Related Resources

Quick Guide to Member ID Cards PDF Document

Medicaid Claims Handling for Medicaid Members PDF Document

BlueCard Provider Manual PDF Document

BlueCard® Program

BlueCard is a national program that enables members of one Blue Cross and Blue Shield (BCBS) Plan to obtain health care services while traveling or living in another BCBS Plan's service area. BlueCard links participating health care providers with the independent BCBS Plans across the country, and in more than 200 countries and territories worldwide, through a single electronic network for claims processing and reimbursement.

Program Advantages to Providers

  • The program allows you to submit claims for members from other BCBS Plans to the Montana Plan.
  • Blue Cross and Blue Shield of Montana (BCBSMT) is your sole contact for claims payment, problem resolution and adjustments.

Covered/Non-covered Services

Covered Services Under BlueCard

  • All inpatient, outpatient and professional services

Services Not Covered Under BlueCard

  • Prescription Drugs
  • Hearing/Vision
  • Dental (non-surgical)
  • Federal Employee Program (FEP)

How the BlueCard Program Works

  1. Identify BlueCard Members

    The main identifiers are:

    • PPO in a suitcase logo, for eligible PPO members
    • Empty suitcase logo, for Traditional, POS or HMO members
    • An alpha prefix (the first three positions of the identification number)
    • The alpha prefix correctly routes BlueCard claims for processing

    Alpha Prefixes are assigned to every BCBS Plan and start with X, Y, Z or Q:

    • First Character — X, Y, Z or Q
    • Second character — A–Z
    • Third character — A–Z

    National Account Alpha Prefixes:

    • Begin with letters other than X,Y, Z or Q
    • Typically relate to the name of the group, as in UAL for United Airlines.
  2. Verify Eligibility and Benefits

    Telephone: Call Blue Card Eligibility 800-676-BLUE (2583). Enter only the alpha prefix on the member's ID number and your call will be routed to the member's home plan.

    Electronic: Receive real-time responses to your eligibility requests by logging on to our Secure Provider Portal and clicking on BlueExchange.

  3. Obtain Pre-certification for BlueCard Members, when applicable

    Telephone: Call BlueCard Eligibility 800-676-2583 and ask to be transferred to the Medical Management Department.

  4. Submit all BlueCard claims electronically to the Montana Plan, for faster service.

See How the BlueCard Program Works PDF Document for more detailed information.

Quick Guide Outlines Member ID Card Basics

As an independently contracted BCBSMT provider, you may render services to BCBSMT members, as well as other Blue Plan members who travel or live in Montana. With the growing number of available products, plans and corresponding networks, it is increasingly important to ask for each member’s current ID card at every visit, along with a photo ID, prior to checking eligibility and benefits. For an overview of key elements to watch for, along with guidance on how to interpret and use this information, please refer to our new Quick Guide to Blue Cross and Blue Shield Member ID Cards PDF Document.

Member ID cards are for identification purposes only and do not guarantee eligibility, benefits or payment of claims. Checking eligibility and/or benefit information is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member's eligibility and the terms of the member's certificate of coverage applicable on the date services were rendered. If you have any questions, please call the number on the back of the member's ID card. the member's certificate of coverage applicable on the date services were rendered. If you have any questions, please call the number on the back of the member's ID card.

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