Claims Update - July 2016

BCBSNC has continued to make progress on processing delayed claims as a result of configuration challenges with their new technology platform. Currently, less than 1% percent of all claims are being held. Since mid-June, they have been successful in normally processing all new claims that don’t require manual review, with the exception of Grandfathered plans. They have made progress on an issue mentioned previously related to our Grandfathered plans. Approximately 160,000 of these claims have been processed as of July 6. They anticipate that remaining claims on these plans will be ready to process no later than July 15. By late-July, they expect to be current in processing new and first submission claims, as well as claims that normally suspend for additional review, manual intervention, or may require medical records.  If you are an in-network provider experiencing financial hardship as a result of claims delays, please discuss this with your Blue Cross and Blue Shield of North Carolina (BCBSNC) Strategic Provider Relationships Consultant.

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