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Problems with New Blue Plus Subscriber IDs in Procentive

vpetrik 2 years ago in Billing/Electronic Modules updated by anonymous 2 years ago 19

Hello! At the beginning of the year, all of our Blue Plus clients received new Policy Group Numbers and Individual Policy Numbers. I tried to input these numbers along with the new payer Id for BCBS of MN - PMAP and it was rejected in the system in Procentive. Procentive is not able to read the new subscriber numbers. Is anyone else having this issue? Any feedback would be greatly appreciated! :)

What we did is created a second payer labeled a little different and added the new ID numbers to that one. That way, we were able to still have the old ID numbers under the old payer name in-case we had to send claims again from 2018. So far no issues. I am not sure how your billing system works but is it possible you are sending 2018 claims with the new ID from 2019? This would cause a rejection in the electronic module.

We did the same thing - Blue Plus 2018 and Blue Plus 2019 and then put an end date of 12/31/2018 for the Blue Plus 2018 and a start date of 01/01/2019 for the Blue Plus 2019. It has worked beautifully. Have to credit Tricia with BillCare for that one!

I'm curious as to why you are using 12-31-18 end date.  The September 6 bulletin says the new numbers start 12-1-20181

Subscriber ID
Subscribers will receive a new ID card to be used for dates of service beginning December 1, 2018. Subscriber ID cards should be verified at every visit. Claims submitted with an incorrect subscriber ID will deny for no coverage.
New prefixes have been assigned:
• LMN – Medicaid (PMAP, MNCare, MSC+)
• JTM

It was changed in the December 3rd bulletin:

December 3, 2018

Continued
Bulletin P77-18 (BMNPEC-0201-18)
Distribution: Available online: https://www.bluecrossmn.com/healthy/public/personal/home/providers/forms-and-publications
Migration of Minnesota Health Care Programs Subscribers to Amerigroup Delayed to
January 1, 2019
To ensure a successful member and provider experience, Blue Cross and Blue Shield of Minnesota and Blue Plus
(Blue Cross) has made the decision to delay the migration of the Minnesota Health Care Programs (MHCP),
including Blue Advantage Families and Children (formerly Prepaid Medical Assistance Program), MinnesotaCare
(MNCare), SecureBlue (MSHO) and Minnesota Senior Care Plus (MSC+) to Amerigroup until January 1, 2019.
Effective January 1, 2019, Providers are required to follow the policies and procedures that were previously
published in the October and November Provider Bulletins and as indicated below for MHCP Subscribers.

A bulletin came out extending the change over through the end of December, so did not put it in effective until 1/1/2019

Hello!, I did go ahead and make a new payer for the new year with the new subscriber IDs and new policy group numbers, along with keeping the old payer and labelling it Blue Plus 2018. The dates I billed for were 1/1/2019 to 1/3/2019 with the new payer ID (00562) and I am having a rejection pop up in the Electronic module saying something is wrong with the subscriber ID? The new subscriber IDs for our facility start with LMN and the group numbers are MNMCDBBS. I'm not sure why it is still being rejected.

Are you getting the ID numbers off of Availity?

On the new payer did you change your electronic ID to be the new one?

We followed the proper steps to separate these two payers; Blueplus PMAP 12/31/2018, and Blueplus PMAP 01/01/2019.  We looked up the new ID numbers on Availity for Blueplus PMAP 01/01/2019.  

A Procentive ticket sent in November 2018 saying we'd like our electronic payer id to be updated when it was time, but it was missed.   Our electronic Payer ID for Blueplus PMAP 01/01/2019 was never switched to 00562.  It still said SB720.   I had to send another ticket.  



That is the right payer ID for 2019.  It may not be the entire claim that is getting rejected.  Look at the batch and search through that to see which specific claims are being rejected.  It may only be 1 or 2.  If that is the case, double check the ID numbers.  Their insurance may have changed to MA or another PMAP plan as of January 1.  We had that happen with a couple clients.

I did get the new numbers off of Availity. The clients are now on Blue Cross Blue Shield Plus Medicaid plans. The new payer has the new payer ID number. I did call to verify and was told that this is their primary and only insurance as of 1/1/2019. In the batch, the dates that are on or after 1/1/2019 are the only ones that are being rejected. I have triple checked their ID numbers. :)

It was my understanding that the provider had to set up a new payer and grab the new Electronic ID.  Our claims have been going through by doing this.

What does that even mean - 'grab' the new Electronic ID?  We were told that the 00562 was the payer ID for 2019...are you saying it is not?

According to the email from Procentive on 11/5/18, if you had two separate payers, Procentive could switch it for you:

  • Blue Plus PMAP (of MN)

    If your agency already has two BCBS payers (BCBS PMAP and BCBS Commercial), the Procentive Care Team can update your BCBS PMAP to the new Blue Plus PMAP for you.

    Submit a support ticket to Procentive Care Team as quickly as possible, and we will make this change in your database.


We had two separate payers, submitted a ticket on 11/7/18 and were told it was taken care of. I just found out today that they didn't switch the BCBS PMAP payer to the new electronic submission number and instead added a "-12/31/18" to the name of the payer which you can only see if you are in the change payer screen. I spent most of a work day updating our 80ish BCBS PMAP clients under this payer ID because I was told it was supposed to be updated. If their response to the "update us" ticket had indicated they were ending the current payer and that I would still have to add the new payer, that would have been fine. Am I going to have to go back into all my recently updated clients and change them back to their old IDs with the original payer, add a new payer and put all their new IDs into it? I'm currently waiting for a response as I re-opened the "Update us" ticket to get clarification. 

Hi Katie, 

We sent additional information out regarding the payer change on 12/13/18. Procentive received further instruction from BCBS on what the changes would entail, and we were informed of the DOS being the important piece on the claims. Due to this, our instruction was to create another new payer, as any claims sent with DOS prior to 1/1/19 would still need to go to the old payer. 

Please see the article that was attached to our communication here in the knowledge hub.

Thank you,

Amanda Kaufmann

+1

In the future, would you be able to add text stating that the previous instructions to submit a ticket were invalidated due to new info? I didn't go through the additional steps because I was under the impression that we had already completed what was required.

+3

Oh my gosh, I had no idea that the instructions had completely, 100% changed from the initial instructions. I immediately added the new Blue plus payer and changed everyone over under the impression that the Payer ID will auto change on 1/1/19.  I assumed the 12/13/18 notification was just a reminder to do this. The notification just said Overview. It did not say, DISREGARD OLD INSTRUCTIONS. THERE ARE NEW INSTRUCTIONS. 

When you set up your new payer for the Blueplus you should have been able to pick "grab" the Blueplus with the correct payer for 2019.  I didnt have to send a ticket in to change it we just set a new payer up. If you go to your payer tab on the left and then add button then on the first line you click the drop down box you can scroll down to Blue Plus it will have a date after it and you can also see the payer ID.