PPO Members: Know Your Member Rights

PPO Members: Know Your Member Rights

This article is intended for PPO members enrolled in an employer health insurance plan.

Below is a list of your member rights. Please be sure to keep this information as a reference.

As a Blue Cross and Blue Shield of Oklahoma PPO Member, you have the right to:
  • Have confidentiality of health information.
  • Receive medically necessary and appropriate care and service.
  • Receive polite and respectful care and services from Blue Cross and Blue Shield of Oklahoma employees and participating health care providers.
  • Receive information in clear and understandable terms.
  • Participate with your health care provider in decision-making about your treatment.
  • Refuse treatment.
  • File complaints when unhappy with the care and treatment received.
  • Appeal an Adverse Benefit Determination or a decision regarding a preauthorization request, if you feel it is in error.
  • Designate an authorized representative to act on your behalf in pursuing a benefit claim or appeal of an Adverse Benefit Determination.

If you have questions about your coverage, please call the toll-free customer service phone number on your member ID card.

Originally published 3/6/2020; Reviewed 2022