPO network doctor each time you need care.

Provider directories are quite large. To contain administrative costs and provide you with the most current information available, we encourage you to search the online list of Doctors and Hospitals. You may also contact the Robert Bosch Customer Service Center at 1-866-540-2130 to determine if your doctor participates, or to find out about participating doctors and hospitals in your area.

If you still want a directory, you may call the Robert Bosch Customer Service Center to request a copy. There will also be a limited supply of directories available through your company's human resources representative.

You will receive one card if you have employee-only or single coverage and two cards if you cover dependents. You may request additional ID cards online or by calling the Robert Bosch Customer Service Center at 1-866-540-2130.

You must show your ID card to your doctor so that he or she knows who to contact for eligibility, what medical benefits are available to you under the Robert Bosch Benefit Plan and if pre-authorization is required.

Benefits may be reduced for certain services if not authorized. You must call the Customer Service Center at the number listed on the back of your ID card prior to obtaining such services as inpatient hospital admission.

No. You only need to pre-authorize one business day prior to any elective hospitalization and within two business days of an emergency or maternity admission. The Blue Cross and Blue Shield of Illinois Medical Services Advisory will handle pre-authorization calls.

The MSA is staffed with nurses who handle case management and pre-authorization for inpatient hospitalizations. The MSA needs to be notified one day prior to any elective hospitalization and within two business days of an emergency or maternity admission at 1-866-540-2130. The MSA is available from 7 a.m. to 7 p.m. (CT) Monday - Friday. You may also leave a message after hours and on weekends and the MSA will call you back on the next business day.

In an emergency, seek immediate attention. While you should always try to access care from a network facility, in some cases it is not feasible. Regardless of whether you access a network or non-network facility, contact the Blue Cross and Blue Shield of Illinois Customer Service Center at the number listed on the back of your ID card within two days of any emergency hospital admission.

If you are hospitalized as the result of an emergency, you, your doctor, or a family member must call the Blue Cross and Blue Shield of Illinois pre-certification number listed on the back of your ID card within two business days of the admission or your benefits will be reduced by 50 percent up to $2,500. (This won't apply to your deductible or out-of-pocket maximum.)

You can go to any doctor or hospital for medical care. Remember, 99% of hospitals and 92% of doctors have some type of contractual arrangement with a Blue Cross and Blue Shield of Illinois plan. Be sure to pre-authorize your care before you receive treatment. Just call the Robert Bosch Customer Service Center at 1-866-540-2130.

If you use a contracting Blue Cross and Blue Shield of Illinois (BCBSIL) PPO network doctor or hospital, your claims will be filed electronically to BCBSIL. You won’t have to fill out any forms. If you use a non-PPO network doctor or hospital, you may have to pay at the time you receive the service and file a paper claim form for reimbursement. Claim forms are available online or by calling 1-866-540-2130.

You will receive an Explanation of Benefits (EOB) statement from Blue Cross and Blue Shield of Illinois after your claim has been processed. The EOB will provide details of what was covered, the level of coverage, and the amount you owe, if any. You can also check your claim status through Blue Access^® for Members.

When receiving care from a network doctor or hospital, you will not have to be concerned about being billed for charges that are considered above "reasonable and customary." If you receive care from a non-network doctor or hospital who charges rates above what is "reasonable and customary," you are responsible for the extra charges.

Please contact your company's human resources representative to report any change in family status or an address change. A family status change must be reported to your human resources representative within 31 days of the qualifying event.