Provider Library
Billing Dispute External Review Process 
Blue Medicare Private Fee-for-Service Terms and Conditions
Fully Insured Vs. Self-Funded Groups
Interactive Voice Response (IVR) system allows you to enjoy self-service inquiry resolution.
National Provider Identifier (NPI)
Physician Advisory Committee (PAC)
Thomas-Love Settlement Provision 7.8(d) — The following information is posted in compliance with the Thomas-Love Settlement:
- Significant edits [As of 11/03/09]
- Significant edits [As of 1/9/09]
- Health Care Service (HCSC) Adverse Denial Rate — Calendar Year 2009
- HCSC has received 6,140 appeals for Adverse Determinations that have been sent for external review. Of that total, 21.6 percent have been overturned. [Posted 2/2/2010]
Claim Tips
- Additional medical records for predetermination
- Alpha prefixes on ID numbers
- Dating your claim forms
- Determining the primary carrier for ESRD patients
- Duplicate claims are costly
- Importance of confirming benefits and eligibility before rendering services
- Importance of pre-authorizations
- Instructions for filing corrected claims
- On-set date / Occurrence date
- Tips for billing corrected medicare claims
- Tips for only one insurance carrier
- Tips for preventing claim delays
Provider Tools
