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Government Programs: Claim Payment Update

Posted February 3, 2017 (Updated February 10, 2017)

Beginning Jan. 1, 2017, Blue Cross and Blue Shield of Illinois (BCBSIL) implemented a number of changes as part of an initiative to help improve efficiencies in claim-related processes for government programs claims. This includes claims submitted for Blue Cross Medicare Advantage (PPO)SM (MA PPO), Blue Cross Medicare Advantage (HMO)SM (MA HMO), Blue Cross Community MMAI (Medicare-Medicaid Plan)SM, Blue Cross Community Integrated Care Plan (ICP)SM, Blue Cross Community Family Health PlanSM (FHP) and Blue Cross Community Managed Long Term Supports and ServicesSM (MLTSS) members. 

Please be advised that some claim payment delays may be experienced by providers, related to this transition. 

  • For Blue Cross Medicare AdvantageSM (MA PPO and MA HMO), payments for most claims submitted between Jan. 1, 2017, and Jan. 20, 2017, were released Feb. 1, 2017. Providers enrolled for Electronic Funds Transfer (EFT) should see payments posted in their accounts on or after Feb. 1, 2017, for these claims; Electronic Remittance Advice (ERA) files also were transmitted on that date. Provider Claim Summaries (PCSs) and paper checks were sent by regular mail and should arrive this weekend or next week depending on provider location.
  • For Blue Cross Community OptionsSM (MMAI, ICP, FHP and MLTSS), or BCBSIL Medicaid, payments for most claims submitted between Jan. 1, 2017, and Jan. 7, 2017, are being released Feb. 3, 2017. Providers may not receive payments (EFT and paper checks) until the first full week of February 2017, with ERAs and PCSs following shortly thereafter. For most BCBSIL Medicaid claims submitted between Jan. 8, 2017, and Jan. 19, 2017, payments were released Feb. 7, 2017. Providers may not receive payments (EFT and paper checks) until the second full week of February 2017, with ERAs and PCSs following shortly thereafter. For most BCBSIL Medicaid claims submitted between Jan. 8, 2017, and Jan. 19, 2017, payments were released Feb. 7, 2017. Providers may not receive payments (EFT and paper checks) until the second full week of February 2017, with ERAs and PCSs following shortly thereafter. 

We appreciate your patience during this transition and apologize for any inconvenience that this issue may have caused your practice.