CommercialAdministrativeMedium impact
See Our BlueCard® Program Checklist for Out-of-Area Member Claims
BCBS Illinois·IL·Reimbursement
Effective date
May 22, 2026
We identified it
Jun 16, 2026
Summary
Blue Cross Blue Shield of Illinois has updated their BlueCard program checklist for processing out-of-area member claims. The policy provides standardized procedures for verifying member eligibility, checking benefits, obtaining prior authorizations, and submitting claims for BCBS members from other states who are receiving care in Illinois.
Action Required
Immediately: Front desk staff must implement new BlueCard verification procedures: 1) Always request current ID card AND photo ID from out-of-area BCBS members, 2) Record member ID number including the three-character prefix, 3) Verify eligibility and benefits through Availity Essentials or call 800-676-2583, 4) Use Availity Authorizations & Referrals for prior authorization requests when required, 5) Submit claims electronically to BCBSIL only (no duplicate submissions). Train staff on these procedures to ensure proper reimbursement for out-of-area BCBS members.