New Feature on ChiroTrack

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EXCITING NEW FEATURE ON CHIROTRACK!

Effective 12/1/08

CNC is VERY excited to announce a great new feature on ChiroTrack! CNC has worked for several months with BCBSNC on this project, which launched on December 1, 2008! This new feature will verify the following information with BCBSNC before we transmit your claims for adjudication.

Patient ID Number

Patient Date of Birth

Patient’s Name

Verifying this patient information with BCBSNC prior to submitting your claims will reduce denials and will help to insure that your claims are paid quickly!

This new feature applies ONLY to BCBS of North Carolina “in-state” plans as well as the Federal Employee Plan. At this time, other BCBS plans cannot be included in this new edit.

How the process currently works:

The ChiroTrack system receives your BCBS claims and submits them directly to BCBS electronically. When BCBS receives the electronic file, before the claims are processed, BCBS checks to make sure that the name on the claim matches the name they have on file in their system. They also check the BCBS patient ID number on the claim against the ID number they have in their system. Additionally, they check the date of birth on the claim against the information in their system. This verification process is done electronically by BCBSNC. If any of the information submitted on your claim does not match what is in their system, BCBSNC rejects the claim and sends it back to CNC. It can take as long as 2 - 3 weeks for BCBSNC to notify CNC of any of these problems. Once we receive this information, CNC notifies you of the problem so that you can correct it and resubmit the claim back through ChiroTrack. We notify you of these issues either via fax to your office or via “BCBSNC Mailback,” which we include in the next scheduled CNC check packet. This means that it can be as long as 3 - 4 weeks after you submit the claim before you are notified that you are submitting incorrect patient information!

How the new process will work:

The ChiroTrack system receives your BCBS claims as usual. CNC will then send a HIPAA compliant file to BCBSNC associated with this new edit feature. When BCBS receives the electronic file, before the claims are processed, the BCBS system will electronically verify that the patient’s name, date of birth and patient ID number matches the information they have on file in their system and will identify those claims with incorrect patient information and notify CNC of those errors. This process can take up to 24 hours. As soon as CNC receives notification from BCBSNC that a claim was received with incorrect information, the claim will then appear as a “claim with error” on the ChiroTrack system. You may then correct these errors on ChiroTrack, just as you do other errors. With this new ChiroTrack edit feature, you will be alerted of errors within 24 hours, instead of to 2 - 3 weeks. This means that your claims will be paid more quickly and you will have fewer denied claims! (Please remember to update your practice management software system with ALL new information that you obtain so that you do not continue to have the same errors in the future.)

This new feature will create a slight delay (less than 24 hours) in the processing of your BCBS claims but this small delay you may experience will reduce the denials and reduce the time it takes for your claims to be paid! We recommend that you wait 24 hours before checking your claim file for errors.

New Error Message on ChiroTrack

If the patient ID number, date of birth or patient name is inconsistent with the information in the BCBSNC system, you will receive the following error message on ChiroTrack:

“Per BCBS, this patient’s insurance information is invalid. Please contact the member to obtain and verify ALL of the following: the patient’s name, date of birth, and insurance ID number.”

Please note: This new error message does not necessarily mean that only the ID number is incorrect; it could be any one of the three issues listed below or any combination of them.

Patient ID Number

Patient Date of Birth

Patient Name

If you receive this error, you will need to contact the patient OR check Blue e to verify ALL of the above patient information. (If you do not have Blue e, please contact your CNC Provider Rep for more information on how to register.)

IMPORTANT NOTE:

Some of you may notice that claims that previously processed correctly may NOW reject back to you as “claims with errors” under this new feature. Let us try to explain why this will happen. While BCBSNC may have accepted some of those claims in the past, because of the discrepancy in the patient information, those claims that were sent electronically had to then be dropped to paper by BCBSNC, and the information was then manually verified and then the claim was manually processed. That resulted in a significantly longer adjudication process. To expedite the processing of ALL of your claims, this new feature will now reject such claims to allow you to obtain correct information before resubmitting them through ChiroTrack. That way those claims can be promptly adjudicated once they reach BCBS and will not have to be manually processed. Submitting claims with correct and clean information is the best method to assure that your claims are adjudicated quickly and correctly the first time you submit them!

Please remember – if you receive this error, you will need to verify ALL patient information (including patient ID number, patient name and patient date of birth) via Blue e or by contacting the patient. Do not resubmit the claim again as it will continue to error out until the information on your claim matches the information in the BCBS system.

Again, this new feature applies ONLY to your BCBS of North Carolina “in-state” and Federal Employee Program claims. Other BCBS plans will not be included in this new edit at this time.

We are very excited to introduce this great new feature to ChiroTrack and to assist you with increasing the number of claims that are adjudicated correctly the first time that you submit them!

As always, if you have any questions, please contact your CNC Provider Rep at (877) 426-2411.