BlueCard Member Claims will Require itemized Bills

Posted on 2019-01-22
Updated on 2019-01-22 14:36:50

Itemized Bills Will Be Required for Some Inpatient Claims, Effective April 1, 2019

Beginning April 1, 2019, CareFirst BlueCross BlueShield (CareFirst) will request an itemized bill for any acute institutional inpatient BlueCard (out-of-area) member claim billed at $250,000 or more. Standard diagnosis related group (DRG) and Federal Employee Health Benefit Plan claims are excluded.

Fax the itemized bill, which should include member identification number, date of service and patient account number to 301-470-4673. This can be done prior to or after submitting the claim electronically.

This change only impacts BlueCard member claims; you do not need to complete this step for your CareFirst members.

For additional information on submitting claims for out-of-area Blue Cross and Blue Shield members, refer to the Institutional Provider Manual. The updated manual will be available on April 1.

If you have questions, please contact Provider Service.