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BCBSNC Experiencing Claim Processing Delays and Reduced Call Center Hours for Providers

(This is an update to information we shared with you in articles posted on December 4, 2013, January 8, 2014, and January 9, 2014.)

In December 2013, we discovered a problem with the reprocessing of corrected claims and communicated our intent to have most of the claims resolved by the start of the new year.  However, in early January a systems problem was revealed that showed many of the claims we had reviewed and adjusted were recycled back through our claims system for processing, instead of releasing and paying as intended.  We’ve been working diligently to resolve the problem, and focusing staff on clearing out the inventory, which has led to slower processing of some claims while we’ve been working on these clean-up efforts.  Please be assured that new claims we receive are being processed uninterrupted as we work through this issue, although some claims are processing through the system at a slower speed than usual.  

Impact to Provider Call Center Hours     

Additionally, we understand there’s frustration with our decision to reduce provider call center hours to 12:30 p.m. - 6:00 p.m. for the rest of January.  We apologize for any inconvenience this has caused you or your staff.  Our goal is to return to normal call center hours as soon as possible. 

We value our participating providers, and we want to maintain consistency while offering solutions to addressing the high volume of member calls we’re receiving in which they need assistance with their Affordable Care Act-related questions.  The actual call volume has far exceeded our highest projections, causing us to re-allocate call center resources to support that volume. 

To help alleviate further delays in having your questions answered because of the current situation, the Provider Blue LineSM (1-800-214-4844) will be open from 8:00 a.m. – 1:00 p.m. this Saturday, January 25.       

We encourage you to continue using our convenient, online self-service tools such as Blue eSM whenever possible, and we thank you for your understanding and flexibility during this unprecedented time.