Filing a Medical Claim for Non-network Services Received Outside of California
Follow the steps below to file a claim from a non-network provider for services received in outside of California.
To avoid a delay in the processing of your claim, be sure you have a recent Coordination of Benefits form on file with the Health Plan before submitting your claims to Blue Cross.
Step 1: Download the Claim Form – Medical – Services Received in the US (outside California).
NOTE: It is highly recommended that you include a claim form with your claim submission. Itemized bills are also accepted as long as the required information (detailed in Step 2 below) is included.
Step 2: Be sure that your claim form and/or itemized bill include the following:
- 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
- Procedure Code (if provided by the doctor)
- Diagnosis Code (if provided by the doctor)
- If the procedure code or diagnosis code is not available, include a description of services and diagnosis (provided by the doctor).
- Amount Paid (if any)
Step 3: Submit your claim.
By FAX (RECOMMENDED) | |
Choose one: (866) 896-1393 (866) 896-6531 (866) 896-6626 (866) 896-6532 |
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When faxing your claim, be sure to keep your fax confirmation sheet for your records. NOTE: If you have Caller ID Block installed on your phone line, you will need to temporarily disable the feature by dialing *82 before faxing your claim to Blue Cross. |
By MAIL | |
DO NOT submit claims to the Health Plan Office.
Click on your home state below to find the mailing address to submit your claim: |
BC & BS of Alabama
P.O. Box 995
Birmingham, AL 35298
BC of Washington/Alaska
Premera
P.O. Box 327
Seattle, WA 98111-0327
BC & BS of Arizona
P.O. Box 2924
Phoenix, AZ 85062-2924
Arkansas BC & BS
P.O. Box 2181
Little Rock, AR 72203
Anthem Blue Cross
P.O. Box 60007
Los Angeles, CA 90060-0007
Anthem BC BS of Colorado
P.O. Box 5747
Denver, CO 80217-5747
Anthem BC BS of Connecticut
P.O. Box 533
North Haven, CT 06473
BC BS of Delaware
P.O. Box 8830
Wilmington, DE 19899
Carefirst BCBS
P.O. Box 14116
Lexington, KY 40512-4116
BC & BS of Florida
P.O. Box 1798
Jacksonville, FL 32231-0014
BC & BS of Georgia
P.O. Box 9907
Columbus, GA 31908
BC & BS of Hawaii
P.O. Box 2970
Honolulu, HI 96802-2970
(please mail your claim to the nearest of the two following addresses)
BC of Idaho Health Service
P.O. Box 7408
Boise, ID 83707
Regence BS of Idaho
P.O. Box 31603
Salt Lake City, UT 84131
BC & BS of Illinois
P.O. Box 805107
Chicago, IL 60680-4112
Anthem BC & BS
P.O. Box 37010
Louisville, KY 40233-7010
Wellmark BC & BS of Iowa
636 Grand Avenue
Des Moines, IA 50309
BC & BS of Kansas
1133 S.W. Topeka Bl
Topeka, KS 66629-0001
Anthem BC & BS
P.O. Box 37690
Louisville, KY 40233-7690
BC & BS of Louisiana
P.O. Box 98029
Baton Rouge, LA 70898-9029
Anthem BC & BS
P.O. Box 533
North Haven, CT 06473
CareFirst BC BS of MD
P.O. Box 14115
Lexington, KY 40512-4115
BC & BS of Mass.
Attn: Data Capture
P.O. Box 986030
Boston, MA 02298
BC & BS of Michigan
27000 W. 11 Mile Road
Southfield, MI 48034
BluePlus of Minnesota
P.O. Box 64338
St. Paul, MN 55164-0338
BC & BS of Mississippi
P.O. Box 1043
Jackson, MS 39215-1043
(please mail your claim to the nearest of the two following addresses)
BC & BS of Kansas City
P.O. Box 419016
Kansas City, MO 64141-6016
Alliance BC BS
P.O. Box 36550
Louisville, KY 40233
BC & BS of Montana
P.O. Box 5004
Great Falls, MT 59403
BC & BS of Nebraska
P.O. Box 3248
Main P.O. Station
Omaha, NE 68180-0001
Anthem BC & BS
P.O. Box 5747
Denver, CO 80217-5747
Anthem BC & BS
P.O. Box 533
North Haven, CT 06473
Horizon BC & BS of NJ
P.O. Box 1301
Neptune, NJ 07754-1301
BC & BS of New Mexico
P.O. Box 27630
Albuquerque, NM 87125-7630
(please mail your claim to the nearest of the six following addresses)
BCBS of Western NY
1901 Main Street
P.O. Box 80
Buffalo, NY 14240
Empire BC & BS
P.O. Box 3877
Church Street Station
New York, NY 10008-3877
Finger Lakes BCBS
165 Court Street
Rochester, NY 14647
BCBS of Central NY
P.O. Box 22999
Rochester, NY 14692
BCBS of Utica-Watertown
Utica Business Park
12 Rhoads Drive
Utica, NY 13502
BS of Northeastern NY
187 Wolf Road
P.O. Box 15013 (12212-5013)
Albany, NY 12205
BC & BS of N. Carolina
P.O. Box 35
Durham, NC 27702
BC & BS of N. Dakota
4510 13th Avenue SW
Fargo, ND 58121-0001
Anthem BC & BS
P.O. Box 37180
Louisville, KY 40233-7180
BC & BS of Oklahoma
P.O. Box 3283
Tulsa, OK 74102
Regence BC & BS of Oregon
P.O. Box 30805
Salt Lake City, UT 84130
(please mail your claim to the nearest of the five following addresses)
Capital Blue Cross
2500 Elmerton Avenue
Harrisburg, PA 17177
Independence BC
1901 Market Street
Philadelphia, PA 19103
Highmark BC & BS
120 Fifth Avenue Place
Pittsburgh, PA 15222
BC of Northeastern PA
70 North Main Street
Wilkes-Barre, PA 18711
Highmark BC & BS
P.O. Box 890062
Camp Hill, PA 17089-0038
(please mail your claim to the nearest of the two following addresses)
Triple-S, Inc
1441 F.D. Roosevelt Ave
Caparra, PR 00920
La Cruz Azul De Puerto Rico
P.O. Box 366068
San Juan, PR 00926-6068
BC & BS of R.I.
Health Partners
444 Westminster Street
Providence, RI 02903
BC & BS of S. Carolina
P.O. Box 100300
Columbia, SC 29202
Wellmark BC & BS of SD
1601 West Madison Street
Sioux Falls, SD 57104
BC & BS of Tennessee
P.O. Box 180150
Chattanooga, TN 37401
BC & BS of Texas
P.O. Box 660044
Dallas, TX 75266
BCBS U.S. Virgin Islands
P.O. Box 366068
San Juan, PR 00936-6068
Regence BC BS of Utah
P.O. Box 30272
Salt Lake City, UT 84130-0270
BC & BS of Vermont
P.O. Box 186
Montpelier, VT 05601
Anthem BC BS
P.O. Box 27401
Richmond, VA 23279
BC of Washington/Alaska
Premera
P.O. Box 327
Seattle, WA 98111-0327
BC & BS of West Virginia
P.O. Box 7026
Wheeling, WV 26003
BC & BS United of Wisconsin
P.O. Box 34210
Louisville, KY 40232-4210
BC & BS of Wyoming
P.O. Box 2266
Cheyenne, WY 82003-226