Itemized Bills Required for BlueCard® Claims Over $200k
Beginning Jan. 1, 2020, we will require facilities to submit an itemized bill for any inpatient institutional claim for BlueCard members billed at or more than $200,000. The Blue Cross and Blue Shield Association requires an itemized bill to complete your claim. An itemized bill helps ensure accurate claim payment and reduces the need to submit more information after claims are paid.
What has changed?
The claim amount requiring itemization is down from the $250,000 threshold in 2019.
How to Submit Itemized Bills
You may submit itemized bills electronically using our Claim Inquiry Resolution tool. Be sure to include the corresponding claim number.
Refer to the “Inpatient/Outpatient Unbundling Policy” on our Clinical Payment and Coding Policy page located on the provider website for more information. If you have any questions, please contact your Blue Cross and Blue Shield of Texas (BCBSTX) Provider Network Representative.
What is BlueCard?
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 members have a suitcase logo on their identification card.