New operating system changes

We’re making a change for the better.

As communicated in the past, Blue Cross and Blue Shield of Georgia, Inc. and Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. (collectively “BCBSGa”) is leveraging the strength and efficiencies of our parent company and continuing to simplify the way we do business by changing our operating systems to those currently used by our sister plans.

 

Changes to your remittance.

Starting in January 1, 2019, some providers may notice a few slight differences in remittance. They include:

Remittance item	Current Process	New Process
Allowed amount	Rounding is applied to the total allowed.	Rounding is applied on each claim line. The final allowed amount is the sum of each line-level rounded amount.
Multiple units*	(fee schedule rate) (units billed) (flex percent) = remittance	(fee schedule rate) (flex percent) (units billed) = remittance

*Only applies to providers contracted with a percentage of fee schedule

 

If you have any questions regarding this notification, please contact your local network consultant or call BCBSGa provider services at 800-428-4446. Thank you for your continued participation in our network.