Missing 835 Electronic Remittance Advice (835 ERA) Files for Medicare Advantage (PPO)SM & Medicare Advantage (HMO)SM

March 10, 2017

If you are a Blue Cross and Blue Shield of Texas (BCBSTX) Medicare Advantage (hereinafter collectively referred to as "government programs") contracted provider who enrolled between Dec. 1, 2016, and Dec. 30, 2016, to receive the 835 ERA from BCBSTX for these products, you may be missing your ERA files for those claims. This information applies to claims submitted by government programs contracted providers for care and services provided to the following BCBSTX members:

  • Blue Cross Medicare Advantage (PPO)
  • Blue Cross Medicare Advantage (HMO)

BCBSTX is in the process of correcting this issue and a resolution is scheduled to be completed by mid-March 2017 to help ensure that impacted providers continue receiving future ERA files for auto-posting of payments. In the interim, impacted providers may refer to their paper Provider Claim Summaries (PCSs), which are sent by regular mail for government programs claims for applying payments. If you are not a government programs contracted provider, please see below* for an important reminder.

More information regarding your 835 ERA delivery may be obtained from your designated clearinghouse or vendor. Please note that ERA files cannot be reloaded for Medicare Advantage claims.

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

* Important Reminder for Non-Contracted Government Programs Providers
The above notice applies only to BCBSTX government programs contracted providers. Contracted BCBSTX providers for commercial lines of business who submit claims for care and services provided to government programs members, including Medicare Advantage, BCBSTX Medicaid (STAR), STAR Kids and CHIP members, will receive paper checks and PCSs by mail for those claims, even if they are enrolled to receive the ERA and Electronic Funds Transfer (EFT) from BCBSTX for commercial member claims.