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How BlueCard works

When an out-of-state or international Blue Cross Blue Shield plan member visits you:

Step Ask for the member’s most current domestic or international ID card (because coverage and ID numbers may change). All domestic cards will have the Blue Cross logo, a three-character prefix and a suitcase logo.  
Step Verify eligibility and coverage with the member’s plan. Call
1-800-676-BLUE (2583) for information about:
  • Eligibility and coverage
  • Dependents
  • Deductibles
  • Copayments
  • Co-insurance
  • Benefit maximums
  • Referral and authorization information
  • Other member information.

You can also check eligibility electronically using Online Services, submitting a HIPAA-compliant 270, or using other electronic tools.
Step The doctor or admitting hospital requests authorization from the Home plan for inpatient admissions. We will reject claims if you don’t request preauthorization.
Step Collect any member cost share for services. This should be the same type of out-of-pocket expenses (deductible, copayment, co-insurance, non-covered services) as you currently collect for in-state or domestic Blue Cross Blue Shield members.  
Step Submit the claim to the Local plan. Make sure the member’s ID number and prefix are correct. This information is used to send BlueCard Program claims electronically to the member’s plan for processing.  
Step The member’s plan reviews the claim and transmits its response to us, either approving or denying payment.  
Step We finalize the claim and send you payment or notification via our Provider Payment Advisory (PPA) and Provider Detail Advisory (PDA).  
Step The member’s plan sends a detailed explanation of benefits to the member.