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A claim is a bill your doctor and other health care providers send to a health insurance company for payment after they have treated you. In most cases, your provider’s office will submit the claim so you don’t have to worry about it. Still, there are times when you may have to submit a claim yourself. For example, if you choose to get care from a provider who's not in your plan's network.
If you need to submit a claim:
You can check the status of your claim by:
Please note the claim will not show up in Blue Access for Members until it is processed. There are five types of claims statuses that you may see:
Once we process your claim, you will receive an EOB, either by email notification directing you to BAM or mail. This document will break down:
If your claim was not paid, you can file an appeal. The appeals information is included with your EOB.
Originally published 2/10/2015; Revised 2022, 2024
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Blue Cross and Blue Shield of Montana, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association
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