The BlueCard® Program Makes Filing Claims Easy
As a participating provider of Highmark Blue Shield of Northeastern New York, you may render services to patients who are national account members of other BlueCross and/or Blue Shield Plans, and who travel or live in our service area. This manual is designed to describe the advantages of the BlueCard program, while providing you with information to make filing claims easy.
This manual offers helpful information about:
- Identifying members
- Verifying eligibility
- Obtaining pre-certifications/pre-authorizations
- Filing claims
- Who to contact with questions
Find out what the BlueCard program is and how it works.
Local Alpha Prefix Listing
View a list of NENY plan prefixes.
Changes to Bluecard Host Vouchers
In conjunction with a recent upgrade to our ITS system an improvement was made to BlueCard provider vouchers.
BlueCard Claim Tips: Automatic Crossover for all Medicare Claims
We automatically cross-over Medicare claims for services covered under Medigap and Medicare Supplemental products to secondary payers. You do not need to submit an additional claim to the secondary carrier.
BlueCard Claims Tips for Border County Providers
Do you practice in a county bordering another state? Do you have contracts with Blue Plans in your state and the neighboring state? File claims with the local Blues Plan based on where the service was provided (unless the member has coverage with the neighboring state’s Blues Plan).
Out of Area Members
Access the information you need about servicing out-of-area Blue members, including:
- How to identify Blue members
- Obtaining information on members' utilization management protocols
- Submitting claims
Out-of-Area Members: Contiguous Areas
If you operate in a contiguous area, get answers to your questions about:
- Contiguous area claim filing
- Overlapping service area claim filing
- Ancillary providers claim filing
- Air ambulance providers
- Pharmacy, dental, and vision providers
- Telemedicine providers
BlueCard Claims Adjustments Notice
BlueCard® Claims Adjustments
We have been notified by the Blue Cross Blue Shield Association that due to a system defect, all BlueCross and/or Blue Shield plans are required to adjust BlueCard® claims that were processed during a two-week period in October, 2013.
There will be no change to your payments. This status adjustment is the plan’s responsibility and is related to the cost of claims processing between plans. The adjustments will appear on your vouchers and member Explanation of Benefits.