Applies to Commercial members only, unless otherwise stated in the group's EOC.
DESCRIPTION
To establish guidelines for eligible travel, meal and lodging (TML) expenses when approved surgical services include travel to an approved facility. Eligible travel related expenses must be pre-approved.
POLICY
BlueCross BlueShield of Tennessee considers eligible travel related expenses (e.g. transportation, lodging, meals) for a pre-approved, covered procedure(s) as follows:
Transplant related travel expenses as follows (Note: Applicable to fully insured, self-funded groups & individual on- and off-market place):
Travel by private car is limited to reimbursement at the IRS mileage rate in effect at the time of travel
Travel expenses are covered to and from an approved institution
Travel for solid organs, stem cell and bone marrow transplants will be covered for those whose home is 30 miles or greater one way from the approved facility or outside the approved facility’s defined service area (this varies from facility to facility); exceptions can be made with Transplant Case Manager pre-approval
Excludes Cellular immunotherapy - CAR-T
Blue Distinction Specialty Care (BDSC) Program with an added TML benefit for one of the following (Note: Applicable ONLY to self-funded groups that opted into BDSC and added TML benefit.)
Bariatric surgery
Cancer care
Cardiac care
Cellular immunotherapy - CAR-T
Fertility care
Gene therapy
Knee and hip replacement
Maternity care
Spinal surgery
Substance use treatment and recovery
Travel expenses related to the applicable Specialty Care Program as follows:
Travel by private car is limited to reimbursement at the IRS mileage rate in effect at the time of travel
Travel expenses are covered to and from an approved Blue Distinction Center
Travel for applicable services will be covered for those whose home is 50 miles or greater one way from the approved Blue Distinction Center; exceptions can be made with Case Manager pre-approval
ORIGINAL EFFECTIVE DATE: 3/16/2017
MOST RECENT REVIEW DATE: 12/31/2020
ID_THM Case Management, THM Transplant Case Management & Product Development
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