Healthy Blue Information Disseminated
Posted by [email protected] on Mar. 15, 2021 / Subscribe 0
Healthy Blue Information Disseminated to APTA–NE, NOTA, NSLHA
- Providers not getting paid issues
a.) Provider records were set to pay at a different provider record level. This has been since corrected. Payment reconciliation process are being researched. Providers that set up EFT through Availity were not affected. Paper checks were affected. Have the provider check with their provider representative to get things taken care of. Uncashed checks will be re-issued in 30-60 days. Cashed checks will take longer, no timeline on this.
b.) Taxonomy issue with payment – state requires a taxonomy on in-bound claims, this is a standard that MCO’s are required to do. Provider clearinghouses are dropping the taxonomy codes during the claims’ submission process. The company that Healthy Blue uses is Availity. Clinics are thus required to contact their own clearinghouses to ensure that the taxonomy codes are NOT being dropped during processing. As of 3/11/2021, the taxonomy issue has been fixed by Healthy Blue and those claims will be processed by 3/16/2021.
- Provider representative distribution has not been posted to Healthy Blue website yet. This has been posted as of 3/11/2021.
- The deadline for timely filing is 180 days.
- All Authorizations for physical therapy must be performed through AIM. Disputes regarding claims, must go through Healthy Blue. Here is the email for Healthy Blue if you have issues. [email protected]
- There are several codes that are on the adjunctive code list that must be pre-authorized through AIM, including 97014, 97012, 97022, 97033, 96001, etc. However, we know that providers are not being reimbursed for these codes and others. We are working on this with NOTA, NSHLA, and the APTA to get this corrected with AIM and Healthy Blue.
- We have been informed that some of you are still having issues with the transition from WellCare to Healthy Blue with authorizations and payments. Please reach out to your Provider Representative to rectify these issues.
- From Healthy Blue, “Please share with your membership, along with our pledge to continue working through these identified (and any not yet identified) issues. We do understand the frustration felt by providers and the concern with fiscal impact on their businesses. Equally important, we also share the concerns with impact to patient care. We are taking these meetings and all preparation necessary very seriously.”
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