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To dispute information on your billing summary, call the Customer Service number listed on your member ID card. You may also contact us through our site: log in and visit the Contact section. If you are a representative from an employer group, please call our Member Services department at 816-395-2950.

You can access up to two years of claim history within your member account.

Members with plans that cover out-of-network care can submit a claim for covered services they have received and paid for. Members who have met deductible and/or out-of-pocket maximum spending thresholds may be eligible to receive reimbursement from Blue KC that cover some or all of these costs. Members who receive care within Blue KC’s service area can expect their claim to process within 30 days, while those residing beyond our service area may see that process extend to 90 days.

If you’ve paid out-of-pocket for care received from an out-of-network provider, you can request reimbursement from Blue KC for those expenses. Go here to submit your claim.

When you see an out-of-network provider, we send a check that is attached to the last page of the EOB you receive in the mail. Please do not throw away mail from Blue KC without reviewing it first!

Since the provider didn’t send us a claim, you are responsible for paying them directly. The check enclosed is for the amount that Blue KC is paying towards the services you received. Use this check to help towards that payment you’re making.

Your EOBs are always available in your member account here, or through the MyBlueKC app. Interested in paperless EOBs? Sign-up for email or text notifications when a claim is ready to view. Simply update your Communication Preferences today!

If you receive care from a provider within Blue KC’s coverage area (32 counties surrounding the Kansas City metro), we will process the claim within 30 business days of receiving it.

When you receive care from a provider outside of our coverage area – for example, you visited an urgent care while on vacation in Colorado – processing times can increase to about 90 days from the date we receive the claim.

The easiest way to submit a claim is through our online form, which you can find in your member account under Claims & Usage.

You will see a few different claims forms available to you, so you will need to select the one that best applies to the services you received.

To ensure your claim processes, make sure you include an itemized bill from your provider that lists, line-by-line, the services you obtained and the charges for each individual service. The bill should include the name of the person receiving these services, as well as the provider’s name.

In-Network and contracted providers have six months from the date of the service to send Blue KC claims to be processed. However, many providers will send us claims much sooner after your visit.

If you need to submit a claim after seeing an out-of-network or non-contracted provider, you have one year following the end of the year the service was rendered. For example, if you receive care on May 1st, 2024, you have until December 31st, 2025, to submit your claim. However, we recommend you submit your claim as soon as possible.

If your plan’s benefits require a copay, then you will need to pay the provider that amount at the time of service. You may owe an additional amount to that provider once your claim processes based on your plan’s benefits and how much you have already paid towards your deductible and out-of-pocket maximum.

Any time you visit an in-network provider, they will submit a claim to Blue KC on your behalf for the services you obtain.

If you decide to visit an out-of-network or non-contracted provider, you will need to confirm whether they will be submitting a claim on your behalf or not. If the provider is not planning to send us that claim, you can submit a claim yourself to ensure any payments you made to that provider count towards your deductible and out-of-pocket maximum amounts. Based on your plan usage and benefits, Blue KC may pay a portion (or all of) the provider charges, and you will be reimbursed accordingly.

If you have questions about how a claim was processed or you think it was processed incorrectly, please let us know. Call the number listed on your member ID card or log in to your account and Contact Us.

To get a claim form, you can log in to your member account and visit the Claims and Usage section, then select Submit a Claim.

For your convenience, you may also obtain a claim form by selecting one of the following:

Medical/Dental Claim Form | Download PDF
Claim Inquiry Form | Download PDF
Pharmacy Claim Form | Download PDF
Blue Cross Blue Shield Global Core International Claim Form

A summary of your claims, the status of those claims and details regarding each claim can be found online. Log in and visit your Claims and Usage to view claims processed during the past 24 months.