Blue Cross Blue Shield of North Dakota (BCBSND) would like to remind our provider community of the participating provider agreement section Provider Group’s Responsibilities 3.11 of your BCBSND provider agreement.
The Provider Group and its providers shall submit claims and supporting documentation as requested for covered services on behalf of a member unless exempted under state or federal laws and regulations (i.e., Health Information Technology for Economic and Clinical Health Act (HITECH Act)). Services shall be submitted on the appropriate claim forms, according to industry standards or as determined by BCBSND policy.
To remain complaint to your signed contract, providers may provide a discounted rate as indicated below, however services should not be given at a discounted rate for not submitting the claim to the members insurance plan.
Member Discounts
BCBSND defines a member discount as any promotion or special consideration that reduces the provider’s customary charge for Covered Services. Participating providers offering member discounts must adhere to the following guidelines:
- The discount must be available to all patients, regardless of whether insurance coverage is involved.
- The provider’s customary charge submitted to BCBSND must reflect the discounted amount as demonstrated in the example below:
