Air Ambulance Claims

Air Ambulance Claims Filing

Claims for Air Ambulance services must be billed to the Blue Plan in whose service area the pickup Zip is located.

Claims that are submitted to CareFirst must be billed on the CMS 1500 Health Insurance Form. When filing the claim, confirm that the following information is completed to avoid your claim being rejected:

• Report the 5-digit ZIP code of the point of pickup in item 23.
• Report the full address of the point of pickup, including 5-digit ZIP code, in item 32.
• Note: If the ZIP codes listed in item 23 and item 32 do not match, the claim will be rejected.

If you file a claim to a different BCBS Plan on the CMS 1450 (UB-04) Form, the 5-digit ZIP code of the point of pickup should be populated in Form Locators 39-41. The code is A0 and the value is the ZIP code.

When filing electronically, populate the origin information (5-digit ZIP code) in the Ambulance Pick-up Location Loop in the ASC X12N Health Care Claim (837) Professional.