Wiki BCBS IL payments

smartcoder

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BCBS IL pays every week. Once in a while the check payment is very low eventhough the volume of claims is the same. Does anyone know why they do this? For last few weeks we received very low payments with same claim volume and I am trying to understand how this works.
Thanks!
 
Low checks

Good afternoon!

From your question, I am not entirely certain how to help you. However, I did have one idea that you may want to check for..... In scheduled increments, Payors may "take back" all the money that they've advanced on claims that were suspended for additional detail. It could be that they need a copy of the supply item invoice, or anything else that may have caused the whole claim to "pend". If your office has not responded to these requests for info after 30 or 60 days, the Payor just processes the credits against your next reimbursement check.

If I've missed the mark on this, please clarify your question and we'll see if we can help.

Take care,
Mary
 
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