Participating providers with a signed agreement are required to submit claims for all covered services on behalf of the patient to BCBSIL. Recently we have seen an increase in member-submitted claims.

Effective Oct. 1, 2009, BCBSIL will no longer accept claims submitted by a member for covered services rendered by a provider who has signed a participating provider agreement. The claim will be returned to the member, along with a letter directing the member to contact you to resubmit the claim on their behalf.

After you receive your Provider Claim Summary (PCS) or Electronic Remittance Advice (ERA)/Electronic Payment Summary (EPS) you may then bill the member for any amount listed under "Patient Share." This will include any uncollected copayment, deductible, coinsurance and/or any charges for non-covered services.

We are always here to assist you in providing the best service to our members. If you have any questions regarding your contract, please call (312) 653-6555, or e-mail to netops_provider_update@bcbsil.com. For assistance regarding a particular claim, please contact our Provider Telecommunications Center (PTC) at (800) 972-8088.