Due to the implementation of HIPAA 5010 on July 24, 2011, the manner in which a member’s eligibility and benefits are displayed on the Blue Cross and Blue Shield of Kansas BlueAccess website has changed.   These changes include:

• Benefit inquiries will now display the member name, patient name and relationship to the member, patient’s gender, and the member’s address.
• Other Payer information will be displayed when applicable.
• The policy’s benefit period will now be displayed on one line as the Date/Time Qualifier.  The policy’s original effective date will no longer be listed below the time period as required by HIPAA 5010.
• The deductible and amount remaining will be displayed only one time (on a majority of inquiries) instead of showing under each service type listed in the benefit string. The deductible and amount remaining will be displayed at the beginning of the benefit information under service type Health Benefit Plan Coverage.   The only time a deductible will be displayed under a specific service type is when the deductible for the service is different from the deductible listed below the Plan Coverage Description.
• A new field - In Plan Network - was added to show whether or not a policy has in-network and out-of-network benefits.
• Service types that have the same benefits (i.e. same copay, visit limit, etc.) will be listed together.
• The coinsurance maximum and coinsurance maximum amount remaining will now be displayed in the Additional Information below the coinsurance percentage benefit.

When using BlueAccess to retrieve member eligibility/benefit information you are encouraged to select the most specific Service Type that is available in the drop down box in order to receive the member’s eligibility/ benefit information more precisely.  

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