Government Programs: Missing 835 Electronic Remittance Advice (835 ERA) Files
Posted March 16, 2017
This notice applies only to Blue Cross and Blue Shield of Illinois (BCBSIL) government programs contracted providers who participate in any of the following listed programs and enrolled between Dec. 1, 2016, and Dec. 30, 2016, to receive the 835 ERA from Blue Cross and Blue Shield of Illinois (BCBSIL) for government programs claims. The government programs impacted are:
- Blue Cross Medicare Advantage (PPO)SM (MA PPO)
- Blue Cross Medicare Advantage (HMO)SM (MA HMO)
- Blue Cross Community Managed Long Term Supports and ServicesSM (MLTSS)
- Blue Cross Community MMAI (Medicare-Medicaid Plan)SM
- Blue Cross Community Integrated Care Plan (ICP)SM
- Blue Cross Community Family Health PlanSM (FHP)
Those providers who fit the above criteria may be missing ERA files for claims submitted for any members enrolled in any of the above listed government programs. BCBSIL is currently in the process of correcting the missing ERA issue and a resolution is scheduled to be completed by the end of this month. In the interim, providers affected by this issue may refer to their paper Provider Claim Summaries (PCSs), which are sent by regular mail, for applying payments for those government programs claims. If you are not a government programs contracted provider, please see below for an important reminder.
Once the issue is resolved, affected providers will receive future ERA files for auto-posting of payments for MA PPO, MA HMO, MMAI, ICP, FHP and MLTSS claims. More information regarding your 835 ERA delivery may be obtained from your designated clearinghouse or vendor. Please note that ERA files cannot be reloaded for Medicare Advantage and BCBSIL Medicaid claims.
We appreciate your patience and apologize for any inconvenience that this issue may have caused your practice.
Important Reminder for Non-contracted Government Programs Providers
Independently contracted BCBSIL providers for commercial lines of business who submit claims for care and services provided to government programs members will receive paper checks and PCSs by mail for those claims, even if they are enrolled to receive the ERA and Electronic Funds Transfer (EFT) from BCBSIL for commercial member claims.