Name of Manual - Blue Cross and Blue Shield of Minnesota

BlueCard®
Definitions Terms that you will hear when dealing with BlueCard members:
How the Program
Works
Term Definition
BlueCard
Program
A program that enables members to obtain health
care services while traveling or living in another
licensee’s service area and receive the benefits of
their Blue Cross contract.
The BlueCard Program is designed to work as follows:
1. A patient having Blue Cross coverage receives services at your
office.
2. You submit the claim to Blue Cross.
3. Blue Cross will price the claim according to your contract and
send the claim electronically to the member’s plan for benefit
determination.
4. The member’s plan applies the member’s benefits and sends
the information back to Blue Cross. They will communicate
the outcome of the claim to the member.
5. Blue Cross will send the electronic remittance advice and
payment for eligible benefits to you.
6. Deductible and coinsurance collection from members can
occur once the claim is adjudicated and you receive your
electronic remittance advice (835) or view your remittance
advice on provider web self service.
Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual (12/30/10) 7-7