Updates to PPO professional calims editing process coming in December
BCBS announced in The Record dated September 2018, that an update to the claims editing processes for select groups will apply to professional claims, including durable medical equipment, prosthetics and orthotics, and medical supplies in the month of December. The outpatient facility implementation will take place in the second quarter in 2019.
These updates will make BCBS PPO claims payment system easier for billing staff to navigate. Unique clinical editing reason codes will appear on the 835 response files or provider vouches.
To read more, click here.