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View requirements for Local Plan and BlueCard Out-of-Area members.

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BlueCard®

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What is BlueCard?
BlueCard® is a national program that enables members of a BlueCross Blue Shield Plan (Blue Plan) to obtain healthcare services while traveling or living in another Blue Plan’s service area. The program links participating healthcare providers with the independent Blue Cross and Blue Shield Plans across the country and in more than 200 countries and territories worldwide through a single electronic network for claims processing and reimbursement. The program allows you to submit claims for patients from other Blue Plans, domestic and international, to your local Blue Plan, Empire BlueCross BlueShield. As an Empire participating provider you are contractually required to provide services to members from other Blue Plans. 
How to Identify BlueCard Members
BlueCard Plan members have a three-character alpha prefix at the beginning of their ID number. The alpha prefix is critical for confirming membership and coverage and key to facilitating prompt payments. In addition, the ID cards may have logos that appear on the front of Blue Plan member ID cards: 

PPO in a suitcase logo, for eligible PPO/EPO members

Blank suitcase logo

 
When you see these logos, it means that the cardholder participates in the BlueCard Program, which provides healthcare coverage for members outside their Blue Plan’s area. 
Claim Submission
Out of area claims should be sent to Empire at:  

Empire BlueCross BlueShield

BlueCard Program

P.O. Box 3877

Church Street Station

New York, NY 10008-3877

 
Quick Tip: For faster processing please submit your claims electronically to Empire. Claims must be submitted within 180 days. The EDI# for Empire is 3154480080. If you would like more information about electronic claims submission, or if you are having problems submitting claims electronically, please call EDI at 1-866-899-7322. 
 
Quick Claims Filing Tips (Border County Providers)
Do you contract with multiple Blue Plans in more than one state? Below are guidelines for filing claims for Blue members. 
 
Border County Providers 

For providers that practice in border areas (contiguous counties), the standard rule is to always file the claim to the Plan located in the state where you provided the service.

Exception: When the member is from a bordering Blue Plan with which you have a contract, then file the claim directly to the bordering Blue Plan.

 
Additional Information
©2014 Empire BlueCross BlueShield

Services provided by Empire HealthChoice HMO, Inc. and/or Empire HealthChoice Assurance, Inc., licensees of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans, serving residents and businesses in the 28 eastern and southeastern counties of New York State. All external sites will open in a new browser window. Please view our Website Privacy Policy for more information.