The BlueCard® Program links health care providers and the independent Blue Cross and Blue Shield Plans across the country and around the world through a single electronic network for claims processing reimbursement.
How to process BCBS claims for out-of-area patients:
Filing Claims for BlueCard Members
Regardless of where your BCBS company patient is a member, you follow these three easy steps for claims reimbursement:
To file claims for Blue members, please follow these three easy steps:
- Ask members for their current member ID card and check eligibility and benefits electronically via your local Blue company or by calling 1.800.676.BLUE (2583). Be sure to provide the member's three letter alpha prefix.
- Verify the member's cost sharing amount before processing payment. Please do not process full payment upfront.
- Once the member receives care, submit their claim to your local Blue Cross and/or Blue Shield company for reimbursement. For providers contracted with multiple Blue companies (i.e. in contiguous counties, overlapping service areas or remote providers) please contact your contracted Blue Plan for claim filing instructions.
Filing Medicare Supplemental Claims
Regardless of which BCBS Plan the patient is a member of, always file with the Medicare contractor first. When submitting the claim to Medicare, remember to always include the following:
- The complete Health Insurance Claim Number (HICN)
- The patient's complete BCBS identification number, including the three-character alpha prefix
- The BCBS name as it appears on the patient's ID card for supplemental insurance
Do not file with your local BCBS Plan and Medicare at the same time. Wait until you receive the Explanation of Medical Benefits (EOMB) or payment advice from Medicare.
Filing COB Claims and BlueCard
Coordination of Benefits (COB) refers to how to make sure people receive full benefits and prevent double payment for services when a member has coverage from two or more sources. There are specific guidelines for which insurer has primary responsibility for primary payment, which has secondary, etc. To find out more about how to file specific COB Claims, contact your local BCBS Plan.
Enter your zip code to connect with your local Blue Cross and Blue Shield company.