This is the latest communication from our contractor with BCBS on the MC Advantage products..  She says Optum is getting ready to apply the penalty on late RAPs.

We setup our BCBS payor to submit RAP in 5.  Health Partners confirmed they do not want the raps.  Humana rep has not responded yet and our VA is under Optum.

FYI

Hello again.

I have been communicating with our pricing team regarding your inquiry.  I have confirmed for you that we do accept and receive RAP claims for our Medicare Adv products.  You have confirmed that you have not submitted any RAP claims to us, so I’m wondering why you are saying that we do not accept them?

Additionally, we did confirm that Optum, the vendor we use to price our Medicare claims, who is planning to update their products to apply the penalty if not submitted within the days. 

Does this help to answer your questions?

Will BCBS start demanding zero dollar RAPs To be submitted in 5 days from SOC in 2021..?  Currently your (BCBS) is not accepting RAPs currently for MA plans and I can see a chaotic mess of not getting paid...you..?



I’m sorry for my delay in getting back to you, Julie.  If you are not currently billing BCBSMN for RAP charges, and I’m telling you that we accept them, what exactly is your question?  I want to make sure that I am fully understanding your inquiry.

 

Thank you.

 

Anne M. Spangenberg

Blue Cross Blue Shield of MN

Provider Contract Manager

651-662-1047~direct

Anne.Spangenberg@bluecrossmn.com

 

"To give real service, you must add something which cannot be bought or measured with money; that is sincerity and integrity." - Douglas Adams

 

From: Julie Embry <jembry@gaehc.org>
Sent: Monday, December 28, 2020 2:27 PM
To: Spangenberg, Anne <Anne.Spangenberg@bluecrossmn.com>
Subject: RE: Medicare RAP Requirements??

 

 

Thanks for your response..  We currently do not send RAPS for MA BCBS plans..  Attached is an example with all the numbers.

 

Thoughts?

 

 

Julie Embry

 

 

From: Spangenberg, Anne <Anne.Spangenberg@bluecrossmn.com>
Sent: Monday, December 28, 2020 10:39 AM
To: Julie Embry <jembry@gaehc.org>
Subject: RE: Medicare RAP Requirements??

 

Thank you for your email, Julie.  BCBSMN already accepts RAP claims today, so there should be no issues with these types of claim submissions. 

 

If you have a specific claim example you would like us to review, please advise.

 

Anne M. Spangenberg

Blue Cross Blue Shield of MN

Provider Contract Manager

651-662-1047~direct

Anne.Spangenberg@bluecrossmn.com

 

From: Julie Embry <jembry@gaehc.org>
Sent: Tuesday, December 22, 2020 12:38 PM
To: Spangenberg, Anne <Anne.Spangenberg@bluecrossmn.com>
Subject: Medicare RAP Requirements??
Importance: High

 

CUTION:	This email originated outside of our organization.
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---

HI Anne

 

Will Medicare Advantage plans start to want to receive RAPs as of 1/1/21?  Currently they don’t accept them but there are rumors from your claims departments that BCBS will start to require a RAP.

 

Be Compassionate. Be Accountable. Be Respectful. Be Excellent!

 

Julie Embry

Director of Business Administrations

Guardian Angels Elim Home Care and Hospice

403 Main Street, Elk River, MN 55330

Main 763-241-0654

Direct  763-452-4104

Fax   763-241-0274

Email jembry@gaehc.org

www.gaehomecarehospice.org