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BlueCard Fund Distribution Program Launched in July

In certain circumstances, providers return money to BCBSNC for BlueCard Host members for previous claim activity. The main reasons this occurs is due to:

  • Refunds due to Coordination of Benefits Overpayments
  • Provider Audit Recoveries

When these dollars are received, BCBSNC is obligated to refund the money to the Home Plan. There are times when dollars cannot be credited back to Home Plans on a specific claim basis due to various reasons. These dollars are held in a special account and must still be returned to Home Plans. BCBSNC will be launching a program to distribute the funds back to Home Plans beginning July 15, 2006.

Working in conjunction with the Home Plans, the BCBS payment you receive will be made up of a combination of money from the Home Plan and money from this special account. This is all done behind the scenes and you will receive payment as you always do. However, due to the complex coordination of payment between the Home Plan and BCBSNC you may occasionally see very small reimbursements (in cases where the member has not met their deductible) paid by BCBSNC.

If you have additional questions about this program, please contact your BCBSNC Network Management representative.