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EFT Expansion to Medicare Advantage Lines of Business

Release Date: June 6, 2012

Effective July 1, 2012, BCBSNC providers participating in Blue Cross and Blue Shield of North Carolina (BCBSNC) electronic funds transfer (EFT) will begin to receive EFT for Medicare Advantage claim payments. If you are a current BCBSNC EFT participant, you are automatically enrolled in the EFT for Medicare Advantage claim payments and no further action is required.

Providers not currently participating in BCBSNC EFT can access Blue e to complete the enrollment form – if you do not have access to Blue e, an enrollment form can be accessed via the "Forms and Documentation" section of our provider portal.  This sign-up alternative means less paperwork, lower administrative costs (i.e., preparing deposits, trips to the bank), and makes it easier for providers to receive the fastest receipt of eligible payments for their BCBSNC claim submissions!  Once we have received and processed a claim, EFT payment is sent directly to the bank account of your designation.  Payments are sent through an automated clearinghouse and typically take up to two days to post, which is a much faster process than a conventional check cycle and our mailing to your bank to process and deposit.  

Providers participating in our Medicare Advantage lines of business can expect the following if enrolled in the BCBSNC EFT:

  • Receipt of paper EOPs will continue for electronic payments with the check number field having a leading “9” in front of the check number.
  • Accessibility to payment and claims information will continue on the Health Trio portal with EFT payments reflecting a “9” in front of the check number.
  • Electronic remittance (835) will have payment type indicator 835 as either “CHK” (check) or “ACH” (electronic payment).
  • As with all other lines of business, copies of the original EOP can be accessed via the Blue e -”Remittance Inquiry”.

What else can providers expect to see as a result of this change?  Regardless if you are a current BCBSNC EFT participant or not, ALL Medicare Advantage, as well as, Medicare Supplement participating providers can expect to see a reduction in paper waste.   BCBCNC is shifting to duplex (two-sided) printing of EOP’s – another environmental benefit! 

BCBSNC EFT participating providers are encouraged to share the expansion of EFT capabilities for our Medicare Advantage lines of business with any entity responsible for making claim status calls for your practice. Furthermore, providers are encouraged to select an individual and a back-up to perform the EFT administration role on Blue e. This person enters the bank account and routing information when setting up your Blue e account, so must be trusted with secure financial information. Only designated EFT users have the capability to view or modify an EFT transaction on their Blue e Home page.

Questions regarding EFT participation may be directed to BCBSNC Financial Processing at 919-765- 2293.  BCBSNC offers EFT free of charge and set-up is completed within five business days from receipt of all documentation by BCBSNC.  Providers are encouraged to verify with their financial institution if processing fees apply.