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Legacy Claims

Inpatient Legacy Claims

Blue Cross Blue Shield of North Dakota (BCBSND) completed the migration to the HM Health Solutions (HMHS) platform at the end of 2018. The process of decommissioning (shutting down) the legacy system has started. The grouper used to establish the APR-DRG was decommissioned on October 31, 2019.

How does this affect participating providers?

Inpatient claims associated with members prior to their migration to the HMHS system (non-migrated members) that have not been completed by the decommission date will incur a delay in processing, as we will need to manually group the diagnosis codes to establish the APR-DRG.

What are the next steps?

Providers were asked to submit any claim corrections and/or appeals for inpatient legacy claims by October 15, 2019 to avoid processing delays.

Who do I contact with questions?

Please email prov.partners@bcbsnd.com with any questions.

HealthCare News Blast | September 10, 2019