Can BlueCross BlueShield of South Carolina pay ancillary claims and withhold payment from the surgeon who has the medical records when medical records are requested?

Please continue to return the medical records requests to us with the referring/rendering providers’ names included. We cannot withhold payment from the surgeon because these are not global charges. We need the medical records to reimburse any professional provider in this situation.

Where do I submit the claim if I am using home as the place of service and there are several out-of-state addresses shown?

Wherever the member receives the item is where you should bill it. For example, if a patient is visiting South Carolina then you should bill to BlueCross BlueShield of South Carolina. When filing claims, the place of service is 12 for home and 99 for other. For more information please review the Ancillary Claims Filing Reminders document.

We receive blood samples from all over the country. Can we file to a BlueCross plan in another state?

Yes, you can file to another Blue Plan. A laboratory provider can file claims where the lab collected the specimen or where the referring physician is located.

Should we notify members you will bill them if they visit an out-of-network lab?

Yes, we require you to inform members that we may bill them for use of a non-participating lab.

Should providers file lab claims to the host or home plan?

Lab claims should be filed to the plan where the ordering or referring physician is located.