Wiki 3 letter prefix on an insurance card

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medschool

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What does the 3 letter prefix stand for on the insurance card? Can you tell by the prefix if that plan has no OON benefits? Is there a list of meanings?
 
If you are talking about Blue Cross Blue Shield plans, the 3-letter prefix identifies the plan to which the patient belongs. BCBS is not a single company, but a franchise that is operated as separate companies in each state. The 3-letter prefix identifies to the local company that receives the claim which state and plan the member belongs to so that the claim can be routed to the correct place for determination of benefits. BCBS would have a list of what these codes mean, but I don't know if it is something that they share with the public. In any case, the prefix will not tell you anything about the benefits or give any information that would be of use to a provider - you would need to contact the plan for that. The patient's insurance card should have information (i.e. a phone number or web site) that will tell you where to go to get the information that you need.
 
3 letter prefix

So just by looking at the member id there isn't any way to tell if they have out of network benefits?
 
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