BlueCard Tips and Reminders

Anxiety The summer travel season is upon us, and that means road trips, vacations, and out-of-area patients, including members from Blue Cross and Blue Shield Plans from other parts of the country.

These patients are covered under the BlueCard® Program, which enables members of one Blue Plan to obtain health care service benefits while traveling or living in another Blue Plan’s service area. The program links participating health care providers with the independent Blue Cross Blue Shield (BCBS) Plans across the country through a single electronic network for claims processing and reimbursement.

The BlueCard Program lets you conveniently submit claims for members from other Blue Plans, including international Blue Plans, directly to Highmark.

BlueCard Tips

As a provider treating patients with out-of-area plans, you may find the following tips helpful:

  • Member ID Cards
    • Ask members for their most current ID card. Since new ID cards may be issued to members throughout the year, this will ensure that you have the most up-to-date information in the patient’s file.
    • Look for the 3-character prefix that precedes the member’s identification number on the ID card.
    • Make copies of the front and back of the member’s ID card.
    • Capture all ID card data to ensure accurate claim processing. If the information is not captured correctly, you may experience a delay with the claim processing.
  • Eligibility Inquiries
    • Submit a BlueExchange® Inquiry via NaviNet® ; or
    • Submit a HIPAA 270 transaction to Highmark.
    • You can also call the BlueCard Eligibility Line at 800-676-BLUE (2583) to verify eligibility.

  • The BlueCard Eligibility Line
    • Reminder: This number is for eligibility, benefit, and precertification and referral authorization inquiries only; it should not be used for claim status. Direct all claim inquiries to Highmark.

Additional Resource

 

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