Coordination of benefits questionnaire for BlueCard^® members – Now Available Online

As part of the BCBSNC Inter-Plan Programs departments' on-going efforts to streamline our claims processing and reduce the number of denials related to COB (coordination of benefits), we are joining with other Blue Plans and offering from our Web site this COB questionnaire for BlueCard members to complete.

Beginning January 1, 2008, Blue Plans are placing on local Web sites, forms that may be printed and presented to members believed to have potential COB. When you see any Blue Cross and/or Blue Shield BlueCard member and you are aware that they might have other health insurance coverage, give a copy of the questionnaire to them during their visit. Ask them to complete the form and send it to their Blue Plan – the Blue Plan through which they are covered – as soon as possible after leaving your office. (A BlueCard member can find the address to send the form on the back of their member identification card or by calling the customer service number listed on the back of the card).

Collecting COB information from members before you file their claim eliminates the need to gather this information later, thereby reducing processing and payment delays.

Download and print a copy of the Coordination of Benefits questionnaire here!

Please note that the Coordination of Benefits questionnaire is only for the BlueCard member's completion and it is not for use by BCBSNC members when visiting in-State, North Carolina providers.