BCBSM is reprocessing claims for preventive mammogram and newborn laboratory services that were processed incorrectly due to a system issue. They have updated their systems and providers will start to receive reimbursement beginning this month through February 2013.
Providers who experienced claim rejections or collected out-of-pocket amounts (coinsurance, copays or deductibles) will receive payments for:
- Preventive mammograms with service dates from Sept. 23, 2010, to Dec. 31, 2012
- Newborn laboratory screening tests with service dates from May 21, 2011 to Dec. 31, 2012.
As a BCBSM member, you will receive notification in a new Explanation of Benefits.
Reimbursement Process
BCBSM will credit affected providers for covered services after claims are reprocessed.
If you are a member that paid for the service in full or paid cost share, you need to contact your provider to receive reimbursement. For members who received mammogram or newborn services from a non-participating out-of-network provider, BCBSM will send the reimbursement directly to them.
We encourage you to share this information with your employees. Questions? Call your dedicated Account Manager at 248-594-5550.
