Coordination of Benefit Claims

Blue Cross Blue Shield of North Dakota (BCBSND) has been continuing work to better resolve the coordination of benefits crossover issues for Medicaid Expansion members who have another BCBSND insurance primary.

A process has been put in place to review these claims as they are received, as well as a follow-up process to review after a claim has been finalized to catch any claims that were missed. This information pulled for the post claim processing review will be a month behind i.e., the mid-August report will capture July claims. Due to this manual review, we are asking providers to allow 60 days from finalization before contacting the BCBSND Medicaid Expansion Provider Service department regarding the crossing over of a claim.

If a provider feels they have any additional claims that did not process to coordinate correctly and/or cannot wait 60 days due to timeliness concerns, please work with the Medicaid Expansion Provider Service department directly.

Impacted providers will receive new remittances with the updated processing information. If providers need to amend these claims, the standard claim correction/adjustment process can be followed, as necessary. Information on claim corrections can be found in the Medicaid Expansion provider manual.

Questions?
If you have additional questions regarding this article, please contact the Medicaid Expansion Provider Service Center at 833-777-5779.