BlueCard^® connection: Why did my BlueCard coordination of benefits claim finalize differently than I expected?

Similar to secondary and tertiary COB claims that you report for Michigan-enrolled members, your reimbursement amount for BlueCard COB claims could be affected by:

• The other carrier’s allowed amount
• A group contracted COB reimbursement policy
• The total charges
• Member cost sharing liability, as determined by the member’s home plan

To ensure that your BlueCard COB claim is processed correctly:

• Report the actual paid amount for the primary or secondary payer.
• Exclude any contractual allowances in the prior paid amount.
• Carefully review the payment information from all payers.

If you disagree with how one of your claims finalized, contact Provider Inquiry for assistance. A representative will work with you to confirm the claim processed as reported and may contact the appropriate plan on your behalf.

For more information on the BlueCard program, including links and articles on online tools, reference the BlueCard chapter of the online provider manuals.

If you’re experiencing issues with the information provided in the BlueCard chapter of the online manual — or if you’d like more information on a particular topic — contact your provider consultant.

Want to suggest a topic to be covered in this series? Send an email to ProvComm@bcbsm.com and put “BlueCard series” in the subject line.