Retrospective Claims Accuracy (RCA) Claim Correction Process

Blue Cross Blue Shield of North Dakota (BCBSND) wants to inform providers of a change to the Retrospective Claims Accuracy (RCA) Process. Previously, providers were informed to request claim corrections as part of the reconsideration process. Effective immediately, a reconsideration should not be requested if a claim correction is more appropriate. 

If it is determined a claim correction is needed:
1. Do not respond to the “Overpayment Notification letter”.
2. Submit a claim correction immediately.
Providers can visit the Retrospective Claims Accuracy (RCA) website for a full process flow.

Please refer the Payment Integrity Program provider webpage or contact the appropriate line of business Provider Service Center for questions related to the three updates.