Published on November 20, 2012
in Clearinghouse - ACTION REQ.
As part of the ongoing commitment to resolving the current issues being experienced with Michigan Blue Cross Blue Shield, the clearinghouse would like to provide the following updates regarding what is currently outstanding with this payer:
- Incorrect Alpha Prefix Being Returned - The payer's estimated resolution date is December 10, 2012.
- Duplicate Subscriber ID Errors - No estimated resolution date has been received from the payer at this time.
- The Payer's Portal Has Information at the Procedure Code Level, While Their X12 system Does Not - the clearinghouse has notified the payer that Emergency Room (ER) co pay is missing from their X12 responses.
- Timing Issues Between the Portal Connection and X12 System, Causing Data to be Out of Synch - For example, one system returns "eligible" when the other returns "ineligible". The payer indicated these occurrences should be minimal and they are working on a fix.
Action Required: Report to the Support Department any other data elements you would like to see added to the X12 system (other than ER co pay), specifically where this information is found on the portal connection. In addition, report any examples where the data is out of synch.
If you have any questions, please contact Client Services at 1-888-348-8457, option 2.