Blue Review
A newsletter for contracting institutional and professional providers

November 2019

Itemized Bills Required for BlueCard® Claims Over $200K

Beginning Jan. 1, 2020, Blue Cross and Blue Shield of Illinois (BCBSIL) will require facilities to submit an itemized bill for any BlueCard member billed at or more than $200,000 for inpatient care. An itemized bill helps ensure accurate claim payment and reduces the need to submit more information after claims are paid.

What has changed?
The claim amount requiring itemization is changing from the $250,000 threshold in 2019, to $200,000.

How to Submit Itemized Bills
You may submit itemized bills electronically for finalized claims using the Claim Inquiry Resolution (CIR) tool. Be sure to include the corresponding claim number.

More Information
Refer to the Clinical Payment and Coding Policy on our provider website for more information. If you have any questions, please contact your BCBSIL Provider Network Consultant (PNC).

What is BlueCard?
BlueCard is a national program that enables members of one Blue Cross and Blue Shield (BCBS) Plan to obtain health care services while traveling or living in another BCBS Plan's service area. BlueCard members usually have a suitcase logo* on their identification card.

As a reminder, it’s important to check member eligibility and benefits through Availity® or your preferred vendor web portal prior to every scheduled appointment. For BlueCard members, you may also call the BlueCard Eligibility® line at 800-676-BLUE (2583). Providers must also ask to see the member's ID card for current information and a photo ID to help guard against medical identity theft.