Frequently Asked Questions (FAQs)

General Questions

How should a claim be filed?

There are virtually no routine forms to fill out or claims to file when a contracting provider is used. If a non-contracting provider will not file claims, send an itemized statement (including the member's identification number, physician's name, service date, complete description of the services received with charges for each service and diagnosis) from that provider, and send it along with a claim form within 90 days to Blue Cross and Blue Shield of Kansas, 1133 SW Topeka Blvd., Topeka, KS 66629-0001. Reimbursement for covered services will be according to the benefits of the program.

What should an employee do with a claim if (s)he goes to a provider in another state?

If services are received in another state, the member will need to know if the provider is participating with the Blue Cross and Blue Shield Plan in that state. If so, the provider will need to submit the claims directly to that state's Blue Cross and Blue Shield Plan. If not, the member may submit the claims to us for processing. Be sure to indicate on the claim that the provider does not participate with their state's Blue Cross and Blue Shield Plan.

How does an employee file for secondary payment through BlueCard with the "Home" Plan?

That claims must be filed directly to the Home Plan for processing of the secondary balances. If Blue Cross and Blue Shield of Kansas is the member's Home Plan, (s)he should submit an itemized claim with the primary carrier's Explanation of Benefits attached. Mail it to Blue Cross and Blue Shield of Kansas, 1133 SW Topeka Blvd., Topeka, KS 66629-0001. Be sure to include the member's Blue Cross and Blue Shield of Kansas identification number.

An employee received services in Kansas but has coverage with a Blue Plan in another state. What happens to the claims?

If the provider is contracting with Blue Cross and Blue Shield of Kansas, the provider will submit the claim. If the provider is not contracting with BCBSKS and will not submit the claim, you can submit it to the Blue Cross and Blue Shield plan in your home state.

Where do I look for participating provider information?

To find a participating provider, see our online Provider Directory.

To see if a particular provider in another state is participating with the Plan in that state, call 1-800-810-BLUE (2583) or go to Blue Card Doctor and Hospital Finder.

How can I find out what the codes mean on my Special Funded claims billing?

You can get the information from the BCBSKS Claims Code Legend.

 

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