Quality Care That’s Right for YouWhether you need a routine check-up or a specialty procedure, you want the best care you can find. BCBS recognizes doctors and hospitals for their expertise and exceptional quality in delivering care. Learn more about our Total Care and Blue Distinction® Specialty Care designation programs and find a designated doctor or hospital that meets your needs. Show
Substance Use Treatment & ResourcesLearn more about substance use disorders and find a treatment provider that meets your needs. Estimate costsDid you know that you can estimate your out-of-pocket costs before you schedule a doctor’s appointment or medical procedure? You can, with the new Care Cost Estimator tool.1 It also lets you compare providers by price, based on your specific health plan. Use it at home at ibx.com or on the go with the IBX App! View our Member Flyer, which has complete instructions for using the Care Cost Estimator. Download flyer  Avoid surprises and save moneyEstimate costs before you go to the doctor. Use the cost estimator at home by logging in at ibx.com or on the go with the IBX App! Log in Know your options — before you need themMake the most of your benefits by getting the most from your health care dollars. Here are some other important ways to save on care: Estimate Medical Costs to Help Budget for Medical ExpensesEstimate medical costs to help plan for out-of-pocket expenses and make informed health care decisions and find doctors in one easy-to-use search tool.
Estimate Medical Costs tool may not be available to all plans. For more information about out-of-network costs: Out-of-Network Costs Out-of-Network Costs examples. Fair Health Consumer.org Medicare costs at CMS.gov fee schedule search tool. Find a Doctor who fits all your needsUsing the same search tool you can:
Network coverage may vary based on your plan Modal for Online Tool Video What is prior plan approval?
Prior plan approval (also called prior approval, prior authorization, prospective review, prior review, certification or precertification) is when Blue Cross NC reviews certain medical services or drugs before they are given to patients to make sure that the service or drug is right for the patient. Even if a doctor gets prior plan approval from Blue Cross NC that says that the service or drug is correct for the patient, this does not guarantee payment. For more information, go to the prior plan approval page. What types of scans need approval from Blue Cross NC before they are done?High-tech scans (diagnostic imaging procedures), such as CT or CTA scans, MRI or MRA scans, PET scans or special heart scans called nuclear cardiology studies, require prior plan approval from Blue Cross NC. If these scans are not part of an emergency room visit or an inpatient hospital stay, then your doctor needs to get prior plan approval from Blue Cross NC. What are these scans and what do they do?
Who is responsible for getting prior plan approval from Blue Cross NC?Your doctor. If your doctor is part of the Blue Cross NC network, he or she should contact Blue Cross NC and request prior plan approval for your scans. If your doctor is not part of the Blue Cross NC network or is located outside of North Carolina, you must tell your doctor to get prior plan approval for you. An out-of-network or out-of-state provider will not be familiar with Blue Cross NC's prior plan approval requirements. If prior plan approval is not obtained, Blue Cross NC will not pay for the scan and you will be responsible for the bill (this does not apply if you see an in-network provider). Tell your doctor to visit our Web site, www.bcbsnc.com/providers/ppa, for more information about how to get prior plan approval for your scan. What if my doctor refuses to get prior plan approval from Blue Cross NC before my scan?If your doctor is part of the Blue Cross NC network, he or she is responsible for getting prior plan approval from Blue Cross NC on your behalf. You will not be responsible for the bill if your in-network doctor does not get prior plan approval. If your doctor is not part of the Blue Cross NC network or is located outside of North Carolina, you must tell your doctor to get prior plan approval for you. If your doctor does not get approval and you have the scan anyway, Blue Cross NC will not pay for the scan and you will be responsible for the bill (this does not apply if you see an in-network provider). Is approval needed if I go to an out-of-network or out-of-state doctor?Yes. If your doctor is not part of the Blue Cross NC network or is located outside of North Carolina, you must tell your doctor to get prior plan approval for you. An out-of-network or out-of-state provider will not be familiar with Blue Cross NC's prior plan approval requirements. If prior plan approval is not obtained, Blue Cross NC will not pay for the scan and you will be responsible for the bill if the provider is out-of-network or out-of-state. Tell your doctor to visit our Web site, www.bcbsnc.com/providers/ppa, for more information about how they can request prior plan approval for your scan. What if an approval is required outside of Blue Cross NC's normal business hours, such as at night or on the weekends?Blue Cross NC is working with a company called American Imaging Management (AIM) for the approval of high-tech scans. AIM has a Web site that lets doctors request approval for high-tech scans 24 hours per day, seven days a week. If your doctor does not have access to the Internet and the request is urgent, your doctor has two business days to file the paperwork to AIM in order for Blue Cross NC to approve the scan. If your doctor does not file the paperwork within two business days after an urgent request, Blue Cross NC may not pay for the scan. If your doctor is in the Blue Cross NC network, he or she is responsible for getting prior plan approval from Blue Cross NC on your behalf. If your doctor is out-of-network or located outside of North Carolina, you are responsible for the cost of the scan if the doctor does not obtain prior plan approval before the scan is done. Remember: You do not need prior plan approval for a high-tech scan if it is part of an emergency room visit or an inpatient hospital stay. Why does Blue Cross NC require prior plan approval for high-tech scans?High-tech scans are great tools for doctors to use when diagnosing patients, but they are expensive and are sometimes not used the way they should be used. By requiring prior plan approval before the scan is done, Blue Cross NC is trying to keep medical costs down and keep patients from having tests they don't need. What is a complete abdominal ultrasound?An abdominal ultrasound is a noninvasive procedure used to assess the organs and structures within the abdomen. This includes the liver, gallbladder, pancreas, bile ducts, spleen, and abdominal aorta. Ultrasound technology allows quick visualization of the abdominal organs and structures from outside the body.
Why would a doctor order an abdominal ultrasound?Doctors order an abdominal ultrasound when they're concerned about symptoms such as belly pain, repeated vomiting, abnormal liver or kidney function tests, or a swollen belly. The tests can show them the size of the abdominal organs and help them check for injuries to or diseases of the organs.
How much does a stomach scan cost?Average Prices, Select CT Scan Procedures. How expensive is an ultrasound?The estimated average cost of an ultrasound without insurance is $410, but prices can vary between $100 - $1,000 depending on where the exam is taking place on the body, the state you live in, and the type of facility you visit.
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