Blue Shield experiencing multiple claims processing issues, some delaying payment The California Medical Association (CMA) began receiving calls in early February from physicians reporting that the explanation of benefits (EOBs) they were receiving on PPO claims from Blue Shield of California were missing EOB reason codes and information regarding the provider dispute resolution process. Blue Shield reports that only the EOB was affected, not the issuance of payment. CMA has since learned that there were two other system issues causing delays in payment on a large number of Federal Employee Program (FEP) and out-of-state BlueCard claims. All three of these issues ... March 31, 2016 Managed Care BlueCard, Blue Shield 0 0 Comment Read More »
Anthem Blue Cross to move eligibility, benefits and claim status inquiry functions to Availity Web Portal in March Anthem Blue Cross has advised that effective March 14, 2014, patient eligibility, benefits and claim status inquiry functions will transition from its ProviderAccess portal to the Availity web portal. As of that date, practices will only be able to access this information via the Availity web portal. While BlueCard eligibility, benefits and claim status functions will also transition to Availity, the BlueCard Advisor function that allows practices to determine which Blues plan to send the claim to will continue to be available on the ProviderAccess portal. In order to access information ... February 5, 2014 General BlueCard, Managed Care, Anthem Blue Cross, Insurance/Reimbursement 0 0 Comment Read More »
