March 15, 2022
We will be making changes to how misdirected claims are handled for Federal Employee Program® (FEP) members.
Claims for FEP members should be filed with the local (Host) Plan where services are rendered.
Currently, some FEP claims are mistakenly submitted to the member’s Home Plan rather than the local Plan where services were rendered. In these cases, Blue Cross and Blue Shield of Illinois (BCBSIL) has manually forwarded the claims to the Host Plan.
Effective June 15, 2022, BCBSIL will no longer forward misdirected claims for FEP members to the following Host Plans for processing: Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas. Instead, we’ll deny these claims and instruct providers to resubmit the claims to the appropriate local Plan where the service was rendered.
Similarly, if you treat FEP members from any of these four out-of-state Plans, and you submit the claims to the member’s Home Plan rather than BCBSIL, your claim will be denied, and you’ll be instructed to resubmit your claim to us, the local Plan where services were rendered.