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.
Learn
more about |
Description
of information |
Identifying
Members |
View sample domestic, international,
Medicare Advantage Preferred Provider Organization
(PPO) and Limited Benefit Product member cards |
Verifying
Eligibility |
Learn how to verify eligibility
by phone or by submitting electronic inquiries |
Obtaining
Pre-authorization/pre-certification |
Contact the member’s
Blue Plan by phone or by submitting electronic
inquiries |
Filing
Claims |
View information about claim
submission, Medicare Advantage PPO network
sharing, coordination of benefits, medical
records, checking claim status, rates, adjustments
and appeals, and dental procedures |
Blue
National Doctor & Hospital Finder |
Use the Blue National Doctor
and Hospital finder to locate providers within
the U.S., Puerto Rico and the U.S. Virgin Islands. |
Revised: May 1, 2010
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