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Filing for Border County Providers

Quick access to our online Provider tools and resources makes it easy to spend more time where it matters most – with your employees.

In this section, you'll find the answers you need about Medicare Part D and Creditable Coverage, as well as fast access to a variety of administrative and HIPAA forms.

As always, if you have any questions, simply contact a representative on our sales team. We’re here to help you sell Blue!

how border county providers work example 1

Example 1— Provider has contracts with BlueShield of Northeastern New York and BlueCross BlueShield of Vermont.

  • Claims for a BlueShield of Northeastern New York member are filed directly with their plan.
  • All other claims are filed with BlueCross BlueShield of Vermont.
how border county providers work example 2

Example 2— Provider is located in a Northeastern New York county that borders Vermont but only has a contract with BlueShield of Northeastern New York.

  • All claims are filed with BlueShield of Northeastern New York.
how border county providers work example 3

Example 3— Provider is located in a New York county that borders Vermont but only has a contract with BlueCross BlueShield of Vermont.

 

  • When this provider renders a service to a BlueShield of Northeastern New York member, the claim is filed with BlueShield of Northeastern New York.
  • All other claims are filed with BlueCross BlueShield of Vermont.