Blue Cross Newsletter - April 2009 - Claim Adjustment Timeliness

April 23, 2009

BC-09-07
HP-09-05
SA-09-06
MS-09-06

HHA-09-05
DC-09-05
ASC-09-06

To:	All Blue Cross Contracting Providers
From:	Cindy Garrison, Communications Coordinator Institutional Relations Blue Cross and Blue Shield of Kansas, Inc. An Independent Licensee of the Blue Cross and Blue Shield Association
Subject:	State of Kansas Claim Adjustment Timeliness

Beginning January 1, 2009, the State of Kansas group modified their requirements for claim adjustments. The new requirement states that once a claim has been adjudicated, any further processing would need to be initiated within 180 days (6 months) of adjudication. Although your provider agreement with Blue Cross and Blue Shield of Kansas (BCBSKS) typically allows providers to initiate claim adjustments within 15 months, the time restriction imposed by the State of Kansas for their employee group takes precedence.

Most State of Kansas memberships can be identified by the alpha prefix KSE or the group number on their identification cards. Attached is a list of group numbers for the State of Kansas group. Full State of Kansas benefit descriptions can be found on the BCBSKS Web site at: http://www.bcbsks.com/CustomerService/Members/State/index.htm.