Due date extended for resubmitting some corrected SNF claims for Medicare Plus BlueSM members
As we communicated through a web-DENIS message on July 1, 2021, Blue Cross Blue Shield of Michigan and Blue Care Network reviewed paid skilled nursing facility claim records with dates of service from Oct. 1, 2019, through Dec. 16, 2020, for our Medicare Advantage members. During the review, we found that some claims included overbilled services or services that didn't match those that naviHealth had authorized.
We sent letters to the affected providers that specified the due dates for correcting and resubmitting claims.
News about due dates, including an extension
While the due dates specified in the letter still apply to all BCN AdvantageSM claims, we're extending the resubmission date for some Medicare Plus BlueSM claims:
As noted in previous communications, our systems will deny some resubmitted claims for Medicare Plus Blue members due to untimely filing. This occurs because our systems are set up to automatically issue denials for claims that are submitted more than one year after the date of service.
If you receive a denial, you don’t need to take any action. We're identifying these claims and will process them for payment after Jan. 26, 2022.
This issue doesn't affect resubmissions of corrected SNF claims for BCN Advantage members.
As a reminder, naviHealth manages post-acute care services for Medicare Plus Blue and BCN Advantage members. For more information about naviHealth, see the Post-acute care services: Frequently asked questions for providers (PDF) document.
Posted: October 2021
Line of business: Blue Cross Blue Shield of Michigan