BlueCard® Alert: Itemized Bill May Be Required for Some Inpatient Claims, Effective Jan. 1, 2019

Posted October 31, 2018

Beginning Jan. 1, 2019, Blue Cross and Blue Shield of Illinois (BCBSIL) will request an itemized bill for any institutional inpatient BlueCard (out-of-area) member claim billed at $250,000 or more. 

The itemized bill is needed for completion of a required pre-payment review process. The purpose of the review is to support accurate claim payment, while reducing the time it takes to finalize payment to the provider. The review also may help reduce the need for further inquiry or review, after claims are paid.

If you receive a request for an itemized bill, you may submit it electronically, along with the appropriate claim number, using our Claim Inquiry Resolution tool.

For additional information on submitting claims for out-of-area Blue Cross and Blue Shield members, refer to the BlueCard Program Provider Manual. If you have questions, contact your BCBSIL Provider Network Consultant (PNC).