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.
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.
Please refer to the following websites for assistance with proper completion of paper claim forms:
- For CMS-1500 (Professional) claims, visit National Uniform Claim Committee (NUCC)
- For UB-04 (Institutional) claims, visit National Uniform Billing Committee (NUBC)
- Mail original claims to BCBSIL, P.O. Box 805107, Chicago, IL 60680-4112.
Government Programs Claims
There are different addresses for Blue Cross Community Health PlansSM, Blue Cross Community MMAI (Medicare-Medicaid Plan)SM and Blue Cross Medicare AdvantageSM claims. Mail original claims to the appropriate address as noted below.
- Blue Cross Community Health Plans, c/o Provider Services, P.O. Box 3418, Scranton, PA 18505
- Blue Cross Community MMAI (Medicare-Medicaid Plan), c/o Provider Services, P.O. Box 4168, Scranton, PA 18505
- Blue Cross Medicare Advantage, c/o Provider Services, P.O. Box 3686, Scranton, PA 18505
- Do NOT submit duplicate claims.
- To confirm receipt and adjudication progress, check claim status.
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.