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Medical Policy, Clinical UM Guidelines, and Pre-Cert Requirements

View requirements for Local Plan and BlueCard Out-of-Area members.

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Quick Tips for Eligibility Information

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The BlueCard Program provides a valuable service that lets you file all claims for members from other BC and/or BS Plans with BCBSGa, your local Plan.  
Here are some key points to remember:
Make a copy of the front and back of the member’s ID card  
Look for the three-character alpha prefix that precedes the member’s ID number on the ID card
Submit the claim to:

P.O. Box 9907
Columbus, GA31908

Always include the patient’s complete identification number, which includes the three-character alpha prefix on all claims and correspondence
If a member contacts you with questions about their claim, tell them to contact their Blue Plan. Refer them to the front or back of their ID card for a customer service number. A member’s Plan should not contact you directly, unless you filed a paper claim directly with that Plan. If the member’s Plan contacts you to send it another copy of the member’s claim, refer the Plan to BCBSGa.
For more information, contact your BCBSGa provider service representative
 
Eligibility and Benefits Verification 
You can submit eligibility and benefits inquiries for both BCBSGa members and out-of-area Blue members on our provider website, ProviderAccess or you can call the BlueCard Eligibility line. 
To submit electronic eligibility requests for Blue members, follow these three easy steps: 
Login to bcbsga.com
Navigate to the Login button to access ProviderAccess
Submit your eligibility and benefits inquiry
 
You may also call the BlueCard® Eligibility line at 1-800-676-BLUE (2583) or submit an electronic HIPAA 270 transaction (eligibility) to the local Plan. 
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Blue Cross and Blue Shield of Georgia, Inc. and Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. are independent licensees of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.