See Our BlueCard® Program Checklist for Out-of-Area Member Claims
AI Summary
This policy provides an updated checklist for billing out-of-area Blue Cross Blue Shield members through the BlueCard program. The guidance reinforces existing procedures for verifying member eligibility, obtaining prior authorizations when required, and submitting claims electronically to BCBSTX as the host plan.
Action Required
Immediately: Review current BlueCard billing procedures to ensure compliance. Front desk staff must verify out-of-area BCBS members have current ID cards and provide photo ID confirmation. Include three-character prefix when recording member ID numbers. Billing team must check eligibility through Availity Essentials before service and obtain prior authorization when required using Availity Authorizations & Referrals. Submit all BlueCard claims electronically to BCBSTX and avoid duplicate submissions.
Plan Types
Commercial
States
TX
Specialties
all-specialties