Bcbs Claims Address and Submission Guidelines

To submit claims to BCBS, you'll need to know the correct address. The Blue Cross and Blue Shield claims address is PO Box 71300, Philadelphia, PA 19176-1300. Make sure to use this address for all claims submissions.

The claims address is specific to each BCBS plan, and you should check your plan's details for the correct address. You can find this information on the BCBS website or by contacting their customer service department.

To ensure timely processing, be sure to include all required documentation with your claim submission. This typically includes the claim form, patient and provider information, and any supporting medical records. Don't forget to keep a copy of your submission for your records.

Submitting claims can be a straightforward process if you know the right steps to take. To start, you'll need to determine which claims address to use, depending on the type of claim you're filing.

If you're filing a claim for medical care, you'll need to forward it to the medical foundation associated with your subscriber's identification card. This information is listed by county in your Blue Shield materials.

To submit commercial claims via mail, you'll need to download and print a CMS 1500 or UB04 form. Make sure to use black ink and complete the form accurately.

Here's a step-by-step guide to submitting commercial claims via mail:

If you receive covered services from a contracting provider, they'll typically file a claim on your behalf. However, if the provider is non-contracting or you have a prescription benefit that requires a claim, you may need to access member forms or contact our customer service center at 800-432-3990.

If you're not satisfied with a claim decision, you can request a review of the adverse decision.

You'll need to complete a claim appeal form, which can be found on the BCBSKS website or by calling their customer service center at 800-432-3990.

The form must be completed with an attached Explanation of Benefit (EOB) to be considered.

Contracting providers can appeal pre and post-service claim denials in writing, submitting all pertinent medical records to BCBSKS customer service.

You can find additional information about appeals in 'Policy Memo No. 1, Policies and Procedures.'

If you need to submit a claim, there are a few different methods you can use, depending on the type of claim and the provider you're working with.

To submit commercial claims via mail, you'll need to download and print a CMS 1500 or UB04 form, complete it in black ink, and mail it to Blue Cross NC at PO Box 35, Durham, NC 27702. Make sure to include the member's Blue Cross NCID on all claims and attachments.

If you're dealing with a medical foundation, you'll want to forward all claims to that foundation for payment. The addresses for these foundations can be found listed by county in the Blue Shield affiliation information.

You can also submit claims through a contracting provider, who will file the claim on your behalf. If the provider is non-contracting or you have a prescription benefit that requires a claim, you can access member forms or call our customer service center at 800-432-3990 to get the correct claim form.

Our Claims-Routing Tool is a convenient way to determine where to send your claims by mail. You can use it to find the correct address for your medical foundation.

Listed below are the addresses of medical foundations affiliated with Blue Shield, organized by county. However, using the Claims-Routing Tool is a more efficient way to find this information.

If the name of a medical foundation appears on your subscriber's identification card, forward all claims to that foundation for payment.

If you receive covered services from a contracting provider, they will file a claim on your behalf.

To file a claim yourself, you can access member forms or call our customer service center at 800-432-3990.

If you're dealing with a non-contracting provider, they might not file the claim, and you'll need to take matters into your own hands.

In such cases, you can obtain the correct claim form by calling our customer service center or accessing member forms.

If you're unsure about where to send your claim, you can use our Claims-Routing Tool to find out.

Here are the addresses for mailing paper claims:

Make sure to use the correct form, such as the CMS-1500 or UB04, and include the member's Blue Cross NCID on all claims and attachments.