Filing Claims
As a participating provider, you agree to submit claims for Blue Cross and Blue Shield members on the CMS-1500 Health Insurance Claim Form. All applicable information should be completed in full, including CPT codes, ICD-10-CM diagnosis codes and applicable medical records to support the use of modifiers or unlisted codes with a charge greater than $500 to ensure payment is made to you accurately and without delay.
Claims should include all services rendered during the visit, using a place of service designation, such as “11” or “19” for office. Our reimbursement allowable for the Evaluation and Management (E&M) service includes the components for physician work, practice expense and malpractice insurance. No additional room usage charge should be billed by any party, since the practice expense component includes overhead expenses, and is an integral part in the E&M or procedure allow able charge. This methodology applies to hospital owned and physician owned practices, and helps ensure that contractual benefits for our members are correctly applied to claims.
An example of a claim form and instructions on completing the CMS-1500 claim form are provided in this manual.
All completed claim forms should be submitted electronically. If you must mail claims hardcopy, please send to the following addresses for processing:
Blue Cross and Blue Shield of Louisiana
P.O. Box 98029
Baton Rouge, LA 70898-9029
FEP claims should be mailed to:
Blue Cross and Blue Shield of Louisiana – FEP Claims
P.O. Box 98028
Baton Rouge, LA 70898-9028
OGB claims should be submitted electronically or by mail to Blue Cross directly.
As a participating provider, you agree to submit claims for Blue Cross and Blue Shield members on the CMS-1500 Health Insurance Claim Form. All applicable information should be completed in full, including CPT codes, ICD-10-CM diagnosis codes and applicable medical records to support the use of modifiers or unlisted codes with a charge greater than $500 to ensure payment is made to you accurately and without delay.
Claims should include all services rendered during the visit, using a place of service designation, such as “11” or “19” for office. Our reimbursement allowable for the Evaluation and Management (E&M) service includes the components for physician work, practice expense and malpractice insurance. No additional room usage charge should be billed by any party, since the practice expense component includes overhead expenses, and is an integral part in the E&M or procedure allow able charge. This methodology applies to hospital owned and physician owned practices, and helps ensure that contractual benefits for our members are correctly applied to claims.
An example of a claim form and instructions on completing the CMS-1500 claim form are provided in this manual.
All completed claim forms should be submitted electronically. If you must mail claims hardcopy, please send to the following addresses for processing:
Blue Cross and Blue Shield of Louisiana
P.O. Box 98029
Baton Rouge, LA 70898-9029
FEP claims should be mailed to:
Blue Cross and Blue Shield of Louisiana – FEP Claims
P.O. Box 98028
Baton Rouge, LA 70898-9028
OGB claims should be submitted electronically or by mail to Blue Cross directly.
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