February 1, 2006

BC-06-04
HP-06-02
SA-06-02

HHA-06-02
DC-06-02

As a health care provider you already know that furnishing medical services is only part of the job that you and your staff must do.  Your other duties include:

• finding out what health insurance coverage the patient has;
• filing a claim; and
• reconciling the patient's account.

By using the BCBSKS Web site or our customer service center interactive voice response (IVR) system, we can help you limit the amount of time it takes to do these duties. 

Our web site and IVR system includes up-to-date information about all BCBSKS members including those who are enrolled in new groups such as Raytheon Aircraft Company or Wichita Clinic.   

By using either the web site or IVR system, you can find out:

• claim status information - including date processed, amount paid, who was paid, total patient responsibility, provider's contractual obligation, patient coinsurance, patient deductible, patient co-payment.

• eligibility information - including level of benefits, coverage level (single/family) effective and/or termination date, time period (calendar year/contract year), deductible amounts, coinsurance percentages and maximums, amounts already applied to the deductible or coinsurance, office visit copay, emergency room copay, inpatient copay.

The BCBSKS Web site also allows providers online access to their payment remittance advice and gives them the opportunity to discontinue having the remittance advice mailed to them. 

USING THE WEB SITE: www.bcbsks.com (access the provider services section)

To protect the privacy of our members, eligibility, claim status and remittance advice information is confidential.  Providers must establish a provider profile before they can access this information from our web site. 

For help setting up your secure profile or for an explanation on how to access and use the secure information, go to the section of our web site titled "Using Secured Services" http://www.bcbsks.com/CustomerService/Providers/using_secured_serv.htm.

USING THE INTERACTIVE VOICE RESPONSE (IVR)

The IVR uses an exchange of spoken information between the person calling and the system to authenticate provider telephone calls and furnish information about claim status and eligibility. 

At the end of either a claim status or eligibility IVR exchange, you can furnish a fax number and a recap of the information will be faxed to you.

We encourage all providers who call BCBSKS for eligibility and claim status information to allow the IVR system to furnish this information.  Our customer service representatives are available to handle other and more complex inquiries.

Complete details about the IVR system were included in our September 12, 2005 provider newsletter.

TIMES AVAILABLE

More good news!!  Providers do not have to plan their work schedule around BCBSKS' operating hours.  Unless there are extenuating circumstances, the only time the BCBSKS Web site and IVR system are not available is:

• Tuesday – Saturday: midnight to 2:00 a.m. CT
• Sunday: 6:00 p.m. to midnight CT

MORE INFORMATION

BCBSKS Web site "Using Secured Services"

September 12, 2005 Newsletter "BCBSKS Announces Implementation of Interactive Voice Response (IVR)"

May 5, 2005 Newsletter "Online Remittance Advices"

April 6, 2004 Newsletter "Remittance Advices Available at Web Site"

Drb