Professional Claims
Professional Claims Submission Guidelines
Each professional claim filed with the Health Fund should include the following information:
- Participant's Name
- Participant's Health Fund ID Number (as it appears on the Health Fund ID Card)
- Provider's Name
- Provider's Address
- Provider's Federal Tax ID Number
- Patient's Name
- Patient's Date of Birth
- Procedure CodeAlso referred to as CPT (Current Procedural Terminology) codes, are numbers or alphanumeric codes assigned to every task and service a medical practitioner may provide to a patient including medical, surgical and diagnostic services. They are then used by insurers to determine the amount of reimbursement that a practitioner will receive by an insurer. Since everyone uses the same codes to mean the same thing, they ensure uniformity. (provided by doctor on bill)
- Diagnosis CodeA three to five digit code representation of the identification by a medical provider of a condition, disease or injury made by evaluating the symptoms and signs presented by a patient. (provided by doctor on bill)
- Amount Paid (if any)
If you are filing your own claim, you must submit your claim directly to your Local BlueCard/Anthem Blue Cross office, using a participant direct submission claim form.
It is recommended that you retain copies of the claims you are submitting. Download and print the Participant Submitted Claim Form 
.
Click on your home state below to find the address where you should submit your claim:
| Professional Claims Submission Addresses | |||||
|---|---|---|---|---|---|
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Blue Cross and Blue Shield of Alabama |
Premera |
BC & BS of Arizona |
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Arkansas BC & BS |
Anthem BC of California |
Anthem BC BS of Colorado |
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Anthem BC BS of Connecticut |
HighMark |
Carefirst BCBS |
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BC & BS of Florida |
Anthem Blue Cross and Blue Shield |
BC & BS of Hawaii |
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Regence Shield |
BC & BS of Illinois |
Anthem |
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Wellmark Blue Cross and Blue Shield |
BC & BS of Kansas |
Anthem |
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BC & BS of Louisiana |
Anthem BC & BS |
CareFirst |
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BCBSMA |
Blue Cross Blue Shield of Michigan, Member Reimbursement |
BluePlus of Minnesota |
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3545 Lakeland Dr. |
(please mail your claim to the nearest of the two following addresses)
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|
P.O. Box 7982 |
BC & BS of Nebraska |
Anthem BC & BS |
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Anthem BC & BS |
Horizon Blue Cross Blue Shield of New Jersey |
BC & BS of New Mexico |
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(please mail your claim to the nearest of the three following addresses)
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BC & BS of N. Carolina |
BC & BS of N. Dakota |
Anthem Blue Cross and Blue Shield |
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BC & BS of Oklahoma |
Regence BCBS |
HighMark |
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BlueCross BlueShield of Puerto Rico |
500 Exchange St. |
BC & BS of S. Carolina |
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Wellmark |
1 Cameron Hill Circle, Suite 002 |
BC & BS of Texas |
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BlueCross BlueShield of Puerto Rico |
Regence |
BC & BS of Vermont |
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Anthem BC BS |
Regence |
HighMark West Virginia Claims |
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Anthem |
BC & BS of Wyoming |
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