Blue Cross Newsletter
 

 

October 6, 2008 

 

BC-08-12
HP-08-07
SA-08-04





 

HHA-08-07
DC-08-08

To: All Blue Cross Contracting Providers
From: Julie Hatesohl, Education Coordinator
Institutional Relations
Blue Cross and Blue Shield of Kansas, Inc.
An Independent Licensee of the Blue Cross and Blue Shield Association
Subject:

Enhanced Claim Status and Eligibility Inquiry Process


In partnership with the Blue Cross and Blue Shield Association (BCBSA) and all Blue Plans nationwide, Blue Cross and Blue Shield of Kansas is pleased to announce enhancements to

  • Eligibility inquiries (270/271) beginning October 6, 2008
  • Claim Status (276/277) beginning November 10, 2008

Eligibility Inquiries (270/271)

For those facilities using the eligibility inquiry process (also known as 270/271 transaction) or the Web-based eligibility inquiry system through the secured section of www.bcbsks.com, you will see the following changes:

  • Deductible, coinsurance and benefit limitations will be displayed as the 'REMAINING' amounts. Today, these amounts are displayed as the 'QUANTITY USED' amounts.
  • The remaining deductible, coinsurance and benefit limitations provided will be based on the benefit period for which the date of service occurs.
  • This will apply to all eligibility inquiries for local and out-of-area members.

 Claim Status Inquiries (276/277)

For those facilities using the claim status process (also known as 276/277 transaction) or the Web-based claim status inquiry system through the secured section of www.bcbsks.com, you may see the following changes:

    • Improvement in retrieving claim status information. Provider should see a decline in the number of 'claim not found' messages on the 276/277 transaction.
    • FOR OUT-OF-AREA CLAIMS ONLY, the claim status information will show only correct subscriber/member information; not the information that was submitted. It will be important for providers to review the claim status information for changes/updates to the subscriber/member data for all out-of-area claim status.