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The BlueCard Program

BlueCard is a national program that:

  • Enables members of a Blue Cross and/or Blue Shield Plan (Blue Plan) to obtain health care services while traveling or living in another Blue Plan's service area
  • Links participating physicians, other health care professionals and facilities with independent Blue Plans across the country and around the world through a single electronic network for claims processing and reimbursement

Advantages to physicians, other health care professionals and facilities
As a participating provider of Regence, you may render services to patients who are members of other Blue Plans.

The BlueCard program allows you to conveniently submit claims for members from other Blue Plans, including international Blue Plans, directly to Regence. We will be your one point of contact for all of your claims-related questions.

Advantages to Blue Plan members
The program allows members to access providers and savings—and receive the same benefits as within their Blue Plan’s service area—while traveling or living in our service area.

Claims and products included
BlueCard applies to all inpatient, outpatient and professional claims. A variety of products and claim types are eligible to be delivered via BlueCard; however, not all Blue Plans offer all of these products:

  • Medigap
  • Traditional
  • Point-of-Service (POS)
  • Exclusive Provider Organization (EPO)
  • Preferred Provider Organization (PPO)
  • Health Maintenance Organization (HMO)
  • Stand-alone State Children’s Health Insurance Plan (SCHIP)

Note: Stand-alone vision and stand-alone self-administered prescription medication programs are eligible to be processed through BlueCard when such programs are not delivered using a vendor. Please see the claim filing instructions on the back of the member card.

Claims and products excluded
The following are excluded from BlueCard:

  • Medicaid and SCHIP that is part of the Medicaid program
  • Stand-alone dental (Learn about dental procedures that qualify.)
  • The Federal Employee Program (FEP) (Members of FEP have the letter “R” in front of their member number.)

Note: Medicare Advantage is a separate program from BlueCard. However, like claims for BlueCard members, claims for Medicare Advantage members should be sent to Regence.

 

 


 

 


 

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