BCBSNC Announces New Upfront Member Collection Policy for Non-Copayment Plans
Effective October 1, 2009, Blue Cross Blue Shield of NC has revised its upfront member collection policy for Blue Options HSA, Blue Options HRA, or any other Blue Options non-copayment plan. This new policy stipulates that providers are no longer limited to collecting up to $50 per office visit or up to $500 for services received by any participating member of these plans. As a result, providers may now collect the member’s liability based on the benefits of the member's specific plan and the provider's current fee schedules for elective or scheduled care.
If a provider office maintains a policy to collect the estimated patient financial responsibility at the time of service, they are required to:
- Collect only according to negotiated network fee schedules in place at the time of service.
- Collect only an amount determined to be accurate with reasonable certainty through validation using BCBSNC provider tools.
- Refund any overpayment owed to the member as soon as identified, but no more than 45 days after they receive our payment for the service in question.
This change is being made in order to streamline the payment and provider reimbursement processes for members of Blue Options non-copayment plans while reducing the administrative expenses associated with the total cost of care.
Should you have any additional questions about the new upfront member collect policy, please click here to access an informational announcement of the changes, or contact our office at 919-403-1986.
Important Notice: Hill, Chesson & Woody does not engage in the practice of law, accounting, or medicine. Therefore, the contents of this communication should not be regarded as a substitute for legal, tax, or medical advice.
October 2, 2009
Hill, Chesson & Woody
Employee Benefit Services
194 Finley Golf Course Road, Suite 200,
Chapel Hill, NC 27517
Phone: 919.403.1986
Fax: 919.869-2063
www.hcwbenefits.com