Blue Cross Blue Shield of North Dakota (BCBSND) was informed during the week of October 28th that claims are being processed inconsistently and that procedure code allowances are not pricing accurately impacting both our Commercial and Medicaid Expansion plans. This claims processing error was researched by our claims processing teams. A resolution was put into place the night of Nov. 1, 2024. Claims impacted will be reprocessed.
This claims processing errors potentially impacts claims processing dates of Oct. 18, 2024, through Nov. 2, 2024, and may affect the following provider and claim types (this is not an all-inclusive list as we are continuing to research the impact):
- Anesthesia Claims
- Chiropractors: chiropractic services, radiology, therapies, Durable Medical Equipment (DME) and Lab
- Clinical Nurse Specialist, Nurse Midwife, Nurse Practitioners, Physician Assistant, Public Health Units: Lab, DME, Medical Drugs, Vaccines, Radiology
- Licensed Addiction Counselor: Labs
- Pharmacist: Vaccines
- Psychologist: Psychiatry Codes, Health Behavior Assessment and Intervention, Development/Behavioral Screening and Testing, Psychological/Neuropsychological Testing, Adaptive Behavior Assessments/Treatments, Psychiatric Collaboration Care Management, Alcohol and Drug Abuse Treatment Services
We will continue to inform our provider community of updates through HealthCare News and apologize for the inconvenience.
Questions?
Contact the appropriate Provider Contact Center.
