Blue Review
A Provider Publication

July 2022

BlueCard® Program Reminder Checklist

Vacation season is here and, through the BlueCard program, many Blue Cross and Blue Shield members are taking their coverage with them when they travel.

This program 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 BCBS Plans, you still have one source for claim filing in most instances – the local or Host Plan. For Illinois providers seeing out-of-area members, 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® Essentials, 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. Use the Availity Claim Status Tool to search for claims by member ID or claim number. 

For more in-depth information to help you when you’re 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 third party vendors and the products and services they offer.