How To Read Claim Statement Content

How To Read Your Claim Statements

A Claim Statement is generated every time you or a covered family member uses your health insurance plan. It provides an at-a-glance record of each occurrence, detailing how much was charged, how much your plan paid and how much you may owe.

  1. 1 This is the date the Claim Statement is generated.
  2. 2 This is the covered member who received the healthcare services listed on the Claim Statement.
  3. 3 If applicable, this is the amount you are owed for overpaid healthcare services.
  4. 4 This provides a brief summary of how your particular health plan works.
  5. 5 This updates your progress towards meeting the plan year deductible and out-of-pocket maximum. NOTE: It does not include any out-of-pocket payments listed on the Claim Statement (only those made before the Claim Statement was generated).
  6. 6 This provides a summary of charges and payments for the healthcare services listed.
  7. 7 This provides detailed charges and payments for the healthcare services listed and the name of the provider.
  8. 8 This is the amount the provider charged the health plan.
  9. 9 This is the amount of the Billed Charges the provider agreed to waive.
  10. 10 If applicable, this is the amount of the Billed Charges the health plan does not cover.
  11. 11 This is the amount owed to the provider after subtracting discounts and adding any non-covered charges.
  12. 12 These are the amounts the health plan(s) paid to the provider.
  13. 13 If applicable, these are the amounts you pay out-of-pocket to the provider. You may still owe the provider, if these amounts were not collected in full at the time of service.

Access your Claim Statements

When you register for myBlueCross, you will receive emails when new Claim Statements are available to view online. Log in to your myBlueCross account. Click the myBlueCross tab in the blue banner, and then click “Claim Statements” under Benefit Summary. You have 24/7 access to two years of claims history.

Alternatively, you can choose to receive paper copies of Claim Statements. Log in to your myBlueCross account. Click the down arrow beside your avatar in the upper right of the screen. Click “Communication Preferences,” and then click the "Edit" button. You can then change your Claims Statements notification setting to mail.