Billing Blue Cross Blue Shield Insurance: A Step-By-Step Guide

Billing Blue Cross Blue Shield Insurance is a straightforward process. Blue Cross Blue Shield members can access a range of services, including searching for doctors, hospitals, and dentists in the United States, Puerto Rico, the US Virgin Islands, and even internationally. The first step is to locate your local Blue Cross Blue Shield company's website, which can be done through their interactive search tool. Your local company can assist with various tasks such as changing your coverage, estimating medical procedure costs, filing or checking on a claim, replacing your member ID card, and providing information about your plan details. Additionally, they offer exclusive discounts on health and wellness products and services through Blue365®. For billing inquiries, it is recommended to contact your local Blue Cross and Blue Shield company directly, ensuring that you have your account number, paperwork, and any other relevant information readily available.

How to pay your monthly bill

To pay your Blue Cross Blue Shield of Illinois monthly bill, you can choose from a few different payment options. You can make a one-time payment by logging into your account on the Blue Cross Blue Shield secure member portal. You can also make a first-time payment this way.

Alternatively, you can set up Auto Bill Pay by logging into the Blue Cross Blue Shield payment portal or visiting the Payments and Billing section in Blue Access for Members. This will ensure that you don't forget to pay your bill each month.

You can also pay by calling Customer Service at 1-800-538-8833 and selecting the option to make a payment. You can also mail a personal check, money order, or cashier's check to Blue Cross and Blue Shield of Illinois, P.O. Box 650774, Dallas, TX 75265-0774. Be sure to follow all the instructions on your bill.

After making your first payment, you can pay with cash at MoneyGram locations, including most Walmart, ACE Cash Express, and CVS stores. MoneyGram locations in Walmart and Albertsons stores also accept debit card payments. Bring a copy of your bill, including your account or billing ID number and your "receive code."

Your monthly health insurance bill is what keeps your plan active, so it's important to pay your bill by its due date every month to maintain your coverage.

What to do if you get a bill from your provider but haven't received your Explanation of Benefits (EOB) yet

If you receive a bill from your provider but haven't received your Explanation of Benefits (EOB), there are a few steps you can take to address the situation:

• Contact your insurance provider to ask if they have processed the claim from your provider. It's possible that the provider hasn't billed your insurance company yet, and you may be receiving a bill that you're not responsible for paying.
• If your insurance company hasn't received a claim, get in touch with your provider and request them to submit one.
• Compare the codes and descriptions of services on your bill with those on your EOB to ensure they match and look for any duplicate charges.
• Review the services listed to ensure that you only received the services mentioned and that the amount you owe aligns with your health insurance benefits.
• Verify that your name and policy number are correct on the bill. This is important to ensure you aren't billed for someone else's healthcare services.
• Contact your healthcare provider's office and ask them to review the bill with you. Ensure that it includes only the services they ordered and that you received. If there are any errors, inquire about the process to correct the billing.
• Request an itemized bill from your healthcare provider or facility, and carefully review it for any potential errors or discrepancies when compared to your EOB.
• Reach out to your health insurance company to discuss the differences between the bill and the EOB. In some cases, you may be able to bring all your paperwork to your insurance plan's customer service department and receive assistance in person.
• Keep a record of your communications, including the names of individuals you spoke with and the dates of your conversations. Make a note of any actions they agree to take, and follow up if you don't receive a corrected bill or a response to your query.

It's important to carefully review your EOB and compare it with your bill to identify any discrepancies or errors. Don't hesitate to contact your insurance provider or healthcare provider's office if you have any questions or concerns.

How to set up automatic payments

To set up automatic payments for Blue Cross Blue Shield Insurance, you can follow these steps:

Firstly, you must be an existing member with an online account. If you are new, you can register on the Blue Cross Blue Shield website. Once registered, log in to your account.

From here, you can set up Auto Bill Pay. This can be done by visiting the Payments and Billing section in Blue Access for Members. Alternatively, you can log in to the payment portal and select 'Auto Bill Pay' from the options.

If you are in Arkansas, you can also set up autopay by submitting a pre-authorized bank draft form based on your plan type. This option is for those who wish to set up automatic payments offline and is not applicable for credit or debit card payments.

For those in California, you can also enroll in AutoPay using your checking/savings account, or your debit/credit card. To do this, access your online account and, on the dashboard, scroll down to the Current Bill tab. From here, click on the AutoPay: OFF (set up) link.

If you bought your insurance directly through Horizon or Get Covered New Jersey, the subscriber on the account can set up automatic monthly payments after making an online payment. To do this, click on 'Payment Center' under 'My Accounts' and then click 'Enroll in Auto Pay' to sign up.

Remember, your health plan coverage won't start until you make your first premium payment.

How to submit a health insurance claim

To submit a health insurance claim, there are a few different options available to you. Firstly, it's important to note that in most cases, your healthcare provider will submit a claim on your behalf. However, if your healthcare provider does not do this, you can file a claim yourself.

To do this, you will need to fill out a "Medical Claim Form". You can find this form by searching for it on the Blue Cross Blue Shield website, or by logging into your Blue Access for Members (BAM) account and navigating to the "Forms & Documents" link under the "My Account" tab. Make sure you fill out the form completely and accurately.

Once you have completed the form, you can submit your claim in one of two ways:

• Online Submission: Log into your BAM account and go to the BAM Message Center. Attach the completed claim form, the original bill issued by your provider, and any relevant receipts or documentation. Select "Claims Submission Attachments" in the subject dropdown, and then send your claim.
• Mail Submission: Mail the completed claim form, the original bill from your provider, and any receipts or supporting documentation to the address printed at the top of the claim form.

It is important to keep in mind that there are different types of claims statuses that you may encounter after submitting your claim: "Paid", "Not Paid", and "Processed". "Paid" means that your claim has been approved and processed. "Not Paid" indicates that your claim was not covered by your health benefits plan, and you may be responsible for some or all of the bill. "Processed" means that your claim was covered, but no payment was required.

If your claim is denied, you have the right to know the reason for the denial and to appeal the decision. You can find this information in your Explanation of Benefits (EOB), which you can access through your BAM account or by requesting it from your insurance provider. The EOB will also include instructions on how to appeal the denial if necessary.

Additionally, if you have received medical care outside of the United States, the process for filing a claim may differ. For example, if you are eligible for the Federal Employee Program or the Blue Cross Blue Shield Global Core program, you can access the appropriate international claim form and instructions on the Blue Cross Blue Shield website. Alternatively, you can contact your local Blue Cross and Blue Shield company for assistance with filing an overseas claim.

What to do if your claim is denied

If your Blue Cross Blue Shield insurance claim is denied, the first thing you should do is carefully review the denial letter. This letter will inform you about your next steps for appealing the decision. It will also outline the specific reason for the denial, as well as key deadlines and submission requirements.

Next, you should contact your local Blue Cross Blue Shield company to discuss the denial. Make sure to have your account number, paperwork, and any other important information to hand when you call. You can find the customer service number on the back of your member card.

If the issue is not resolved through this discussion, you can submit a written appeal. This should be addressed to the Member Services Department and sent to the address on your Member ID card. Your letter should include your name and ID number, admission and discharge dates (if applicable), a copy of the Explanation of Benefits, and any relevant medical records.

If this appeal is unsuccessful, you may have the right to an independent external review of the decision. This will involve presenting your case to a third-party reviewer, with Blue Cross Blue Shield also required to attend and give concrete reasons for the denial. If this review is also unsuccessful, you may wish to initiate legal proceedings.

Frequently asked questions