Filing a Medical Claim for Services Received Outside the United States Prior to 1/1/2017
To submit a medical claim for services received outside the U.S. prior to 01/01/2017, follow the steps below:
Step 1: Download the BlueCard Worldwide International Claim Form.
You should submit the completed form along with any itemized bill you might have.
Step 2: Be sure your completed claim (which includes a completed BlueCard International Claim Form with or without an itemized bill) includes all the information below. If you do not provide all of the required information, your claim could be delayed.
- Health Plan Participant’s information
- Name
- Health Plan ID Number (as it appears on your Health Plan ID Card)
- Health Plan Group Number
- Patient’s information
- Name
- Date of Birth
- Provider’s Information
- Name
- Address
- Federal Tax ID Number
- Service Information
- A Description of Services and Diagnosis (provided by the doctor).
- Amount Paid (if any)
Step 3: E-mail or mail your claim to Blue Cross using the information below.
By EMAIL (RECOMMENDED) | |
claims@bluecardworldwide.com NOTE: It is recommended to email your claims in order to have proof of your claim submission. |
By MAIL | |
DO NOT submit claims to the Health Plan Office.
Mail your claim directly to Blue Cross at the address below: Blue Cross Worldwide Service Center |
If you have any questions regarding your medical claim, you can reach BlueCard Worldwide at (800) 810-BLUE (2583).