provider connection
 

Claims Routing Tool

Enter the valid 3-character prefix which is the first 3 characters as displayed on the Member ID card
to find where to submit your
claims.
*3-Character prefix 
* Date of service 
 

Submit Claims for Free with Office Ally

Enroll in EDI and submit claims for free using Office Ally.

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How to Submit Claims

Claims should be submitted to Blue Shield of California electronically using Electronic Data Interchange, though they can also be submitted by mail.

Prescreen Claims

Clear Claim Connection (C3) is a simulation tool that enables providers to transparently view claim auditing rules, payment policies and clinical rationales reflected in Blue Shield of California's (BSC) claims processing tools. C3 does not submit claims to BSC and is not a guarantee of member eligibility or claim payment. It is a tool used to test codes on mock claims and reference their rationales from nationally recognized sources.

Providers can enter CPT and HCPCS coding scenarios and immediately view the audit result. By prescreening claims, you will minimize your administrative costs and simplify doing business with us. 

To get started using Clear Claim Connection, open the How to Prescreen Claims (PDF, 405KB) quick start guide.

Submitting Claims Electronically

Blue Shield encourages healthcare providers to submit claims and receive payments electronically in order to reduce administrative costs and improve cash flow. Please visit Enroll in EDI for more information.

Using EDI, you can submit all of your claims and receive your payments electronically for faster processing and payment. EDI allows paperless billing and payment for healthcare services and supplies and automates many types of routine inquiries.

To enroll in electronic payment options and learn more about using EDI to save time and money, see our Manage Electronic Transactions page.

Sign up for a live webinar to learn about submitting electronic claims and receiving electronic payment, including tips for claims submission, and live Q&A with the experts.

Dates and Times
Tuesday, March 27, 2018, 12 p.m. – 1 p.m., Pacific Time
Monday, May 14, 2018, 12 p.m. – 1 p.m., Pacific Time
Wednesday, August 15, 2018, 12 p.m. – 1 p.m., Pacific Time

Submitting Claims by Mail

If you still need to submit paper claims, use the Claims Routing Tool, located in right-hand area of this page, to determine the correct mailing address for each member.

Because claims mailing addresses are different for different Blue Plan members, using the Claims Routing Tool is the most accurate way to determine a claims mailing address.

However, if you are unable to use the Claims Routing Tool, you can access our list of Claims Mailing Addresses.