Itemized Bills Required for Some Facility Claims Over $100K

October 2, 2023

Beginning Jan. 1, 2024, Blue Cross and Blue Shield of Illinois (BCBSIL) will require facilities to submit an itemized bill for inpatient care billed for $100,000 or more. This applies to facility claims billed at $100,000 or more, or as required by the member’s benefit plan, submitted for some BCBSIL commercial members.*  

What’s Changing  
This claim review is already in place for BlueCard® (out-of-area Blue Cross and Blue Shield) members. The review is being expanded to include some BCBSIL commercial members.  

How To Submit Itemized Bills  
You may submit itemized bills electronically using the Claim Inquiry Resolution (CIR) tool. Be sure to include the corresponding claim number for quicker review and turnaround time. 

Join Us for a Webinar 
You can attend a free, instructor-led overview to learn more about the itemized bill review process. Use this link to register now for your preferred session. Times listed are Central Time.

  • Session 1: Nov. 7, 2023 – 1 to 2 p.m.
  • Session 2: Nov. 14, 2023 – 11 a.m. to noon
  • Session 3: Nov. 20, 2023 – 11 a.m. to noon

More Information  
Refer to our Inpatient/Outpatient Unbundling Policy (Clinical Payment and Coding Policy 002) for more information. If you have questions, please contact your BCBSIL Provider Network Consultant (PNC). 

*The information in this article does not apply to Federal Employee Program® (FEP®), Medicare, or Illinois Medicaid members.