The Blue Cross Blue Shield System is made up of 35 independent and locally operated companies. (Blue Cross Blue Shield)

Blue Cross Blue Shield Association is a federation of 35 separate United States health insurance companies that provide health insurance in the United States to more than 106 million people. (Wikipedia)

Your Local BCBS Carrier

To file claims with BCBS, providers must register with their local carrier. We regularly file for a variety of BCBS carriers, including but not limited to:

• Regence BCBS (Oregon, Washington)
• Premera Blue Cross (Washington, Alaska)
• Anthem BCBS (Including California, Colorado*, Central Regions, Maine and New York)
• Blue Shield of California*
• BCBS of Vermont
• Carefirst BCBS of Maryland (commercial and non-commercial) -- also operates in Washington DC
• BCBS of Illinois and Texas
• Empire BCBS of New York (is now Anthem as of 2024)
• BCBS of Minnesota
• Horizon BCBS New Jersey
• Highmark and Independence BCBS PA

*We also bill to third party entities when required such as ASH

BCBS rarely or never covers acupuncture in...

AL, AR, DE, FL, HI, ID, IA, KS, KY, LA, MI, MS, MO, MT, NE, NV, NH, NM, NC, ND, OK, RI, SC, SD, TN, UT, VA, WV, WI, WY

California, Washington, and Maryland are Different

In California, Blue Cross and Blue Shield are discrete entities.

• Anthem is the Blue Cross carrier; CA providers filing professionally must use Anthem to file out-of-state BCBS claims.
• All BCBS Federal Employee Plan (FEP) policies must be filed via Blue Shield. 

 

Blue Cross and Blue Shield are separate in Washington, too.

• Premera is the Blue Cross carrier, and also covers Alaska.
• Regence is BCBS in Oregon, but only carries Blue Shield in Washington.

The provider's location determines their local. Regence BS WA covers King, Pierce, and Snohomish counties (source) as well as Clark County.

Premera is local in Spokane where there's no Regence entities nearby available to BCBS patients.

 

Carefirst BCBS of Maryland has unique payer identities for commercial vs. noncommercial accounts (NCA).

• Carefirst is the correct claims recipient for commercial policies.
• Carefirst NCA is used for BCBS FEP policies.

Out-of-State BCBS Claims

Sometimes your patients may have a BCBS policy for another state. For example, an Oregon provider may have a patient whose policy is via BCBS of Illinois.

 

The correct procedure is to file all BCBS claims to your local BCBS carrier.

• If you're a California provider, out-of-state claims should be filed via Anthem Blue Cross.
• Washington providers may use either Regence or Premera, as long as it is their local BCBS carrier (see above).

 

Out-of-state claims are mediated through a national BCBS program called BlueCard. BlueCard makes it possible for BCBS members to obtain healthcare while traveling or living out-of-state (source).

 

When filing for an out-of-state policy, claims may take longer to process.

The status of an out-of-state claim can be researched via BlueCard. Your local will generally be unable to provide this info.