Maybe check the plan bill code…
The Bill Option Code describes the beneficiary’s relationship with the MA plan. Valid codes are:
1 – Intermediary processes all (Part A and Part B) provider bill (unrestricted). Submit your claim to the intermediary.
2 – HMO processes directly provided services and arranged services. Intermediary processes all others (unrestricted).
A – Intermediary processes all (Part A and Part B) provider bills (restricted).
B – HMO to processes only bills for directly provided services (restricted); intermediary to process all other
bills.
C – HMO to process all bills (restricted). Submit your claim to the Medicare Advantage plan.
Annetta Smith, LPN
Billing Specialist
(M)1-651-442-0228
(O)1-651-388-2223
(F)1-651-388-2227
From: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Brittany Schwecke
Sent: Monday, August 5, 2019 9:16 AM
To: billers@list.mnhomecare.org
Subject: BCBS Medicare Advantage Claims
Does BCBS Medicare Advantage plans send payment for both RAP and FINAL or just FINAL claim? I have submitted 2 RAPs on different clients and both are not being paid.
Wondering if this is because something is wrong with the claim or because they only send payment on FINAL claim?
Tried talking to BCBS about this, but of course the customer service reps don’t understand Advantage plans. Any insight would be great, Thanks!
Brittany Schwecke
Accountant
Renville County Public Health Services
105 South 5th Street, Suite #119H
Olivia, MN 56277
Direct: 320-523-3721
Public Health : 320-523-2570
Email :
brittanys@renvillecountymn.com
Web :
www.renvillecountymn.com
