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Knowledge Center

How to submit a claim

Need to submit a claim for medical services you received? Learn about when and how to file a claim.

When should you submit a claim?

You should submit a claim

You might need to submit a claim to Blue Cross and Blue Shield of North Carolina (Blue Cross NC) to get reimbursed or paid back for covered services you received.

You might need to submit a claim when you:

  • Visit an out-of-network provider.
  • Receive medical services in another country (use the international claim form) or while on a cruise ship (use the member claim form).
  • You’re being reimbursed for vision or prescription products or services.1

You might not need to file a claim

You might not need to submit a claim when you:

  • Visit a North Carolina hospital for services or emergency care. If they have your insurance information, they'll file your claim for you.
  • Use an in-network doctor. Need help finding an in-network provider? You can search for in-network doctors all in one place.

What to include with your claim


To avoid delays and have your claims processed accurately, be sure you submit all of the following:2

Claims forms

You can submit a claim online in your Blue Connect℠ member services portal. You can also download, complete, and sign a claim form for each member who received care.

  • Most claims forms ask you to include additional documents or info.

Receipts

Your doctor will give you an itemized receipt for all the services you received.

  • You'll submit the original receipt with your claim.
  • Keep a copy of your receipt and claim form for your records.

Procedure codes

Ask your doctor for a list of all the procedure codes they used for your visit. You need to get:

  • A different procedure code for each service.
  • A separate charge for each procedure code.    

Diagnosis codes

You'll need a diagnosis code for services or supplies.

  • You can get diagnosis codes from your doctor as well.

Ways to submit your claim

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.

Log In to Submit a Claim Access Member Forms

Already submitted a claim?

Track your claim status in the documents section of your Blue Connect member portal.

Look Up a Claim in Blue Connect