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Changing out of state BCBS plan to local BCBS in client's chart

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Meredith DuBose

Hi, I see a lot of college kids on their parents' insurance plans so they have a different BCBS plan originating in another state then where I practice/am credentialed. I saw a help article saying I need to submit through my local BCBS instead of their state of origin BCBS, but there was no instruction on how to do this. Has anyone does this before and know how? I also have already submitted a claim that was rejected (was submitted to BCBS of TX instead of BCBS of LA where I work), and I'm not sure how to amend this claim and resend out. Help! 

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8 comments

Date Votes
  • Yolanda Winfield

    You have to first go the the patients insurance page and edit the insurance payer to the local BCBS of the state you are credentialed in. (LABLS  is the blue cross blue shield of Louisiana.

    Delete the claim from the patient's billing screen, and recreate it for submission it should now have the right insurance company.  

    I hope this helps.

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  • Meredith DuBose

    Thanks - do I just keep the group and policy numbers all the same? 

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  • Yolanda Winfield

    Yes they should be exactly what is on the insurance cards.

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  • Meredith DuBose

    Ok thanks. I was confused because exactly what is on the insurance cards is not BCBSLA! I wasn't able to delete the encounter but I was able to resubmit it after I changed BCBSTX to BCBSLA in the chart. Here's hoping it works, thanks for your help!

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  • Alison Kramme

    I have a handful of clients who live in IL but have out of state BCBS policies as their corporate offices are elsewhere.  When I was billing through Availity this was never a problem as I have always billed through my local bcbs.  This is my first month billing through SP. All of my out of state policy holders claims were rejected even though I bill through ILBLS.  Please advise.  Thank you!

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  • Gillian

    Hi Alison, I'd be happy to help. All you need to do is change your client's insurance information to ILBLS, then resubmit the claims. ILBLS will route the claims to the appropriate out-of-state payer. 

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  • Madison Wallace

    I am having a similar issue.  I am trying to bill from Kentucky and BCBS Texas and BCBS ILBLS has been rejecting my claims. Why should I Enroll with BCBS Texas and ILBLS if I can change the insurance information and have Blue Cross Blue Shield Kentucky (KYBLS) bill them for me? 

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  • Judith A. Freed

    I am trying to bill from PA and BCBS ILBLS have rejected my claims.  The client's card says bill to local BCBS.  What is payer ID for local BCBS of PA?  Do I have to make this change permanent on the client's billing page?

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