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Updates Regarding the FEP Migration to the Power MHS System

Recently, we notified you via Provider News that effective May 16, 2013, we transitioned the claims processing system for the Federal Employee Program (FEP) from our Legacy system to our Power MHS system.   Making the move to the newer Power MHS system allows us to provide better service, expedite claims transactions, improve accuracy, and reduce the costs associated with the many manual processes required for FEP claims processing on the older system. 

In our original notice dated June 2012, we shared information with you about some specific enhancements that would be made related to the move.  Please see below for updates on those enhancements: 

  • The future 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 the existing BCBSNC policies and procedures relating to products on Power MHS to FEP.  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 will electronically transfer funds directly into your account.  This convenient feature will be coming soon. 

It is important to note that although pricing will be determined based on current Power MHS coding and system edits, claim submissions will be adjudicated in the claims management system for the Federal Employee Program. The FEP claims management system contains membership data, applies benefits, stores claims history, adjudicates claims, and provides payment information to generate checks, EOPs and EOBs. 

If you have any questions, please contact your Strategic Provider Relationships representative directly, or you may call the Provider BlueLineSM at 1.800.214.4844.