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Crediting Remittance Advices on Previously Processed Claims


Provider Administrative Policy

Section
Provider Information
Policy Date
May 2008
Status/Date
Revised/May 2008

Disclaimer

Our provider administrative policies contain information regarding claims submission, reimbursement, and other information in order to achieve an efficient relationship with our providers. These policies are not an authorization or explanation of benefits. Blue Cross of Idaho retains the right to add to, delete from and otherwise modify this policy in accordance with our provider contracts.

Policy

Crediting Remittance Advices on Previously Processed Claims

Credits to previously processed Blue Cross of Idaho Medicare Advantage claims will automatically appear on your remittance advice. The remittance advice will specify the credit and date of the original payment.

  • Blue Cross of Idaho prefers that providers not return overpayments for services given to Medicare Advantage members. Instead, we will recoup an overpayment on the next Medicare Advantage remittance advice. We will send back any money that providers return for overpayments on Medicare Advantage claims.

Exception:

  • If a credit balance is carried forward for 90 days, Blue Cross of Idaho may send a letter requesting a refund to clear the credit balance.

Providers Accepting Two Payments: COB, TPL and Workers` Compensation are not routine overpayments and can be recouped/credited outside the 12- month period.

If you need to return an overpayment, please use the attached form so that Blue Cross of Idaho can apply the funds appropriately.

Overpayment Return Form


Policy History

Date Action Reason
May 2008 Revised Language clarification

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