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BlueCard Tutorial: Access Claimsquestions:
[email protected] version 5 – updated 12/01/2016
BlueCard Tutorial Access Claims
You can securely access your BlueCard claims processed by Blue Shield of California on Provider Connection
After completing the Access Claims tutorial, you will be able to:
• Check BlueCard claim status by member
• Check BlueCard claim status by payment
• Search claims by claims activity, create custom reports and more
• Locate helpful claims resources
BlueCard Tutorial: Access Claimsquestions:
[email protected] version 5 – updated 12/01/2016
Log in to blueshieldca.com/provider and click on the Search BlueCard Claims link within the BlueCard Program section. You can also access the Claims tab, located at the top of the page.
Provider Connection home page
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BlueCard Tutorial: Access Claimsquestions:
[email protected] version 5 – updated 12/01/2016
Search claim status by member
To search claim status for an out-of-state Blue plan member, you have three options to choose from.
* Enter the member'ssubscriber ID number(including the three-
character prefix).
OR
* Enter the member's lastname, first name and dateof birth.
OR
* Enter your patient'saccount number.
Then click on Search under the option you completed.
Claims page
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BlueCard Tutorial: Access Claims
Search claim status by payment
In step 1, choose the "BlueCard" radio button as the card type.
Then in step 2, enter required data in the fields to get results.
Click Search.
Results will be displayed, including billing information and messages, any payment details, and access to EOBs.
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Claims page
questions: [email protected] version 5
– updated 12/01/2016
BlueCard Tutorial: Access Claimsquestions:
[email protected] version 5 – updated 12/01/2016
Search claims by claims activity
Create a customized claim report that allows you to view multiple claims. This helps in the reconciliation of claims, with features to save and download a report in an Excel spreadsheet.
Claims available in this report are claims processed by Blue Shield for BlueCard Program, commercial and standard business, Federal Employee Program and Medicare.
Various customizing options are offered such as dates of service, claim received or finalized dates, date ranges, practice location(s) and more!
Claims page
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BlueCard Tutorial: Access Claimsquestions:
[email protected] version 5 – updated 12/01/2016
Additional claim resources are available online. Click on the dedicated Claims tab, located at the top of the page, to access a variety of claims information.
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Claim resources
BlueCard Tutorial: Access Claimsquestions:
[email protected] version 5 – updated 12/01/2016
Access Claims Conclusion
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• Member eligibility ‒ blueshieldca.com/provider/eligibility-benefits/eligibility-search/home.sp?cardType=otherplan• Authorization request – blueshieldca.com/provider/authorizations/pre-service-review/electronic-access/home.sp• Claims status – blueshieldca.com/provider/claims/search/home.sp
Or contact:• BlueCard Eligibility at (800) 676-BLUE (2583)• Authorization request – call the Medical Management number printed on the back of the member's ID card• BlueCard Claims Unit at (800) 622-0632• Web technical support at (800) 541-6652
Congratulations. You have completed the Access Claims tutorial.We encourage you to continue your learning. The BlueCard Tutorials Web page contains other informative BlueCard tutorials, plus additional resources you may find helpful.
Your online resources for:
BlueCard Tutorial: Access Claimsquestions:
[email protected] version 5 – updated 12/01/2016
BlueCard Tutorial Access Claims
Your BlueCard claims processed by Blue Shield is available to securely access on Provider Connection
After completing the Access Claims tutorial, you will be able to:
• Check BlueCard claim status by member
• Check BlueCard claim status by payment
• Search claims by claims activity, create custom reports, and more
• Locate helpful resources
BlueCard Tutorial: Access Claimsquestions:
[email protected] version 5 – updated 12/01/2016
log into blueshieldca.com/provider, click on Search BlueCard Claims link within the BlueCard Program section. You can also access the Claims tab, located at top of page.
Provide Connection Homepage
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BlueCard Tutorial: Access Claimsquestions:
[email protected] version 5 – updated 12/01/2016
Search claim status by Member.
To search claims status for an out-of-state Blue plan member, you have three options to choose from.
* Enter the member'ssubscriber ID number(including the three-
character prefix)
OR
* Enter the member's lastname, first name and dateof birth.
OR
* Enter your patient'saccount number.
Then click on "Search" under the option you completed.
Claims page
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The three options a provider can choose to search for their claim are by Subscriber ID, Complete Name and DOB, or by Patient Account Number.
BlueCard Tutorial: Access Claimsquestions: [email protected]
version 5 – updated 08/01/2016
Search claim status by payment.
First, choose "BlueCard" radio button as card type, in step 1.
Then enter data in fields to get results, in step 2.
Click Search.
Results will be displayed, including billing information and messages, any payment details, and access to EOB's.
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Claims page
BlueCard Tutorial: Access Claimsquestions:
[email protected] version 5 – updated 12/01/2016
Search Claims by Claims Activity
Create customized claim report, allowing ability to view multiple claims. This is beneficial in assisting reconciliation of claims, with features to save and download report in an Excel spreadsheet.
Claims available for this report are claims processed by Blue Shield for BlueCard Program Commercial and standard business, Federal Employee Program and Medicare.
Various customizing options are offered, such as, dates of service, claim received or finalized dates, date ranges, practice location(s), and more!
Claims page
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BlueCard Tutorial: Access Claimsquestions:
[email protected] version 5 – updated 12/01/2016
A starting point for instructions/introduction to this page:
You can reconcile claims much easier by creating and downloading custom reports on claims processed by Blue Shield including BlueCard, Commercial, Federal Employee Program and Medicare. The Claims Activity Tool helps you research the status of your claims, view billing information and messages, confirm payment details and access online EOBs, allowing you to view multiple claims.
To locate the tool, log on to Provider Connection, click on the Claims tab, click on the Check Claims Status link, then select the Claims Activity sub- tab to customize your claims report.
You can create a customized claims report by selecting various search options such as:• Dates of service, claim received dates or finalized dates
• One business location or multiple locations
• A date range of between one and 31 days in the last two years
• All types of claims statuses, such as only claims in process or only finalized claims
You can further refine your report by selecting a place of service, adding a patient’s last name range or identifying a total billed amount range.
Once you select Search, your report will appear onscreen. You can download your report with the associated EOBs for your claims in an Excel spreadsheet.
Your report provides details on your submitted claims, check or EFT details, messages from Blue Shield regarding the claims and your online EOBs.
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Claims page
BlueCard Tutorial: Access Claimsquestions:
[email protected] version 5 – updated 12/01/2016
Access Claims Conclusion
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• Member eligibility - www.blueshieldca.com/provider/eligibility-benefits/eligibility-search/home.sp?cardType=otherplan• Authorization request - www.blueshieldca.com/provider/authorizations/pre-service-review/electronic-access/home.sp• Claims status - www.blueshieldca.com/provider/claims/search/home.sp
Or contact:• BlueCard Eligibility at (800) 676-BLUE (2583)• Authorization request - call the Medical Management number printed on the back of the member's ID card• BlueCard Claims Unit at (800) 622-0632• Web technical support at (800) 541-6652
Congratulations. You have completed the Access Claims tutorial.We encourage you to continue your learning. The BlueCard Tutorials web page contains other informative BlueCard tutorials, plus additional resources you may find helpful.
Your online resources for:
