How do I submit a claim?
Who is this for?
If you've gone to a doctor who's not in your network, follow these instructions on submitting a claim for reimbursement.
We want to make it as easy as possible for you to submit your claims. All you have to do is:
1. Fill out the appropriate claims form. The form you need depends on your plan and the service you want to be reimbursed for. For example, the forms for dental and prescription drug claims are different than the forms for medical, vision or hearing claims. The forms can also be different if you get your health care through the federal or state government. Please visit our list of claims forms to find the one you need.
2. Attach the original copies of your receipts to the claims form. The receipts should include an itemized list of the services you want to be reimbursed for. We can’t accept cash register receipts, canceled checks or money order stubs.
3. Mail the claim and receipts to the address on the form. Most forms have the address in the top right corner. The prescription drug claims forms list the address in the instructions for filling out the form.
What do my receipts need to have on them?
To help us process your claim quickly, please be sure that your receipts and claims forms include:
- The enrollee's name
- Your health insurance contract number
- The patient's name
- The date the service was performed
- Your health care professional's name
- Your health care professional's address
- Your health care professional's tax identification number
- A description of the service performed (HCPCS or procedure code)
- The diagnosis
- How much the service cost (itemize the charges if there's more than one service on a receipt)
We've provided some sample receipts to help you understand the information that should be included.
What if I'm outside the U.S.?
If you receive health care services while you're traveling outside of the United States, you'll pay the health care professional at the time of service and fill out an international claims form to be reimbursed by us later.
The form and more detailed instructions about this can be found at the Blue Cross Blue Shield Association's website in the section about the BlueCard® Worldwide program.