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There are several ways to find a participating doctor in your area:
You do NOT need to select a PCP under the BCBS options. You can choose any participating BCBS doctor when you need care.
No, you can choose any participating doctor each time you need care.
Most doctors are familiar with BCBS Plans and BlueCard® program and know how to file claims. The doctor should follow the filing instructions on the back of your member ID card.
Blue Cross Plans negotiate discounted rates with local doctors and hospitals. To help you benefit from those discounts, doctors and hospitals may file claims with the local plan. The local plan then exchanges information with Blue Cross and Blue Shield of Illinois to ensure that the benefits are paid appropriately.
You will receive an Explanation of Benefits (EOB) from Blue Cross and Blue Shield of Illinois once your claim has been processed. The EOB will provide details of what was covered, the level of coverage, and the amount you owe, if any. To view your EOBs online, log on to Blue Access for MembersSM.
Among the advantages of using participating doctors and hospitals are the negotiated rates, which means your out-of-pocket costs are lower, and there's less paperwork because the doctors and hospitals file the claims. If you pay at the time of service you may not receive the appropriate discount.
Your local Blue Cross and Blue Shield plan will not be able to assist you. Blue Cross and Blue Shield of Illinois Customer Service for employees is thoroughly trained on your options and will be able to assist you with questions regarding the processing of your claims. To ensure you receive a quick and accurate response to any questions you may have regarding your claims or benefits, please call 1-800-537-9765.
MSA is staffed with nurses who handle case management and pre-notification for inpatient hospitalizations. MSA must be notified two business days prior to any elective hospitalization and within two business days of an emergency or maternity admission. MSA must also be notified for Skilled Nursing, Private Duty nursing and home health care services. The MSA is available 7:30 a.m. to 5:30 p.m. Central time, Monday – Friday at 1-800-433-3232. You may also leave a message after hours and on weekends and the MSA will call you back on the next business day.
Benefits are determined according to the guidelines of your program. If you have questions regarding the availability of benefits for a specific service, please contact Customer Service at 1-800-537-9765.
You can log on to Blue Access for Members. You can also call the BCBS Customer Service Center at 1-800-537-9765. A Customer Service Representative can advise you on the status of any finalized claims, as well as those that are still being processed.
The ID card will come from Blue Cross and Blue Shield and will contain your medical coverage information. Please present your ID card when obtaining services from both hospitals and doctors.
If you elect single coverage, you are sent one ID card. If you elect family coverage, you will receive 2 cards. If you need additional cards, call BCBS Customer Service at 1-800-537-9765. You can also request replacement ID cards through your Blue Access® for Members account. Please allow 10 business days for delivery. Blue Access for Members also allows you to print a temporary ID card that can be used immediately.
Replacement ID cards can be requested through your Blue Access® for Members account or by contacting BCBS Customer Service at 1-800-537-9765. Please allow 10 business days for delivery. Blue Access for Members also allows you to print a temporary ID card that can be used immediately.
Claim forms can be obtained by calling BCBS Customer Service at 1-800-537-9765.
Blue Cross and Blue Shield of Illinois
P.O. Box 660603
Dallas, TX 75266-0603