Blue Cross Newsletter - May 26, 2009 - Accident Claim Guidelines

June 16, 2009

BC-09-09
MS-09-08
HHA-09-06
HP-09-06

ASC-09-07
SA-09-08
DC-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:	No Reply To Other Party Liability Questionnaire

Your Blue Cross and Blue Shield of Kansas (BCBSKS) remittance advice (RA) lets you know when our Other Party Liability (OPL) department needs information from the member before we can complete the processing of your claim. This is indicated on the RA with OP in the CNTR column, 17 in the ADJUST REASON CODE column, and N179 in REMARKS.

Effective July 1, 2009, OPL ADJUSTMENT REASON CODE 17 will change to 227.

Charge	Amt Allowed	Provider Write-off	Amt Pt Owes	Total Amt Pd	C N T R	Adj RSN Cd	R E M A
9699.30	.00	.00	9699.30	.00	OP	227	N179

As reflected by the AMOUNT PATIENT OWES column on the RA, providers may bill the patient for these services. You are not required to wait for the requested information to be furnished to BCBSKS.

If members call you about their OPL claim denial, you should instruct the patient/member to contact our OPL department direct at 800-430-1274 or 785-291-4013 (Topeka).