How To File a Claim

Medical Claims

Blue Cross PPO providers throughout the country will file your claims for you. When visiting a Blue Cross PPO provider, all you need to do is show your I.D. card. Most hospitals and doctors will usually file your claim on your behalf.
 
When your provider submits your claim to the local BCBS plan, it is important that the alpha prefix from your I.D. card is included. This prefix is the key to timely and accurate claims processing.
 

Submit a Claim Yourself

If you need to submit a claim yourself, send itemized bills to your local BCBS plan (the BCBS plan in the provider’s state). For example, if you received medical services in Florida, you must submit your claim to Blue Cross Blue Shield of Florida. Your local BCBS plan will transmit the claim to this Plan’s home plan (BCBSGA). Be sure to include your BCBS alpha prefix, and your group and individual identification numbers.
 
You can get
the address of your local
BCBS plan by calling
1-877-937-9602
(FMCP customer service)
or go to
www.anthem.com
 
The Blue Cross affiliate who receives the claim will forward it electronically to the FMCP claims administrator that will pay the Plan’s portion of the claim and mail you an Explanation of Benefits (EOB). You will be responsible for any deductible or coinsurance amounts, in addition to any services that are not covered by the Fund.
 
You may be required to complete claim forms in certain situations, including claims for injuries. The FMCP will send you a claim form and return envelope whenever you submit medical expenses for which a claim form is needed. Claim forms will also be available on the website.