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Visit BlueCrossNC.com/Claims for prescription drug, dental and international claim forms, or call the toll-free number on your ID card. Important Notes When Completing the Claim Form: Type or use blue or black ink to complete. Complete a separate claim form for each covered family member.
About six million filed claims by the November 2021 deadline, so the payouts are expected to be around $333 per claim.
Documentation: Medical claim forms provide a detailed record of the medical services provided to patients, including procedures, treatments, and medications administered. This documentation is vital for accurately billing insurance companies and patients for services rendered.
BCBSNC Commercial Plans (including out-of-state plans) Primary Claims must be submitted within 180 days from the date of service. (The BCBSNC timely filing policy supersedes the out-of-state plans timely filing policy.) Secondary Claims must be filed within 180 days of the date of service.
The two most common claim forms are the CMS-1500 and the UB-04. These two forms look and operate similarly, but they are not interchangeable. The UB-04 is based on the CMS-1500, but is actually a variation on itits also known as the CMS-1450 form.

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Most Blue Cross NC members can submit medical claims online through Blue Connect. Just enter some information, upload a copy of your receipt, and hit submit! If you prefer to submit a paper claim form, you can download the form you need, fill it out, and send it to the mailing address or fax number provided.
You can file claims directly to us, through a clearinghouse or by using My Insurance ManagerSM. We accept all claim types electronically including primary, secondary, institutional, dental and corrected claims. With electronic filing, we can begin processing your claim right away.
Submit a separate claim for each patient. Complete the form following the instructions on the back. (You can fill the form in electronically or complete it by hand.) Print and mail the form to your local Blue Cross and Blue Shield company by December 31 of the year following the year you received service.

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