Blue Cross and Blue Shield of Texas (BCBSTX) has identified an overpayment error for certain ground and air ambulance claims. For dates of service between January 2017 through April 2022 the claims were erroneously allowing billed charges for some Commercial, FEP, Fully Insured/Retail and Host members.
This error has been corrected and as of March 6, 2023, we have begun requesting applicable overpayments for these claims. This includes pursuing overpayments for claims within the last 24-month payment period for ASO and Blue Card and 5 years for FEP as required by these plans. Payments for Fully Insured and retail claims are not being pursued.
Claims will be adjusted upon receipt of the refund. Where applicable, BCBSTX will utilize its standard recoupment process described in the applicable provider manuals.