Print

Claim Submission

This section provides a quick introduction to filing claims with BCBSIL. For additional information, including Timely Filing Requirements, Coordination of Benefits (COB), Medicare Crossover process and more, please refer to the BCBSIL Provider Manual.

Electronic Claims

You or your billing agent will need to utilize a third-party claims clearinghouse vendor to submit electronic Professional and Institutional claims (ANSI 837P and 837I transactions) to BCBSIL. For vendor options and information, see our E-Commerce Connections menu.

  • Advantages include greater security and accuracy of data, along with faster processing and payment.
  • Claims may be submitted one-at-a-time by entering information directly into an online claim form on the vendor portal; or batch claims may be submitted via your Practice Management System (check with your software vendor to ensure compatibility).
  • Electronic reports are generated and sent automatically to confirm receipt and identify any errors that need to be rectified prior to adjudication and payment.

Paper Claims

There may be situations where your office needs to submit paper claims.

Out-of-area (BlueCard®) Claim Process

BlueCard is a national program that enables members of one Blue Cross and Blue Shield (BCBS) Plan to obtain health care services while traveling or living in another BCBS Plan’s service area.

  • The program allows you to submit claims for members from other BCBS Plans to the Illinois Plan.
  • The three-character alpha prefix preceding the member’s ID number is critical for proper routing of BlueCard claims.
  • For complete details, refer to the BlueCard Program Manual.