Medicaid Claims Handling for Medicaid Members
Blue Cross and Blue Shield (BCBS) Plans currently administer Medicaid programs in California, Delaware, Hawaii, Illinois, Indiana, Kentucky, Michigan, Minnesota, New Jersey, New Mexico, New York, Pennsylvania, Puerto Rico, South Carolina, Tennessee, Texas, Virginia and Wisconsin as a Managed Care Organization (MCO), providing comprehensive Medicaid benefits to the eligible population. Because Medicaid is a state-run program, requirements vary for each state, and thus each BCBS Plan.
This is a generic manual that provides helpful contact information, valuable resources, claims processing and operational information as well as information regarding preferred care and participating programs. The content of the manual is intended to be general and applicable to providers of all specialties.