BlueCard® Alert: Itemized Bill May Be Required for Some Inpatient Claims, Effective March 1, 2019

Dec. 31, 2018

Beginning March 1, 2019, Blue Cross and Blue Shield of (BCBSMT) will request an itemized bill for any institutional inpatient BlueCard (out-of-area) member claim billed at $250,000 or more.

The itemized bill is needed for completion of a required pre-payment review process, as mandated by the Blue Cross and Blue Shield Association. The purpose of the review is to support accurate claim payment. The review also may help reduce the need for further inquiry or review of itemized bill statements, after claims are paid.

If you receive a request for an itemized bill, you may submit it electronically, along with the appropriate claim number, using our Claim Inquiry Resolution tool.

For additional information on submitting claims for out-of-area Blue Cross and Blue Shield members, refer to the BlueCard Program Provider Manual. If you have questions, contact your BCBSMT Provider Network Consultant.