One question, though - is this an individual policy? If it's employer sponsored, or any other kind of group plan (fully or self-funded), the maximum pre-existing look-back period is 6 months prior to the effective date (4.1.10). They can only request 2 years for individual plans, so if I were you, I'd double check that before sending anything. You could end up with an unnecessary headache from denied claims, otherwise.
Also, if the patient had prior credible coverage (a previous policy whose term date is within 63 days of 10.1.11), the amount of credible coverage from that policy, and from any other policies before that (again, without more than a 63 day lapse in coverage between plans), should be counted to deduct from the end of the pre-existing waiting period. The max waiting period, under HIPAA, is 12 months for group plans, and 18 months for individual plans; so if they had enough prior credible coverage to offset the pre-ex waiting period for their plan, you may not need to send records at all.
You should contact the patient to find out if they've had any prior coverage, and get the effective and term dates for the policy (or policies) - if they're eligible for credit, have the patient obtain a Certificate of Creditable Coverage from each eligible policy, and send those to BCBS instead.
It can be a hassle for them to do this, but I've found that if they understand how long they'll have denied claims for pre-existing conditions, that they'll have to pay out of pocket, without getting that stuff turned in, they're usually motivated to take care of it.
Even if their prior coverage isn't enough to completely offset the whole waiting period, every little bit counts for something - maybe they'll only have a 6 month waiting period, versus the whole amount, when it's all said and done. It'll give you a good idea of how long you'll need to collect the whole allowable for conditions that you know will be denied as pre-ex.
One last thing: always remember that with BCBS patients under a pre-ex waiting period, you have to include the condition onset dates in boxes 14 & 15 of the CMS-1500 (1st Tx Date & Similar Illness) - if you forget it, you should receive a denial asking for it relatively quickly; but that's one you can fix over the phone. Good luck!
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