See Our BlueCard® Program Checklist for Out-of-Area Member Claims

July 22, 2025

The summer vacation season may be ending for some, but holiday visits and winter escape planning are just beginning for others. Through our BlueCard program, many members with Blue Cross and Blue Shield can take their coverage with them when they travel. 

Here’s how the program works: The program offers convenience for members, without causing more work for you.

  • As a participating provider with Blue Cross and Blue Shield of Illinois, you may see members with BCBS from other states. 

  • BCBSIL is the host plan for these “guest” members while they’re traveling or living away from their home plans.
  • When you welcome these out-of-area members as patients, BCBSIL welcomes your BlueCard claims for their care.

BlueCard claim filing checklist: Follow these steps when seeing members from out-of-area plans.

  • Ask members for their current ID card. Look for the suitcase logo for BlueCard program participation. Also ask for a photo ID to confirm the member’s identity. 
  • When recording the member’s ID number, include the three-character prefix. This prefix indicates the member’s group information. 
  • Check eligibility and benefits. For faster results, check membership and coverage details electronically through Availity® Essentials, or your preferred web vendor. If you don’t have online access, call the BlueCard Eligibility line at 800-676-2583. This step also helps you confirm prior authorization requirements.
  • If prior authorization is required, you can use Availity Authorizations to initiate an electronic request (278 transaction). If the patient is a member with BCBS in another state, you’ll be routed to that payer’s platform to complete the request as part of the electronic provider access process.
  • Submit BlueCard claims electronically to BCBSIL. Learn more about claim submission. Don’t submit duplicate claims. 
  • Check claim status online. Check the status of the original claim via Availity or your preferred vendor portal. Use the Availity Claim Status tool for detailed results.  

Learn more about our BlueCard program. 

Checking eligibility, benefits and prior authorization information is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member’s eligibility and the terms of the member’s certificate of coverage applicable on the date services were rendered. If you have any questions, call the number on the member’s ID card.  

Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSIL. BCBSIL makes no endorsement, representations or warranties regarding any products or services provided by third party vendors such as Availity. BCBSIL makes no endorsement, representations or warranties regarding third party vendors and the products and services they offer.