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Subrogation Update for Hospitals

When treating a patient that has been involved in an accident of any nature, claims should be filed with Blue Cross and Blue Shield of Alabama immediately upon discharge. In accordance with the Participating Hospital Contract, it is Blue Cross’ policy to consider each claim under normal contract benefits and make payment accordingly to the participating hospital. All standard procedures for inpatient and outpatient services should be followed.

Should a hospital receive a check from the patient’s own insurance, or that of another party involved, it would then be necessary to contact Blue Cross on each individual case to determine any subrogation activity. When Blue Cross is involved in subrogation activity, the full amount of the Blue Cross payment should be refunded to Blue Cross out of the money received. Any remaining amount should be refunded to the subscriber or returned to the issuing carrier.

Payment made under the terms of the member hospital agreement is to be considered as payment in full. Liens should not be filed against a patient with valid Blue Cross and Blue Shield of Alabama coverage, except to cover any deductibles, copayments or other out-of-pocket expenses related to that treatment period. Any such liens should be filed only after reasonable efforts to collect such patient-pay amounts have been made.

Please e-mail Subrogation concerning overpayments after auto insurance has paid or you may fax your written inquiries to the Subrogation area at 205-220-6354.

Blue Cross and Blue Shield of Alabama appreciates your cooperation with our subrogation efforts. If you have any questions, contact your Network Services Representative for additional information.