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However, if the member paid in full at the time of service, the member must submit a claim to obtain reimbursement for covered healthcare services. Members must contact Florida Blue to obtain precertification for non-emergency inpatient services. • Outpatient Services Physicians, urgent care centers and other outpatient providers located outside the BlueCard service area will typically require members to pay in full at the time of service. Members must submit a claim to obtain reimbursement for covered healthcare services. • Submitting a BlueCard Worldwide Claim When members pay for covered healthcare services outside the BlueCard service area, they must submit a claim to obtain reimbursement. For institutional and professional claims, members should complete a BlueCard Worldwide International claim form and send the claim form with the provider's itemized bill(s) to the BlueCard Worldwide Service Center address on the form to initiate claims processing. The claim form is available from Florida Blue, the BlueCard Worldwide Service Center, or online at www.bluecardworldwide.com. If members need assistance with their claim submissions, they should call the BlueCard Worldwide Service Center at 1.800.810.BLUE (2583) or call collect at 1.804.673.1177, 24 hour s a day, seven days a week. 2. BlueCard Worldwide Program-Related Fees Employer understands and agrees to reimburse Florida Blue for certain fees and compensation which we are obligated under applicable Inter-Plan Arrangement requirements to pay to the Host Blues, to the Association and/or to vendors of Inter- Plan Arrangement related services. The specific fees and compensation that are charged to Employer under the BlueCard Worldwide Program are set forth in Exhibit B, if applicable. Fees and compensation under applicable Inter-Plan Arrangements may be revised from time to time. 3. Except as otherwise specifically noted in this Amendment, all other terms and conditions of the Agreement shall remain unchanged and in full force and effect. IN WITNESS WHEREOF, this Amendment has been executed by the duly authorized representatives of the parties. BLUE CROSS AND BLUE SHIELD INDIAN RIVER COUNTY BOARD OF FLORIDA, INC. D/B/A FLORIDA OF COUNTY COMMISSIONERS BLUE By: By: ose E. Flescher 40v�••••••�! k Title: airman * ''•:riot STATE OF FLORIDA �+t INDIAN RIVER COUNTY 'y Date: Date: DEcember 6 2016 THIS IS TO CERTIFY THAT THIS IS Arm A TRUE AND CORRECT COPY OF THE ORIGINAL ON FILE IN THIS OFFICE. ,?�.•, ATTEST: JEFFR MIT ,CLEffJC APPROVED AS TO FO` �•,fl►.�4*34 gey R. Smith, C �+r o� AN LEGAL SUFFICIENCY""""• roller BY BY: YLAN REINGOLD Deput e COUNTY ATTORNEY