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Inpatient/OP facility In-network with BCBS that claims are being processed as OON. This has been going on for over 3 years with Anthem with no resolve. The representative assigned to our company has been ineffective and not able to fix our claim processing issue, nor has advised us on the timing for them to be reprocessed correctly. We are informed the system is not processing claims correctly since migration to new system and I have no confidence they know how to get them processed correctly. They have instructed us to make changes to locations and TIN as probable cause for the error in processing, after updates we had same results. We currently have over 600k in claims processed as OON with payments going to members.
We continue to provide treatment to members in need, but BCBS is not holding up to their part of the agreement with reimbursement according to our contract. I would like some assistance in getting Anthem to address our
claims issue in a timely manner. I would say 3 years' trying to resolve a problem is way too long!
Our facility is located in Missouri, treating those D & A addiction.
Contact Info: Kevin Luffey [protected]- Please call me if you can assist in moving this along.
Thanks
Claimed loss: We have 650k in claims open with payments going to members as OON claims for an In-Network contract.
Desired outcome: Have Representative call us on status and get our claims paid correctly
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