Anthem Blue Cross Blue Shield of Colorado
Colorado • Traditional Indemnity, Medicare Advantage, EPO
Traditional indemnity coverage means the member has fee-for-service insurance with no network limitations. Any licensed provider can be seen without referrals. Claims are reimbursed based on usual, customary, and reasonable (UCR) charges. The member typically pays a deductible and a percentage of allowed charges.
This prefix includes Medicare Advantage coverage. MA plans follow CMS guidelines for timely filing (365 days from date of service), which may differ from the commercial plan's deadline. The payer ID for Medicare Advantage claims may differ from the standard commercial payer ID. Verify before submitting.
EPO (Exclusive Provider Organization) plans require members to use in-network providers, similar to an HMO. The key difference is that referrals are usually not required to see a specialist. Out-of-network care is not covered except in emergency situations. Submit claims to the payer listed above.
Independent licensee of the Blue Cross Blue Shield Association serving more than 1.5 million Coloradans with commercial, Medicare, and Medicaid plans. Operates in all Colorado counties.