Blue Cross experiencing problems with electronic eligibility and benefits information March 27, 2014 General Covered California, Health Insurance Exchange, Anthem Blue Cross 0 The California Medical Association (CMA) has received several reports of physician offices being unable to electronically verify eligibility and benefits for Anthem Blue Cross patients. When attempting such verification, the Anthem system returned a message asking the practice to call to obtain the information. However, practices report significant hold times of one hour or more when calling for this information. Anthem has acknowledged a system problem affected the ability of practices to electronically verify eligibility and benefits information for patients with coverage issued on or after January 1, 2014, which mainly affects Covered California/mirror product patients. Adding to the confusion for practices, Anthem also scheduled a transition of eligibility, benefits and claim status functions from its ProviderAccess portal to the Availity website effective March 14, 2014. (Click here for more information on the transition to Availity.) According to Anthem, it is working to restore eligibility and benefits information for affected enrollees. As of today, the insurer reports that the information has been restored for about two thirds of affected enrollees and expects the work to be complete on March 22. CMA is monitoring the issue closely. Physicians are reminded that when unable to verify eligibility and benefits, they can require patients to pay at the time of service and issue a refund to the patient once benefits are verified and the claim is paid. Contact: CMA’s reimbursement helpline, (888) 401-5911 or economicservices@cmanet.org. Comments are closed.
