Blue Review
A Provider Publication

October 2021

Change to Some Primary and Secondary Claims Coordination, Effective Dec. 13, 2021 

As of Dec. 13, 2021, we’ll be making changes to increase efficiencies in coordinating claims for providers when a Blue Cross and Blue Shield of Illinois (BCBSIL) member has primary and secondary health insurance coverage from two BCBSIL health plans or BCBSIL and one of the following four Plans:

  • Blue Cross and Blue Shield of Montana
  • Blue Cross and Blue Shield of New Mexico
  • Blue Cross and Blue Shield of Oklahoma
  • Blue Cross and Blue Shield of Texas

What’s changing for providers?
In the new process:

  • First, you’ll submit just the primary claim.
  • You’ll receive the determination on the primary claim through your normal channels detailing the primary claim adjudication.
  • Next, submit the secondary claim with the primary claim payment information under the secondary policy following the Coordination of Benefits (COB) guidelines documented in the Provider Manual.

These changes will help decrease the time it takes to process and coordinate payment of these claims. This new process is for members with a BCBSIL health plan and another plan with BCBSIL or one of the other four Plans listed above.

Note: The standard guideline for timely filing with COB is as follows and will not be changing:

  • Primary claim timely filing begins at date of services rendered.
  • Secondary claim timely filing begins at date of primary claim final adjudication.