Name of Manual - Blue Cross and Blue Shield of Minnesota

BlueCard®
Claim Status Inquiry ............................................................................................................... 7-19
Overview..............................................................................................................................7-19
Calls from Members and Others with Claim Questions ...................................................... 7-20
Overview..............................................................................................................................7-20
Traditional Medicare-Related Claims ................................................................................... 7-21
Guidelines ............................................................................................................................7-21
Medicare Advantage Claims through BlueCard .................................................................. 7-23
Overview..............................................................................................................................7-23
Types of Medicare Advantage Plans ...................................................................................7-24
Eligibility Verification.........................................................................................................7-25
Medicare Advantage Claims Submission ............................................................................7-26
Reimbursement for Medicare Advantage PPO, HMO, POS ...............................................7-26
Reimbursement for Medicare Advantage Private-Fee-for-Service (PFFS).........................7-28
7-2 Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual (12/30/10)