Benefits Value Advisor: Helping to Navigate the Often Choppy Waters of Health Care

Your doctor tells you that she wants to schedule a CT scan. You are a little worried about it since you’ve never had one and are not sure how it will go. You’re also unsure about how much your out-of-pocket costs will be, where you can go to have the test done and how you can get help with pre-certification. Maybe you, or a loved one, has been through this similar experience.

Did you know that a BCBSTX Benefits Value Advisor (BVA) can help with all these things? Sometimes, navigating through the health care system can be much like being on a boat in choppy waters, shifting you one way, and then another as you try to get to your final “medical” destination.

For example, the same procedure performed in the same area by different providers can vary greatly in cost. So, you may save by talking to a BVA first, before your procedure. Besides the cost, you may also be unsure exactly why your doctor ordered the test. Education tools are available that can help explain why you may need a procedure, which could ease your mind.

Here’s what a BVA can assist you with:

• Understanding your benefits
• Comparing costs at different providers near you¹
• Scheduling your appointment ­
• Helping with pre-certification for in-network providers
• Telling you about online educational tools

They help with contacting providers for many conditions, including:

• CAT or CT scans
• MRIs
• Endoscopy procedures
• Colonoscopy procedures
• Back or spinal surgery 
• Knee surgery
• Shoulder surgery
• Hip replacement or joint replacement surgery
• Bariatric surgery

It’s Easy to Talk to a Benefits Value Advisor

Just call the Customer Service number on the back of your BCBSTX ID card and ask to speak to a Benefits Value Advisor, who is ready to help make accessing and understanding your next procedure smooth sailing!

1. Benefits Value Advisors offer cost estimates for various providers, facilities and procedures. Lower pricing and cost savings are dependent on the provider or facility of your choosing.
2. Member communications and information from Benefits Value Advisors are not meant to replace the advice of health care professionals. Members are encouraged to seek the advice of their doctors to discuss their health care needs. Decisions regarding course and place of treatment remain with the member and his or her health care providers. Cost estimates are just an estimate. In addition to your usual deductibles, copayments and/or coinsurance, the actual cost of the services may vary based on a number of factors including the date of service, the actual procedure performed and what services were billed by the provider and your particular benefit plan. Coverage is subject to the limitations, exclusions and terms of your plan.