Musculoskeletal Program Authorization Corrections

On September 28, 2023, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) posted a communication regarding the new Musculoskeletal Program and Interventional Pain Management program, effective October 1, 2023, through Carelon Medical Benefits Management (Carelon).

Recently, Blue Cross NC became aware of an issue after the effective date of the program that was causing providers to show as “out of network” in the Carelon system.

This issue was corrected on October 17, 2023; however, minimal authorizations were processed as out of network. Those authorizations have since been identified and will be corrected to reflect providers as in-network, and any claims that have been impacted will also be reprocessed and adjusted accordingly.

It is not necessary for providers to contact us and request their claims to be reprocessed as we have identified the impacted authorizations and are working to have them updated.

We apologize for any inconvenience this may have caused and thank you for your patience as we work to correct the issue.