Itemized Bills Required for BlueCard® Facility Claims Over $100k
Beginning Jan. 1, 2021, we will require facilities to submit an itemized bill for inpatient care billed for $100,000 or more. This applies to all facility claims for $100,000 or more submitted for BlueCard out-of-area Blue Cross and Blue Shield members. An itemized bill helps ensure an accurate claim payment and reduces the need to submit more information after a claim is paid.
The BlueCard claim amount requiring itemization will be lowered to $100,000 from the current $200,000 threshold.
How to Submit Itemized Bills.
You may submit itemized bills electronically using our Claim Inquiry Resolution tool. Include the corresponding claim number for quicker review and turnaround time.
Refer to our Inpatient/Outpatient Unbundling Coding and Compensation Policy on our provider website for more information. 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.