Update Regarding Processing of Individual Member Claims

Following discovery of some configuration issues affecting certain types of claims processed on their new technology platform, known as Facets, it was determined that processing certain types of claims and then performing secondary review of them  was not the best way to proceed. Instead, BCBSNC placed a hold on most of the claims in Facets.  They do still expect these claims to be processed within the 60 to 120-day time frame communicated to providers on March 11. Once claims are processed, providers can expect payments to be made within seven to 10 business days. They are also developing a back-up plan to address cash-flow issues should the processing of these claims take longer than currently expected.  This issue affects claims related to services for individuals (under age 65) members, which is approximately 15 percent of all claims. Please do not submit duplicate claims, as they will increase our inventory and potentially delay processing time.