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contact for BCBS PMAP payments

Mardi 2 years ago in Accounting/Collections Modules updated by amybenson 2 years ago 34

Please run a 1130 report and email lucas.y.peterson@state.mn.us along with the following information:

organization name

What is your NPI #?

Dates of service in question?

contact name

contact phone

contact email

sample claim numbers that are impacted

summary of the situation.

Let's get someone's attention to the seriousness of this issue for our organizations!

Mardi 

Done! Thank you for the information. Hopefully we can make some noise and be one step closer to resolution.

I received a call from BluePlus today, letting me know a payment will be coming this weekend and also received a reply back from a state rep. who gave me the same information and asked me to follow up next week if we do not receive payment. Thank you so much, Mardi, for the information as to who we should contact and what we should send!

I also received a call last night from BCBS and a State representative stating some of our funds are scheduled to be released on the 9th and number to call if there are any issues.  


Mardi would you be willing to share the telephone number.  And is this from contacting the state rep.

The person that called me was responding to my email that I had sent to lucas.y.peterson@state.mn.us. Did you see my previous email yesterday on what needed to be sent to them?

Yes I did I was looking for the number to call if there are any issues.  I may have misunderstood I thought it was a bcbs number if there were issues.

Kelly, I sent the information at the top of this feed, to the email address Mardi also provided. I was impressed at how quickly everyone responded.

Anyone receive a payment today 3/12/19 from BCBS PMAP, and NOT receive the ERA?

Yes! We are having the same issue. 

We received payment last night, no ERA ,cannot locate on Avality has not hit Procentive ! 

We received a deposit last night; posting today.

Alright - thank you!  Good to know we are not the only ones.

I have a feeling it's going to take me a very long time to post the ERA! :) 

Hi Kali,

Yes. I work with several agencies. These agencies are reporting pending deposit but no remits populating in Pro. We indeed will be taking significant time posting these remits when they populate.

Can you tell me if these are mental health payments or Substance use payments

Has anyone received payments on their Substance use charges?

Unfortunately no.  I was told they were releasing about 50% of our outstanding charges on Saturday March 9th and I am yet to see a deposit or ERA anywhere.  I did see an article this morning about BCBS and what they received as a tax refund and net earnings from last year.  Very frustrating! 

Mine were substance abuse

Once I sent all info to Lucas at DHS, BCBS contacted me that very afternoon. No remit yet though, a payment hit bank today,by total dollars deposited ,still owing us money, It's a start at least

Our payment is about 50% of outstanding charges. 


It is positive to see something come through after so long.  I'm glad they took the time to make sure they are processing the claims properly, as I would dislike if they sent out over payment letters a year later.....

Our claims are Mental Health. 

Mardi - Curious about the article.  Do you mind sharing it?

+1

Large Blues health insurer pockets $1.7 billion tax refund

Health Care Service Corp. headquarters in Chicago. Photo: Raymond Boyd/Getty Images

Health Care Service Corp. didn't pay a dime in federal taxes in 2018, according to its latest financial report. Instead, the health insurance conglomerate received a $1.7 billion tax refund, which swelled the company's net profit to $4.1 billion.

The big picture: As Axios reported last year, the Blue Cross Blue Shield companies were on track to retain huge sums of money in 2018 due to the Republican tax overhaul and the growing profitability of their health plans. HCSC was among the biggest winners.

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Go deeper177 Words

By the numbers: HCSC, which is the parent of the Blues plans in Illinois, Montana, New Mexico, Oklahoma and Texas, tallied a net profit of $4.1 billion on $35.9 billion of revenue in 2018 vs. $1.3 billion net profit on $32.6 billion of revenue in 2017.

  • These numbers don't include the fees self-insured employers pay to HCSC for administrative work.
  • A separate financial filing shows the company's plans in the ACA marketplaces were extremely profitable last year: Just 64% of their premiums were spent on medical care, resulting in almost $2.7 billion in gross profit.
  • David Anderson, a health care researcher at Duke University, recently wrote that ACA plans likely will have to pay rebates back to consumers this year because they've set their premiums too high, which occurred in part to offset the uncertainty from the Trump administration.
  • HCSC said in a statement that it would pay any rebates consistent with federal law and that it "experienced record customer retention" last year.

Go deeper: Blues plans lobbied heavily to get tax reform over the finish line.

I see that some of ours are processed on Availity but so far nothing in our electronic module.  Haven't heard if the payment has hit our bank.  Is anyone getting the ERA in the electronic module?

My ERA hit Pro this morning ! EOB settled slightly different, but at least the money arrived.

My ERA finally hit Procentive this morning as well! When I put in my routing daily call on Feb. 27th, I was told that we were going to be paid interest on all claims that were processed before Feb. 28. In interest, we received a whopping $9.52. Definitely doesn't make up for the extreme delays in payment. On the plus side, we are breathing a little easier.

The interest is laughable for sure. I'm grateful to see positive activity from Amerigroup. Let's hope moving forward we will endure smooth claims adjudication and payment from this group.

I thought the interest was laughable as well.  At least payments is finally coming through. 

So am I correct in thinking that we should be receiving consistent weekly payments after this?

You need to submit a ticket to Procentive and let them know you are NOT receiving the ERA in Procentive, They had to "re-enroll" me as when the new payer was set up. Apparently I dropped off the list to receive electronic ERA's. I provided the below Provider information on my Ticket to Procentive and they sent it in and said it would take up to 2-6 weeks for this to happen-if I still didn't receive a Electronic ERA at the 6 week timeframe to open up a new ticket. 

In the meantime to get my paper remit I call the new BCBS number 1-866-518-8448 and do claim status on whomever and request the remits to be faxed to me to manually post. They will tell you if you have any checks recently cut to you by giving them your NPI as well.


This is what Procentive said when I sent my ticket in



Blue Plus remits were supposed to follow the same set up that you were under for BCBS commercial plans, in other words you're correct you should not have had to re apply.
Unfortunately it sounds like something was missed with your account when the switch was made, and we have had no way of knowing which of our agencies this issue has happened with. Other agencies are receiving their remits in Procentive without a new enrollment.
We will be happy to re enroll you through the new ID of 00562, if you could please provide the following pertaining to your contract with the payer.

Billing Name

Billing Address

Tax ID

NPI(s)

PTAN (if applicable for Medicare)

Name, Email, Phone #, and title of the staff that has authority to sign applications