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FEP Claims Processing Enhancements

Release Date: June 1, 2012

Notice:  FEP Claims Processing Enhancements – making the move to the Power MHS processing system

At Blue Cross and Blue Shield of North Carolina (BCBSNC) we are continuously looking to improve performance, which is why we’re excited to tell you about changes taking place within our Federal Employee Program (FEP) department that will affect FEP claims processing.  Beginning August 3, 2012, we will transition all FEP claims processing functions from our Legacy claims system to our newer Power MHS system. We’re doing this to provide better service, speed claims transactions, improve accuracy and reduce the cost associated with the many manual processes required for claims processing on the older system.

After the weekend of August 3, 2012, FEP claims and claim adjustments will process on the Power MHS claims system.  Some of the enhancements resulting from the move:

  • The Explanation of Payment (EOP) will have the same, familiar look as the EOP for our commercial lines of business (i.e., clearer descriptions on column headers, enhanced remark codes with easy to understand descriptions).
  • Improvements to claim processing accuracy by utilizing current Power MHS code editing systems to assist in evaluating the accuracy of submitted CPT and HCPCS codes. 
  • Improved consistency and predictability by applying to FEP the existing BCBSNC policies and procedures relating to products on Power MHS.  The medical policies that apply to FEP today will not be removed as a part of this migration, but the claims editing, bundling, reimbursement policies, and other provider-related policies associated with our other products on Power MHS will now apply to FEP instead of those policies and procedures specific to Legacy.
  • Participating providers enrolled for electronic funds transfer (EFT) will no longer have to wait for their manual checks to arrive in the mail - BCBSNC can electronically transfer funds directly into your account!

If you have questions regarding the transition of the FEP claims processing move to Power MHS, please contact your Strategic Provider Relations representative or you may call the Provider Blue LineSM at 1.800.214.4844.