BCBS prefix XOH: BCBS of Illinois, HMO Illinois
The short answerXOH is a Blue Cross and Blue Shield of Illinois prefix: commercial HMO, on the HMO Illinois, Blue Advantage HMO, and Blue Precision HMO for small groups network (hMO Illinois and Blue Advantage HMO members, and Blue Precision HMO small groups off the Marketplace). File the claim to your local Blue plan; outside Illinois, BlueCard routes it to BCBS of Illinois by the prefix.
By Javier Alvarez · Updated · 2 min read
What the XOH prefix means
| Home plan | Blue Cross and Blue Shield of Illinois, a division of Health Care Service Corporation (HCSC). Commercial HMO. 1 |
| Network | HMO Illinois, Blue Advantage HMO, and Blue Precision HMO for small groups (network code HMO, ADV, BAV). Plans: HMO Illinois, Blue Advantage HMO, Blue Advantage HMO Value Choice and Blue Precision HMO. 1 |
| Who it covers | HMO Illinois and Blue Advantage HMO members, and Blue Precision HMO small groups off the Marketplace. 1 |
| Area | Designated areas in the State of Illinois. 1 |
| How the network works | Managed care: care is covered when the member's PCP provides or authorizes it. Care the PCP didn't provide or authorize is not covered, except in a medical emergency. 1 |
| Referrals | Care must be provided or authorized by the member's PCP; otherwise it is not covered, except in a medical emergency. 1 |
| Where to file | To your local Blue plan, the one you're contracted with. Outside Illinois, BlueCard uses the prefix to route the claim to BCBS of Illinois. In Illinois, that is BCBS of Illinois itself. Send the member ID exactly as printed, prefix included. 2 3 |
| Verify benefits | Through your local Blue plan's eligibility tools, or BlueCard Eligibility at 1-800-676-BLUE (2583), before the first visit. 2 |
| Preventive MNT | BCBS of Illinois's preventive services policy (RP006) lists 97802 to 97804 under the USPSTF rows for healthy diet counseling with cardiovascular risk factors and for adults with a BMI of 30 or more. To process with no member cost share, the claim needs a preventive diagnosis code and a preventive procedure code. MNT for other reasons may be covered under another part of the plan, with cost sharing. Grandfathered plans don't have to cover preventive services at no cost share. 4 See MNT coverage at Blue Cross Blue Shield plans. |
Before a visit with prefix XOH
- Copy the current card, front and back, and enter the member ID exactly as printed, XOH included.
- Verify benefits for 97802 and 97803: through your local Blue plan's eligibility tools, or BlueCard Eligibility at 1-800-676-BLUE (2583). Ask whether nutrition counseling is covered, how many visits, whether a referral is needed, and what the member pays.
- File to your local Blue plan, not to BCBS of Illinois directly, unless BCBS of Illinois is your local plan.
Another prefix? Type it in the lookup above or see every prefix we have. For how BlueCard routes an out-of-state Blue card, see BlueCard for dietitians.