BlueCross and BlueShield providers serve nearly 90 million Blue members nationwide, including almost 20 million national account members. We understand the importance of ensuring easy administration for you and we want your patients to have a positive experience with each visit.
As a result, we are committed to meeting your needs and expectations by giving you a single point of contact through your local Blue Plan for claims, customer service and provider education-related inquiries.
How to Identify Members
- BlueCard® members have a three-character alpha prefix at the beginning of their ID number. The alpha prefix is key to facilitating prompt payment.
- The member ID is a combination of alpha and numeric characters.
Some Sample ID Cards:
The PPO suitcase may be at the top or bottom of the card, and may be blank.
Important Facts About the Alpha Prefix
- We use it to identify and correctly route claims and confirm a patient's membership and coverage.
- It is critical for the electronic routing of specific HIPAA transactions to the appropriate Blue Plan.
- It is very important to capture all ID card data at the time of service.
- It is important that you do not make up alpha prefixes or any part of the member's ID number.
Helpful Tips Concerning Member IDs
- Do not assume that the member's ID number is the Social Security number.
- Be sure that all of your system upgrades accommodate the alpha prefix and all subsequent characters, up to 17 characters total.
- A correct member ID number includes the alpha prefix (first 3 positions) and all subsequent characters, up to 17 characters total.
- Some member ID numbers may include alphabetic characters in other places following the alpha prefix, while others may be fewer than 17 characters.
- Do not add or delete characters or numbers within the member ID.
- Do not change the sequence of the characters following the alpha prefix.
- Please make copies of the front and back of the ID card, and pass this information to your billing staff.
It's Easy to File Claims for BlueCard® Members
- Ask for the current member ID.
- Check benefits and eligibility by calling 1-800-676-BLUE (2583) and provide the alpha prefix, or use electronic capabilities.
- Submit the claim to your local Blue Plan. For faster processing, please submit your claims electronically to your local Blue Plan.
Please do not request full payment up front. To check claim status, visit My Insurance Manager (first-time users will need to create a profile).
If you have any questions about the BlueCard® Program or filing claims for out-of-area patients, please contact your education specialist.