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Blue Plus New Payer ID 00726

BillingAS 6 months ago in Payers Module updated by Heather L. Heim 5 months ago 31

I don't see the new Blue Plus Payer ID in Procentive. Are they working on adding it? The new payer ID is 00726 and starts 1/1/2024. 

I sent an email to my BillCare rep last month asking about this. They don't seem to think there needs to be a change. I have been following up weekly and was told today that we need to just use the old one. I am interested in seeing what response you get. This is not how we worked through the change from BCBS to Amerigroup in 2019 so I am very anxious about the lack of a new payer for this change.

Something was done and it has affected claims we billed on 12/21/23 which were rejected due to the payer ID.

Procentive automatically updated the Blue Plus payer ID last Friday but now we are getting new rejections. Blue Plus stated there would be no changes to the way claims needed to be coded or sent but these rejections say otherwise. 

I called provider support and they informed me the correct number is 00720.  For what it is worth.

I noticed that when verifying Blue Plus (Payer ID: 00726) insurance in Availity the client will show up in both BCBS and Blue Plus. When in Blue Plus, there is a message that shows up:

Messages

Either the patient's ID, name, date of birth, or address in the response does not match the information sent in the request. The response reflects the correct information. To avoid future errors in submission, please update this information in your computer system.


When you look up the client under BCBS (Payer ID: 00720), there is no message. This made me think that the Payer ID 00720 would be the correct one to submit to with the client's new ID number.

Thoughts?

The correct payer ID for Blue Plus is 00726. Claims are being rejected because our friends at Procentive changed the payer ID code prior to 1/1/2024. Rejected claims (which should have gone to Amerigroup) were instead sent to BCBSMN before the 00726 code became "live" on 1/1/2024. From what I can tell, the rejected claims now have to be resubmitted to BCBSMN but we have to use the clients' new ID numbers and pray BCBSMN programmed their system to accept 2023 dates of service under the new IDs. Thanks Procentive.

Any update on if BCBSMN is accepting claims from 2023 with the new ID and Group numbers? 

Has anyone received payment for 2023 DOS since the payer ID was changed?

I am refiling my Dec. claims that were all rejected, using the LMN prefix, as I was instructed by Blue Plus to do, and they are all rejecting again.

All of these changes are news to us somehow... Can anyone clarify, do we need to update to all new ID and group numbers and/or switch the payer in Procentive? I have gotten no updates on the ticket I created for the rejections and I am just now noticing the change in ID and group numbers... 

Thanks! 

No need to switch the payer ID, they already switched it in Procentive to the correct one. Member ID will depend on the DOS. Old ID for 2023 DOS new ID for 2024 DOS. 

Thank you! Do we know when or if the rejected payments for Blue Plus are being rebilled with correct payer ID for DOS 2023? I have an open ticket but have not received an update since they were "researching". This is going to be a BIG mess trying to cover all these rejections i think(?) 

My rep said that its huge internal issue they are trying to sort out internally at BCBS. They were hoping to have it fixed early this week last I heard on Thursday. 

BCBS is not swift in fixing internal issues. As a huge MN payer, I hope this is a situation that is not the norm for them and they are able to adjust quickly!

I am sorry but I don't understand, as our EMR how Procentive doesn't have more definitive answers for us... I tried calling Blue Plus and keep getting disconnected in the process of being transferred. I just want to know how to have our patients set up moving forward and in order to receive payment for the dates that are currently being rejected.

Also, is this just blue plus or all of BCBS? Are we supposed to be pausing on billing to Blue plus/BCBS? I feel like we are very in the dark during this HUGE issue and we just would expect that Procentive would have more options and answers for us as apart of our monthly fees we pay.

Checking in to see if anyone has received payment on anything yet?  We're continuing to get this error, and I've already fixed what needed to be fixed in our Procentive set up.

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Outpatient claims are fixed but residential they are still working on fixing. BCBS states Availity is updating something on their end and are hoping to have that fixed by the 25th. I've received outpatient payments from Blue Plus and BCBS. 

It appears our O.P. CD claims went through without any issues but I am still seeing rejections for our O.P. mental health providers... Anyone else having trouble billing for 90837, 90791, etc. codes? The rejections say "Category: Acknowledgement / Rejected for relational field in error. Status: Entity's National Provider Identifier (NPI) Entity: Billing Provider"

This is the message I received from Blue Plus this morning:

"We are just starting to make some payments on the new platform this week which will test all the downstream processes such as EFT, Remittances, and outbound letters as required in the payment cycle. As such, the volume of claims being released out of the new system is small (approximately 1000) and likely will not include a lot of behavioral health providers as we are doing just a few of each type. I don’t yet have the report to show which providers will have any claims (or no claims) until the cycle is fully run over the weekend. We are currently expecting a much larger release of claims to occur on Friday 1/26 which would be remittance date 1/31 from the new platform. I will know more on this by mid next week."

I just got that same information from my BCBS rep. BluePlus is a huge payer in our area. This is a long time to not get paid. :( Thank you for sharing this information!

+1

We are a small agency and Blue Plus is one of our largest payers.  It would be nice if they would give the providers some heads up when they know there will be payment delays.

This came out on 01/24/24

"Blue Cross previously advised that providers should submit claims using the subscriber ID effective on the date of service; however, using the subscriber ID effective for dates of service prior to 2024 is causing claims to reject as “Subscriber not found.” Providers should use the subscriber ID effective 1/1/2024, regardless of the date of service on the claim. If checking Eligibility and Benefits, the new subscriber ID will show dates of coverage prior to 2024, if applicable."

Anyone get paid by blue plus today? We are still waiting... 

We got a small payment for some December DOS.

Has anyone had any success with billing professional mental health claims? (Code ex: 90837, 90791, etc) Ours are still rejecting for Category: Acknowledgement / Rejected for relational field in error. Status: Entity's tax id Entity: Billing Provider. Just wondering if it is a specific issue with our claims or if its still an issue with Blue Plus/Availity? 

Thanks! 

I received a remit today that included payment for 2024 services.  

I know Procentive was having issues; all the claims for all my payers rejected last week and they said to resubmit them all. 

+1

Hello

Good News!

I am receiving a payment, dated tomorrow 2/7/2024, for a large Blue Plus payment through the ERA.  It looks like DOS go thru 1/29/2024. I did not re-submit any of these claims, I believe that Procentive did that on my behalf.

Just a FYI

Thanks

Paula

I see we have a deposit pending as well. This is finally good news!

+1

I've got a large deposit coming as well.  So relieved!