37 Access to CareFirst Administrators Participating Providers While on Travel If you, your Spouse, or your Eligible Dependent Children need medical care while away from home, including travel outside the U.S., you have access to a national network of participating providers through the Blue Cross Blue Shield Global Core ® Program. Call 800-810-BLUE (2583) toll-free or 804- 673-1177, 24 hours a day, 7 days a week for information on doctors, hospitals, other health care professionals or to receive medical assistance services. A medical assistance coordinator, in conjunction with a medical professional, will make an appointment with a doctor or arrange hospitalization if necessary. If you Have a Complaint about CareFirst Administrators If you have any type of complaint about CareFirst Administrators, you may contact CareFirst Administrators member services. You should contact CareFirst Administrators member services if you have any concerns regarding a CareFirst Administrators employee, the quality of care provided by CareFirst Administrators participating providers, or the processing of your claims (including claims for your covered family members). The toll-free number for member services is 866-871-0839 as shown on the back of your CareFirst Administrators identification card. You also will be able to find the CareFirst Administrators number on any copy of your Explanation of Benefits (EOB) CareFirst Administrators provides to you. You also have the option to express your concerns to CareFirst Administrators in writing. CareFirst Administrators will make every effort to resolve the concerns you raise on your initial contact. However, CareFirst Administrators may need more time to address your concerns. In this case, someone will get back to you as soon as possible, but no more than 30 days after your initial contact. The Fund Office also is available to you should you have any complaints about CareFirst Administrators or any aspect of the administration of the Plan. You may contact the Fund Office at 202-785-8148 or toll free at 800-457-3481. Contacting CareFirst Administrators’ member services or the Fund Office to make a complaint does not replace the requirement that you file a written appeal if you are not satisfied with the results of a decision by CareFirst Administrators on a claim you have submitted for benefits or services received under the Plan. If you do not agree with CareFirst Administrator’s decision on any claim, you may contact CareFirst Administrators member services or the Fund Office about your concerns. In addition, you must make a written request as set forth under the section governing appeals and as explained in the section “Claims and Appeals Procedures” included in this SPD.
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