Blue Cross Newsletter

January 13, 1998                             BLUE CROSS NEWSLETTER
                                             *********************

TO:         FREESTANDING RURAL HEALTH CLINICS

FROM:       Donna Bartee, Communications Coordinator
            Provider Relations Department

SUBJECT:    OBTAINING PAYMENT FROM BLUE CROSS FOR
            MEDICARE'S DEDUCTIBLE AND COINSURANCE
            *************************************

At Blue Cross and Blue Shield of Kansas, we have begun using an imaging
system to more effectively handle, route and file the volumes of paper
that we receive.  With this imaging system, anytime a highlighter marker
is used on the original piece of paper, when it's imaged, the highlighted
area turns black and then we cannot read it.

We're asking all providers to assist by discontinuing use of highlighter
marking on any paper documents that are sent to us.  This includes the
remittance advice copies which you submit to us to obtain payment from
Blue Cross for Medicare's deductible and coinsurance.

In place of using a highlighter marker, we suggest that you circle or
bracket the payment information that needs to be processed.  It would
also be most helpful if you would circle the deductible/coinsurance
fields.

A complete recap of the correct procedures to use when submitting
information for processing of Medicare balances is:

--  Send us a copy of the Medicare remittance advice which clearly
    reflects:
               your name and complete address
               your Medicare provider number
               your BLUE CROSS OF KANSAS (not 'Blue Shield')
                    provider number

NOTE:  When we were first notified that you were certified by Medicare
as a rural health clinic, we assigned to you A BLUE CROSS PROVIDER
NUMBER THAT IS TO BE USED ONLY FOR PAYING BALANCES REMAINING AFTER
MEDICARE'S PAYMENT.  This Blue Cross provider number is entirely
different than your regular Blue Shield number and the two ARE NOT
INTERCHANGEABLE.

--  On the Medicare remittance advice, CIRCLE or BRACKET the payment
    information that needs to be processed (limit to one request
    per page)

--  **IMPORTANT** If you have multiple payments or patients on the
    same page of the remittance advice that need to be processed by
    Blue Cross, you will need to duplicate that page and submit a
    separate copy for EACH CASE that needs handled.

--  Make sure the patient's 'complete' name and Blue Cross of
    Kansas identification number are reflected on the remittance
    advice.

--  Circle the deductible/coinsurance fields on the Medicare
    remittance advice.

--  For insureds enrolled in a Medicare Exclusion Rider (MER)
    contract, IN ADDITION to the information listed above, you will
    also need to include a copy of the UB-92 claim form that was
    submitted to the Medicare intermediary.

--  **IMPORTANT**  Never send a copy of a HCFA 1500 claim form with
    these requests.  If you need to send a copy of the claim, make
    sure it's the UB-92 that was submitted to the Medicare
    intermediary.

If you indicate the wrong provider number or if you attach a
HCFA 1500 instead of the UB-92, this causes us processing problems
and in turn, eventually, causes you problems too (slow payments,
incorrect payments or no payments).

If you have any questions, contact the provider relations department.

jw