Blue Review
A Provider Publication

August 2023

BlueCard® Program: Reminders and Claim Filing Checklist

Through our BlueCard Program, many Blue Cross and Blue Shield (BCBS) members take their coverage with them when they travel.

The program is convenient for members, without causing extra work for providers. Here’s how it works:

  • As a Blue Cross and Blue Shield of Illinois (BCBSIL) participating provider, you may see patients from out-of-area BCBS Plans when they need care.
  • BCBSIL is the Host Plan for these “guest” members while they’re away from their Home Plans.
  • When you welcome these out-of-area members as patients, BCBSIL welcomes your BlueCard claims for their care.

Here’s a checklist for your reference:

  • Ask members for their current ID card. Most BlueCard members have a suitcase logo on the front of their BCBSIL 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 Availity® Essentials or your preferred web vendor.
  • When recording the member ID number, include the three-character prefix. This prefix indicates the member’s group information.
  • Submit BlueCard claims to BCBSIL electronically. Don’t 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 information, 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, 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 or services they offer.