See Our BlueCard® Program Checklist for Out-of-Area Member Claims
AI Summary
This policy provides a checklist for billing teams when treating Blue Cross Blue Shield members from other states through the BlueCard program. Key steps include asking for current ID card with three-character prefix, checking eligibility through Availity, obtaining prior authorizations when required, and submitting claims electronically to BCBSTX as the host plan.
Action Required
Immediately: Front desk staff must collect current ID cards with three-character prefix and photo ID from out-of-state BCBS members. Billing team must verify eligibility through Availity Essentials before services and check for prior authorization requirements. Submit all BlueCard claims electronically to BCBSTX and use Availity Claim Status tool to track claims. Do not submit duplicate claims.
Plan Types
Commercial
States
TX
Specialties
all-specialties