December 2016

Provider Claim Summary Paper-to-electronic Conversion Coming March 1, 2017

Blue Cross and Blue Shield of Texas (BCBSTX) recognizes that immediate access to the Provider Claim Summary (PCS) is vital for posting patient accounts and reconciling financials. Often times, providers who receive this information via post office mail are waiting on delivery, which delays administrative processes.

As of Dec. 12, 2016, a new report viewer application will be available in the BCBSTX branded Payer Spaces section on the Availity^® web portal. This new tool permits you to readily view, download, save and/or print the PCS online as often as needed. This report viewer offers you the opportunity to obtain claim outcome results for multiple patients in one central location.

Effective March 1, 2017, claim summary information will be delivered through this online report viewer application, rather than distribution via paper mailing. This online alternative is an additional offering to our other electronic tools through Availity. If you currently rely on paper claim summaries, Availity registration is strongly recommended to gain access to the report viewer application.

Providers who are already enrolled for Electronic Remittance Advice from BCBSTX will continue receiving their remittances electronically. They will also have the same opportunity to view, download and/or print the claim summary as a complimentary option.

Exceptions to continue receiving paper mailings may be considered for extenuating circumstances. To submit this type of exception or request training for online applications, email PECS@bcbstx.com. Otherwise, beginning March 1, 2017, claim summary information will be accessible exclusively on the report view application on Availity. Additionally, providers will be directed to make use of the BCBSTX report view application if an exception request is not received by Feb. 17, 2017. The exception review process may require up to five business days before a response is returned.

BCBSTX supports an array of online tools to registered Availity users, including the report viewer, at no additional cost. To register, simply go to availity.com, select Register and then complete the online application.

Additional communications regarding the change will be published in upcoming issues of this newsletter and on our provider website.

Availity is a registered trademark of Availity, LLC. Availity is a partially owned subsidiary of Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC), an independent licensee of the Blue Cross and Blue Shield Association. Availity operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSTX, a Division of HCSC. BCBSTX makes no endorsement, representations or warranties regarding any products or services offered by independent third party vendors. If you have any questions about the products or services offered by such vendors, you should contact the vendors directly.