Important Notice for IL Medicaid Electronic Funds Transfer (EFT) Recipients
Posted January 7, 2019
The following notice is applicable to Blue Cross Community Health PlansSM (BCCHPSM) and Blue Cross Community MMAI (Medicare-Medicaid Plan)SM providers only.
On Jan. 3, 2019, Blue Cross and Blue Shield of Illinois (BCBSIL) experienced an internal system issue that affected certain providers who are currently enrolled and/or are receiving claims payments via EFT. This system issue may have caused an erroneous credit to be applied to your bank account on Jan. 4, 2019. BCBSIL has taken steps to resolve this issue as quickly and efficiently as possible. Additional information is included below.
How can providers tell if they were affected?
Look on your bank statement for the EFT payment date – the same EFT trace number/amount will appear twice on Jan. 4, 2019. On the Electronic Remittance Advice (ERA), the EFT Trace Number will appear in the TRN02 segment. You can also review the ERA information using the Remittance Viewer tool in the Availity® Provider Portal.
What is BCBSIL doing to resolve the issue? What are the next steps?
BCBSIL started debiting affected provider bank accounts on Jan. 7, 2019, for all erroneous credits, in accordance with section 1.2 of the EFT Agreement. Debits will be reflected on the provider’s bank statement on the day following the transaction. For provider accounts that cannot be debited, BCBSIL will follow the guidelines of the Payment Recovery Program (PRP). The PRP allows BCBSIL to recoup duplicate payments made to contracted facilities and professional providers.*
What should providers do right now, if anything?
- Review your bank statement and/or ERA to gain awareness of erroneous credits. Please do not move or withdraw the erroneous credits from your accounts.
- If you use the ERA for auto-posting to your patient accounting system, check with your billing service or clearinghouse – most software vendors have controls in place to remove duplicate auto-postings. (Smaller provider offices may have to adjust manually to back out additional payments.)
We thank you for your patience and apologize for any inconvenience this issue may have caused.
*As a reminder, the PRP process is as follows: Providers will receive a refund request letter. If no action is taken by the provider within the allotted time frame, BCBSIL will recover the duplicate payment by offsetting current or future claim payments. The recovery details will appear on the ERA or Provider Claim Summary (PCS).
Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSIL. BCBSIL makes no endorsement, representations or warranties regarding any products or services offered by third party vendors such as Availity. If you have any questions about the products or services offered by such vendors, you should contact the vendor(s) directly.