1. Identify BlueCard Members - The main identifiers are:
- PPO in a suitcase logo, for eligible PPO members
- Empty suitcase logo, for Traditional, POS or HMO members
- A three-character prefix (the first three positions of the identification number)
- The three-character prefix correctly routes BlueCard claims for processing
Three-character prefixes are assigned to every BCBS Plan and start with X, Y, Z, or Q:
- First Character – X, Y, Z or Q
- Second character – A-Z
- Third character – A-Z
National Account Prefixes:
- Begin with letters other than X,Y, Z or Q
- Typically relate to the name of the group, as in UAL for United Airlines.
2. Check Eligibility and Benefits
Telephone: Call the Blue Card Eligibility® line at 800-676-BLUE (2583). Enter only the three-character prefix on the member’s ID number and your call will be routed to the member’s home plan.
Electronic: Submit an electronic eligibility and benefits inquiry (270 transaction) to BCBSIL via the Availity® Provider Portal or your preferred web vendor. Electronic eligibility and benefits (270/271) transactions may be conducted almost continuously, with the exception of Sunday, 8 p.m. to midnight, CT.
3. Obtain Pre-certification/Preauthorization for BlueCard Members, When Applicable
Telephone: Call the BlueCard Eligibility line at 800-676-2583 and ask to be transferred to the Medical Management Department.
Electronic: Use the Pre-Cert/Pre-auth Router (out-of-area members) to view the applicable Blue Plan's medical policy or general pre-certification/preauthorization information. If pre-certification/preauthorization is required, submit an electronic request (278 transaction) through Availity or your preferred web vendor portal.
4. Submit all BlueCard claims electronically to BCBSIL, for faster service.
Refer to the BlueCard Program Provider Manual for more information.
Availity is a trademark of Availity, L.L.C., a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSIL. BCBSIL makes no endorsement, representations or warranties regarding any products or services offered by third party vendors such as Availity. If you have any questions about the products or services offered by such vendors, you should contact the vendor(s) directly.
