Medicare Advantage Plans: Claim Payment Update

February 21, 2017

Beginning Jan. 1, 2017, Blue Cross and Blue Shield of Texas (BCBSTX) implemented a number of changes as part of an initiative for claim-related processes for government programs claims. This includes claims submitted for Blue Cross Medicare Advantage (PPO)SM and Blue Cross Medicare Advantage (HMO)SM members.

Please be advised that some claim payment delays may have been experienced by providers, related to this transition.

For Blue Cross Medicare Advantage PPO and Blue Cross Medicare Advantage HMO most payments for claims submitted between Jan. 1, 2017, and Jan. 20, 2017, were released Feb. 1, 2017. Providers enrolled for Electronic Funds Transfer (EFT) should see payments posted in their accounts on or after Feb. 1, 2017, for these claims; Electronic Remittance Advice (ERA) files also were transmitted on that date. Provider Claim Summaries (PCSs) and paper checks were sent by regular mail and should arrive this weekend or next week depending on provider location.

We appreciate your patience during this transition and apologize for any inconvenience that this issue may have caused your practice.