Wiki BCBS Issues

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For some reason on all surgery we send to the local BCBS they are requesting records. BCBS is waiting 15-30 days to request records in order to process the surgery claims. We send records via Availity, Mail and fax. They never seem to be able to find them, or month later we call and they say they were received but no-one has uploaded them for processing? How do they get by with this? We are not receiving payment/denial for 90-120 or more days after submitting the original claim.
 
My super recently stated that if we have proof of delivery, and they cannot find the records, that is a HIPAA violation. She states we should mention this and ask to speak with a supervisor to resolve the issue.
 
We were told Anthem is having alot of system issues right now. Watch your payment allowances as well. :cautious:
Mayzoo, I agree 100% Anthem has been recouping payments stating patient had other insurance at time of service which was over a year ago. The other insurance was termed 2 years ago. And had the nerve to say that the patient updated their COB in August. We had to get the patient involved.
 
For some reason on all surgery we send to the local BCBS they are requesting records. BCBS is waiting 15-30 days to request records in order to process the surgery claims. We send records via Availity, Mail and fax. They never seem to be able to find them, or month later we call and they say they were received but no-one has uploaded them for processing? How do they get by with this? We are not receiving payment/denial for 90-120 or more days after submitting the original claim.
Is your office still having an issue with this concern? We send all claims electronically to get a claim# even on claims we know we are going to have to be sending notes for payment , this cuts back on claims denied for timely filing especially with the 90 day time limit now.
 
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