Blue Review
A Provider Publication

July 2021

BlueCard® Program Reminder Checklist

The BlueCard program is designed to help our members take their coverage with them when they travel. It also offers providers access to an electronic network for claim submission and reimbursement. As a result, while you may see multiple patients from out-of-area Blues Plans, you still have one source for claim filing in most instances – your local Blue Plan. For Illinois providers, that’s Blue Cross and Blue Shield of Illinois (BCBSIL).

Here’s a quick checklist of important BlueCard reminders:

  • Ask members for their current ID card. Most BlueCard members have a suitcase logo on the front of their ID card. Also ask for a photo ID to confirm the member’s identity.
  • Verify the member’s eligibility, benefits and copayments. For faster results, check coverage electronically through the Availity® Provider Portal, or your preferred web vendor.
  • When recording the member ID number, be sure to include the three-character prefix. This prefix indicates the member’s group information.
  • Submit BlueCard claims to BCBSIL electronically. Do not submit duplicate claims.
  • Check claim status online. Check the status of the original claim online by submitting an electronic claim status request to BCBSIL via Availity or your preferred vendor portal. You may use the Availity Claim Status tool for detailed claim status results.

For more in-depth information to help you when you are filing claims for out-of-area members, refer to the BlueCard Program Provider Manual.

Checking eligibility and/or benefits information is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member’s eligibility and the terms of the member’s certificate of coverage applicable on the date services were rendered. If you have any questions, please call the number on the member’s ID card.

Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSIL. BCBSIL makes no endorsement, representations or warranties regarding any products or services provided by third party vendors such as Availity. If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly.