Asthma and Asthma-Associated Conditions.We’ve put together some documentation and coding tip sheets for the following conditions: High quality documentation and complete, accurate coding can help capture our members’ health status and promote continuity of care. For complete details, refer to the BlueCard Program Manual.The three-character prefix preceding the member’s ID number is critical for proper routing of BlueCard claims.The program allows you to submit claims for members from other BCBS Plans to the Illinois Plan.To confirm receipt and adjudication progress, check claim status.īlueCard 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. Blue Cross Medicare Advantage, c/o Provider Services, P.O.Blue Cross Community MMAI (Medicare-Medicaid Plan), c/o Provider Services, P.O.Blue Cross Community Health Plans, c/o Provider Services, P.O.Mail original claims to the appropriate address as noted below. There are different addresses for Blue Cross Community Health Plans SM, Blue Cross Community MMAI (Medicare-Medicaid Plan) SM and Blue Cross Medicare Advantage SM claims. If necessary, government programs paper claims may be submitted. Box 805107, Chicago, IL 60680-4112.Įlectronic claim submission is preferred, as noted above. If necessary, commercial paper claims may be submitted as follows: For UB-04 (Institutional) claims, visit National Uniform Billing Committee (NUBC)Įlectronic claim submission is preferred, as noted above.For CMS-1500 (Professional) claims, visit National Uniform Claim Committee (NUCC).Please refer to the following websites for assistance with proper completion of paper claim forms: Electronic reports are generated and sent automatically to confirm receipt and identify any errors that need to be rectified prior to adjudication and payment.Claims may be submitted one-at-a-time by entering information directly into an online claim form on the vendor portal or batch claims may be submitted via your Practice Management System (check with your software vendor to ensure compatibility).Advantages include greater security and accuracy of data, along with faster processing and payment.For vendor options and information, refer to the Electronic Commerce page. You or your billing agent will need to utilize a third-party claims clearinghouse vendor such as Availity ® Essentials to submit electronic Professional and Institutional claims (ANSI 837P and 837I transactions) to BCBSIL. For additional information, including Timely Filing Requirements, Coordination of Benefits (COB), Medicare Crossover process and more, please refer to the BCBSIL Provider Manual. All Rights Reserved.This section provides a quick introduction to filing claims with BCBSIL. © Copyright Health Care Service Corporation. All of our trainings emphasize using electronic options before, during and after the claim submission process.īlue Cross and Blue Shield of Illinois, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company,Īn Independent Licensee of the Blue Cross and Blue Shield Association Also see the Electronic Commerce page for an overview of other electronic options and visit the Webinars and Workshops page to sign up for a webinar. Refer to our Claim Submission page for tips on how to get started with electronic claim filing. This change aligns with the Illinois Department of Healthcare and Family Services (HFS) transition toward paperless claim filing last year, as outlined in this HFS provider notice from November 2021.Įlectronic claim filing offers greater security and accuracy of data, with faster processing and payment. 1, 2023, Blue Cross and Blue Shield of Illinois (BCBSIL) will require electronic submission of all claims for services provided to BCCHP and MMAI members. The last date of service to submit paper claims for BCCHP and MMAI members is Dec. If you provide care and services to any of our Blue Cross Community Health Plans SM (BCCHP) or Blue Cross Community MMAI (Medicare-Medicaid Plan) SM members, it’s time to switch to electronic claim filing, if you haven’t done so already. October 2022 BCCHP SM and MMAI Member Claims Must Be Submitted Electronically, Beginning Jan.
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