Effective March 1, 2016, all providers participating in Blue Cross and Blue Shield of North Carolina’s (Blue Cross NC’s) commercial product networks will be required to be enrolled in and able to accept electronic funds transfer (EFT) from Blue Cross NC. Additionally, all providers participating in Blue Cross NC’s commercial product networks must enroll in Blue eSM, and complete registration to receive Electronic Remittance Advice (ERA) reports from Blue Cross NC before March 1, 2016. Completion of EFT enrollment, Blue e access, and ERA enrollment will be required for participation in the Blue Cross NC commercial provider networks after February 29, 2016.
Beginning August 1, 2015, all new provider applications requesting a contract to participate in Blue Cross NC’s provider networks serving Blue Cross NC’s commercial products will include the requirement to enroll in EFT, Blue e, and ERA, regardless of whether this is a new practice or an existing practice adding an additional contract.
All providers participating in the Blue Cross NC provider networks that serve Blue Cross NC’s commercially offered products must be enrolled in EFT, Blue e, and ERA by February 29, 2016, or they will risk payment disruption and termination from Blue Cross NC’s commercial product networks.
Providers already enrolled in EFT, Blue e, and ERA will not need to take any action, unless changes are made within the health care organization that affects how Blue Cross NC directs payments to the organization.
Please note that Blue Cross NC’s Medicare Advantage (Blue MedicareSM) provider networks are exempt from these electronic payment requirements at this time. However, Blue Cross NC is currently evaluating electronic payment requirements for its Medicare Advantage provider networks, and we will notify participating providers if electronic payment acceptance becomes a requirement for Blue Medicare provider participation in the future.
Why Is Blue Cross NC Requiring Providers Use EFT?
Each year, Blue Cross NC issues approximately three million payments to providers participating in our commercial product networks, and almost 2.3 million of those transactions are sent via EFT. We also issue nearly 700,000 paper checks annually to providers participating in our commercial product networks. Each paper check includes print and postage charges and can cost almost 64 times more than if the same payment was sent using EFT.
Based on Blue Cross NC’s internal projections, continuing to issue paper checks would add more than $400,000 dollars to the overall expense of issuing provider payments in 2016, and that amount is expected to continue to rise. This annually reoccurring cost is an unnecessary expense that comes out of our members’ health care premiums, which is why Blue Cross NC will stop sending paper-based payments and payment explanations to providers who participate in our commercial product networks as of February 29, 2016. This is part of our continuing commitment to offer affordable and competitive health plans to our members.
More About EFT
Electronic funds transfer (EFT) is a convenient, confidential and secure method for receiving claim payments. With this free, paperless service provided by Blue Cross NC, funds are transferred directly into a participating provider’s designated bank account. With EFT, your health care organization can have access to the following benefits:
- Electronically transferred payments are posted to bank accounts before normal checks can be posted, which makes funds available sooner.
- Transfer of funds eliminates the time waiting for payments to arrive and can decrease bank deposit holds, which can lead to an overall improvement in your practice’s cash flow management.
- Less paperwork and lower administrative costs. No more time spent opening envelopes, endorsing checks, preparing deposits, and making trips to the bank.
- Possible elimination or reduction of lockbox service fees.
- Reduced opportunity for error and theft. Deposits are made directly into a designated bank account without the need for additional manual processing or handling.
Enrolling in EFT, Blue e and ERA
You don’t have to wait to sign up for the convenience of our EFT service or the secure access of making member eligibility and claims inquiries with Blue e. Just go online for instructions for how to sign up for EFT, which can be found in the “Forms and Documentation” section of our provider Web portal at Blue Cross NC.com.
If you are not currently a Blue e user, you can find information about Blue e and how to register under the “Manage Claims and Inquiries” section of our provider Web portal at Blue Cross NC.com.
If your practice opens or acquires any new subsidiaries, please review the payment information for each new location. Blue Cross NC offers EFT and Blue e services free of charge. Please check with your financial institution and/or automated clearinghouse to see if any EFT processing fees may apply.
If you have general questions about the EFT process, please contact Blue Cross NC’s Financial Processing Department at 1.919.765.2293. If you have questions about how to register for Blue e or how to set up an EFT account through Blue e, please contact the eSolutions HelpDesk at 1.888.333.8594.
Related Updates to Provider Blue Book
Blue Cross NC will revise our online provider e-manual, the Blue BookSM, to include these updates about EFT, Blue e, and ERA enrollment as they will now be required for participation in our commercial product networks. As a reminder, it’s important that you regularly check the provider section of Blue Cross NC.com for updates to the Blue Book and Blue Cross NC’s online policies and procedures. Blue Cross NC’s posting of the Blue Book and other policies and procedures located on Blue Cross NC.com serves as our method of providing you with electronic notice about new and amended policies and procedures per the terms of your contract with Blue Cross NC.
We value your continued participation and support in providing quality, cost-effective health care services to our members. If you have any questions related to this reimbursement delivery change scheduled for the spring of 2016, please contact Blue Cross NC Network Management at 1-800-777-1643.