A Powerful 24/7 Resource: Meet a Benefits Value Advisor

No doubt about it, the health care system can be confusing. When you have questions about your health care coverage. Blue Cross and Blue Shield of Illinois offers members a great go-to resource — Benefits Value Advisors (BVA).

Get clear answers to your questions with just a phone call or live chat from our mobile app. Our BVAs are ready 24/7* to help you make the most of your benefits — from researching providers to providing cost estimates and much more.

We talked with a few of our BVAs about the different situations they’ve helped members navigate. Here are their stories.

Help Right After a Cancer Diagnosis

Being a BVA, I strive to help each caller in any way I can. Sometimes the calls hit home and I’m able to really relate to a member's situation.

A husband and wife called in together. The wife was very upset because they had just found out she had breast cancer. They were confused and didn't know what to do in regard to their health care coverage.

Being a breast cancer survivor, I empathized with them. I explained  which tests were needed for a recommended clinical review (predetermination)** of her treatment plan. I also explained their benefits and what things may need prior authorization. I researched cost estimations and provided them with costs for various tests. I also made sure all the providers they were using were in their network so they could get the highest level of benefits.

After that, I offered to set them up with a registered nurse case manager. By the time the call was finished, they felt more prepared and comfortable

They thanked me over and over again, saying they felt so much better about what to expect from their benefits. I really felt I made a big difference.

-- Janet

Coverage Quickly Reinstated

A member trying to fill a prescription was frustrated after being told her coverage wasn’t active. She called her but was unsuccessful in fixing the issue. That’s when she called the BVA number and was connected with me.

Her employer’s benefit center said the inactive status was due to an error, so a request to reinstate her policy was submitted. But it would be three to four days for processing and she needed the medication sooner. So I jumped into action.

We called the employer’s benefit center together and walked a supervisor through submitting an urgent request for reinstatement. I then reached out to the prescription vendor to see what was needed to get the policy reinstated. Once they explained the process, I called the employer’s benefit center again and had the same supervisor submit the urgent request per the prescription vendor’s process. After ending that call, I reached out to a BCBS supervisor so they could help get the request processed ASAP. The coverage was reinstated effective immediately. We then reached back out to the prescription vendor, who was able to reinstate the member’s policy.

From start to finish, this took about two hours but the member’s gratitude in the end made it all worthwhile.  As a BVA, I get to help members with their health care coverage questions every day.  

-- AJ

Finding Urgent In-Network Care for a New Member

As BVAs, we are ready and waiting to help members when they are in confusing or frustrating situations.

In one instance, a new BCBS member’s health issues required he have lab work performed weekly. In addition to being on a new health care coverage plan, he had recently moved to a new state and wasn’t familiar with where to go for care. He needed help connecting with a new doctor who could then refer him to get his lab work done. By the time I got in touch with the member, he was frustrated and needed to be connected with a doctor at a specific hospital system quickly.

First, I researched in-network physicians who were accepting new appointments.  I pulled together a list of options, we reviewed them together, and he told me who he’d like to schedule an appointment with. I contacted the doctor's office and got the appointment scheduled.  I was able to further assist him by locating an in-network lab that could take him immediately for his specific lab work.

He was relieved to have services available to him, and someone to take responsibility for resolving his issue.

As a BVA, I am equipped to help members in all kinds of unique situations. If you have a question, give us a call.

-- David

Ensuring Uninterrupted Treatment

A new BCBSTX member  was calling for his daughter who needed medical supplies for her condition. The supplier they had been using was not contracted through Blue Cross and Blue Shield. I helped him locate a new contracted provider and gave them a call to make sure they had the needed supplies.  I did a conference call with the provider and member to verify they had the information they needed to get the order started.

I made sure the supplies would be shipped right away.  I also confirmed that the member understood his new benefit plan, including the deductible and out-of-pocket expenses. 

The member was relieved that we were able to help him quickly find the right resources so his daughter wouldn't have any interruption in her treatment. I felt good about helping this member because I have a daughter of my own and understand how important it is to take care of family.

-- Suzie

If you have health care coverage questions, BVAs are a great resource. To find out if your health care plan includes BVAs, log in to Blue Access for Members^SM.

* Excludes major U.S. holidays
**Check with your doctor to confirm which tests are needed for predetermination.

Benefits Value Advisors offer cost estimates for procedures and services from various providers and facilities. Lower pricing and cost savings are dependent on the provider or facility you choose. Benefits Value Advisors do not give medical advice. Talk to your doctor or health care professional about any health questions or concerns.

Originally published 6/11/2018; Revised 2021, 2022, 2023, 2025