kellz0913
Networker
Does anyone know who BCBS follows? do they follow NCCI Edits...? AAOS....? McKesson...? I've been getting a ton of denial letters & the majority say they follow NCCI but some mention something about McKesson....
Thanks so much! How would I be able to find the McKesson Clear Claim Connection?Per my last conversation with a Michigan claim rep, they aren't quite sure either . I use the McKesson Clear Claim Connection as that is what is attached to their provider portal but I also review NCCI when submitting claims and appeals.
Thanks so much for all your help.Do you have access to the portal? On the login page on my state's BCBS, there is a link to Clear Claim Connection that brings you over to the McKesson web portal. This would be for Michigan claims. I think for Illinois it's under the Education and Reference center tab?
That's what we're trying to figure out too. They send denial letters based off of NCCI edits but then when you show them your within the NCCI edits they still deny payment.Not IL or MI here but BCBS in Minnesota may follow the edits but they do NOT follow the NCCI Correct Coding Policy Manual. We are part of a group of providers trying to figure out why and also trying to figure out how they can dismiss it and still be allowed to adjudicate Medicare and Medicaid claims.
At this point I may get your provider rep involved!That's what we're trying to figure out too. They send denial letters based off of NCCI edits but then when you show them your within the NCCI edits they still deny payment.