The national blue cross organization has instructed all state blue cross plans to change the processing
methods for out of state claims.
What you should do:
Make sure you verify all your patient addresses. If they are not in the state where you are providing
services, the claim will need to go to the state where they live and the claim will be processed as out
of network and very well could be paid to the patient. You will need to inform the patient they may
receive the check and they will need to pay you directly, or you may decide to not provide the service at
This has created quite a stir in the industry with new claim edits. There has been conflicting information
of billing place of service 11-office instead of 12- home, but do not have confirmation from any payor
that this will get the claim processed correctly for retail sales at the store.