Blue Cross Blue Shield of North Dakota (BCBSND) wants to inform providers of updates made to the Commercial provider manual over the past thirty days.
New:
- Section: Appeals, Grievances and Disputes
- New appeals and dispute form links
- Section: Electronic Funds Transfer (EFT)
- Additional information added
Revised:
- Section: Disclaimer
- Added sentence: If information within the manual conflicts with your contractual Participation Agreement or a member’s benefit plan, the Participation Agreement or benefit plan information should be used.
- Section: Utilization Management Program
- Language additions, revisions, and removal of outdated information
- Updated the process instructions under the Precertification & Concurrent Review/Discharge Planning sub section
- Section: Tips to Avoid Delays
- Updated wording and tips
- Section: National Provider Identifier (NPI)
- Added information about types of NPI’s
- Section: Provider Audit and SIU Process
- Language additions, revisions, and removal of outdated information
- Removed DRG coding audit information
- Section: Accreditation
- Updated language related to accreditation
- Section: Claim Corrections: Criteria
- Added information regarding purged claims
- Section: Reimbursement & Billing Guidelines
- Sub section: Inpatient Swing bed and Inpatient Transitional Care Unit– Hospital Billing were combined due to the similar process. New section is called Inpatient Rehabilitation, Swing Bed and Transitional Care Unit Per-Diem services‑Hospital Billing
Questions?
Contact our Medicaid Expansion Provider Service Center at 1-800-368-2312.
