Thursday, September 9, 2010

New BCBSNC processes for late payments and reinstatement

Please note the following process changes BCBSNC has made regarding late premium payments.

Overdue Payment Notice
Effective September 10, BCBSNC will begin notifying groups of their account status earlier. For groups that have not yet paid their premiums for the current month, a notice will be mailed on the 10th day of the month. Currently, this notice is mailed on the 21st. Claims for services rendered after the paid-through date will be suspended as of the 10th day of the month. Employees will still be able to fill prescriptions during the claim suspension period.

Additionally, the BCBSNC Overdue Payment Notice has been revised to include more detail regarding the employer group’s legal and contractual obligations to their employees with health benefits.

Termination Letter
For groups that have not paid their premiums for the previous month of coverage, BCBSNC will continue to mail notices of termination 37 days from the first day of the month for which payment is due. The BCBSNC Termination Letter has been revised to provide clear guidelines and accurate information about the termination.

Due to new process efficiencies, BCBSNC will begin processing terminations (for non-payment) 38 days from the first day of the month for which payment is due. Today terminations are processed between the 45th and 50th day from the first day of the month in which payment is due.

Reinstatement Policy
BCBSNC has revised and clarified its reinstatement policy, effective October 1, 2010, as follows:
• Requests must be made within 30 days from the date of the group’s cancellation letter.
• Only one reinstatement per group will be permitted in a 12-month period.
• A group cannot have had more than one instance of non-sufficient funds within the last 12-month period.
• The group must be able to pay to the current billed period noted in BCBSNC’s systems.
• Payment must be in the form of a cashier’s check or money order and received within 3 business days of the approval to reinstate.

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