The BlueCard Program links participating health care providers and the independent Blue Cross and Blue Shield Plans across the country and around the world through a single electronic network for claims processing and reimbursement.
The program allows you to submit claims for patients from other domestic and international Blue Cross Blue Shield Plans directly to your local Blue Plan. Your local Blue Plan will be your contact for claims payment, problem resolution, adjustments, and inquiries.
BlueCard members are easy to identify
Not sure what to do when a patient hands you an identification card from another Blue Cross and Blue Shield Plan?
- Look for the three-character alpha prefix that precedes the identification number on the ID card. The alpha prefix identifies the member's Blue Cross and Blue Shield Plan or national account, and it also confirms membership and coverage.
- Cards that do not have an alpha prefix may indicate that claims are not handled through the BlueCard Program; please look for instructions or a telephone number on the member's ID card for how to file these claims.
- BlueCard members may also have a suitcase logo located in the corner of their ID card:
- We suggest that you make copies of the ID card (front and back) and pass this key information on to your billing staff.
Three easy steps to file BlueCard claims
- With the member's ID card in hand, call BlueCard Eligibility® at 1-800-676-BLUE (2583) to verify the patient's eligibility and coverage.
- Tell the operator the first three characters (alpha prefix) of the member's ID number. The operator will then connect you directly to the appropriate membership and coverage unit at the patient's Blue Cross and Blue Shield Plan.
- After the patient receives care, submit the claim to:
Blue Cross and Blue Shield of New Mexico
P.O. Box 27630
Albuquerque, NM 87125-7630
To ensure prompt payment, be sure to include the patient's complete identification number, including the three-character alpha prefix. Do not make up or guess an alpha prefix. Some alpha prefixes are assigned to specific accounts, not Plans. Incorrect or missing alpha prefixes and identification numbers delay claims processing. Also, make sure you price the claim according to your contract with us, including our hold harmless agreement.
Please do not request complete payment up front. After we receive your claim, we will electronically route it to the patient's Blue Cross and Blue Shield Plan. The patient's Plan then processes the claim and authorizes payment. We will then pay you according to our contract with you.
To check claim status, please contact your local Blue Plan. If you are a BCBSNM Provider, you can also call the New Mexico Provider BlueCard Customer Service Department at 1-800-222-7992.
For additional information, see the The BlueCard Program Provider Manual. You can also view Member information about the BlueCard Program.
