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Medical Records

Provider Administrative Policy

Claims Submission
Policy Date
November 2007
Revised/September 2014
Provider Type(s)
All Providers  


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


Medical Records

Medical records do not need to be routinely submitted with a claim, except in the following circumstance:

  • Prolonged service with direct patient contact CPT ® 99354 - 99357
  • Prolonged service without direct patient contact CPT ® 99358-99359
  • Modifier 22 or 63

If Blue Cross of Idaho determines that medical records are necessary to adjudicate any other claim, we will send a letter or fax requesting the specific records on a case-by-case basis. 

Send requested medical records to:

Blue Cross of Idaho
Attn: Medical Review Department
PO Box 7408
Boise, ID 83707

Clearly mark the envelope with “Confidential"

Policy History

Date Action Reason
September 2014 Revised Added address to send medical records to
April 2013 Revised Added services that require medical records
July 2009 Revised "Route to" language clarified
May 2008 Revised Language clarified

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