out of state BCBS claims - who submit claims and where

BCBS Claims

When I receive services outside the State of Florida, who submits the claim to BCBSF?

If the physician or provider is participating in the Blue Cross and Blue Shield network in that state, they will submit the claim for you. If not, then you will be responsible for submitting the claim to BCBSF.

What makes up Member Responsibility

Member Responsibility is the out-of-pocket portion of a claim that a member is expected to pay. For example, deductibles, copayments, and non-covered services are considered Member Responsibility.

How do I obtain information on my right to appeal?

View information about your Appeals Rights
     BlueCare (HMO) Members
     BlueChoice, BlueOptions, BlueSelect, GoBlue and Florida Healthy Kids Members.

Do I have to submit claims?

Not if you choose a provider from within your plan provider network. Your provider should process all claim submission paperwork on your behalf. If you choose a provider outside the network, you may have to file claims for reimbursement.

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