Member Home
Member Benefits
Claims
Prior Approval
Understanding Your Benefits
Subscriber Contract Documents
Non-Group Membership Changes
Verifying Coverage
Emergency & Urgent Care
Health Insurance 101
Complaint Process
Report Fraud
Member Forms
Plans and Products
Rx Center
Health & Wellness
Newsletters
Claims
Responsibility for Submitting Claims
Assuming BCBSVT provides your primary coverage, the table below shows who is responsible for submitting claims for processing.
| If you receive services from A... | Then... |
|---|---|
| Network Provider | The provider submits claims on your behalf |
| Participating Provider | The provider submits claims on your behalf |
| Non-participating Provider | YOU (the member) need to submit the claim to BCBSVT within 12 months of receiving the service/supply |
Check Claim Status
To check the status of a claim,
- login to the Member Site
(first time users will need their member ID),
or
- call customer service at the number on the back of your member ID
Family Members Over Age 12
- To discuss claims for a family member over 12 years of age, we may require a signed Authorization to Release Information Form from the dependent
Payment of Benefits
- We pay network and Vermont participating providers directly.
- We usually pay you for services you receive from non-participating providers
Payment in Error
- If we pay benefits to you incorrectly, we may require you to repay us any overpayment
- We may reduce or withhold future benefits to recover incorrect payments
Learn More
For more details, please refer to the "Claims" section within your Certificate of Coverage.
