Blue Cross of Idaho Logo

Express Sign-on

Thank you for registering with Blue Cross of Idaho

If you are an Individual or Family Member under age 65, please register here.

If you are an Medicare or Medicare Supplement member, please register here.

New Options for Affordable Health Insurance

PAP104

Contracting/Non-contracting Providers


Provider Administrative Policy

Section
Information
Policy Date
February 2008
Status/Date
Revised/May 2008
Provider Type(s)
All Providers  

Disclaimer

Our provider administrative policies contain information regarding claims submission, reimbursement, and other information in order to achieve an efficient relationship with our providers. These policies are not an authorization or explanation of benefits. Blue Cross of Idaho retains the right to add to, delete from and otherwise modify this policy in accordance with our provider contracts.

Policy

Contracting/Non-contracting Providers

Blue Cross of Idaho works diligently on behalf of our Idaho members to develop contracting relationships with Idaho healthcare providers. The following information outlines the administrative relationship with Blue Cross and each type of provider.

Contracting Providers:

  • Must submit both primary and secondary claims on behalf of their patients.
  • Are directly reimbursed from Blue Cross of Idaho for covered services.
  • Must write off provider adjustments.
  • May submit claims electronically.
  • May only collect copayments, coinsurance, deductible and non-covered amounts from their patients.

Non-Contracting Providers:

  • Must submit claims on behalf of patients or provide completed claim forms for patients to submit the claim themselves.
  • Do not receive direct reimbursement for covered services from Blue Cross of Idaho.
  • Reimbursements made directly to the patient.
  • May submit claims electronically.

Medicare Supplements:

  • Reimbursement for Medicare supplements will follow Medicare assignment regardless of contracting status with Blue Cross of Idaho.
  • If you accept assignment on the Medicare claims you will be paid directly.
  • If you do not accept assignment on the Medicare claims the patient will be paid directly.

Policy History

Date Action Reason
May 2008 Revised Excluded providers removed from title

Search for Policies

Policy Feedback