Blue Cross Newsletter
 

 

January 8, 2007

 

BC-07-02
HP-07-02
SA-07-02

 

HHA-07-02
DC-07-02

To: All Blue Cross Contracting Providers
From: Donna Bartee, Communications Representative
Institutional Relations
Blue Cross and Blue Shield of Kansas, Inc.
An Independent Licensee of the Blue Cross and Blue Shield Association
Subject: Network Pricing Groups - Two New Groups Added January 1, 2007

Effective with January 1, 2007 service dates, two employer groups located in McPherson, Kansas will begin using the BCBSKS Competitive Allowance Program (CAP) network.  They are:

  • Farmers Alliance (group number FARMERS00)
  • National Cooperative Refinery Association (group number NCRA00100)

Other groups currently using the BCBSKS CAP network are:

  • International Brotherhood of Electrical Workers (IBEW) Local 226
  • Kansas Building Trades Health and Welfare Trust Fund (KBTHWTF)

Procedures for Network Pricing Groups are:

  • The identification card for network pricing groups will indicate the CAP logo.
  • All claims should be submitted to BCBSKS electronically.
  • BCBSKS will price the claim according to the CAP contracting provider network and forward it on to the specialty network group for finalization. 
  • The specialty network group (not BCBSKS) will finalize the claim and report the claim processing information, including payment, directly to the CAP provider.
  • The specialty network group (not BCBSKS) should be contacted with all requests for benefit/eligibility information, customer service assistance, or pre-admission certification.  The backside of the identification card indicates the telephone numbers providers should use. 
  • Claim status and eligibility information about network pricing groups is not available on the BCBSKS Web site.

drb