Update on BCBSNC Payment Problems

Physicians throughout the state continue to encounter significant difficulties in their interactions with Blue Cross and Blue Shield of North Carolina (BCBSNC). Common complaints range from delays in claim and payment processing to long hold times for authorizations, eligibility checks and general support.

The North Carolina Medical Society (NCMS) is communicating with BCBSNC staff as we assist medical practices in need of support. We also continue to coordinate with NC Insurance Commissioner Wayne Goodwin and his staff at the NC Department of Insurance, who are closely monitoring BCBSNC’s handling of these problems and have launched a formal investigation of the company. The Raleigh News & Observer recently published an article outlining the Commissioner’s efforts on behalf of physician practices.

The Insurance Commissioner’s office reports that BCBSNC’s goal is to have delayed pending claims processed by May 27th, including any and all interest due to medical practices pursuant to the provisions of the Prompt Pay Law, N.C. General Statute 58-3-225.

NCDOI also sought and BCBSNC has established a fast-track payment process for those physicians presently facing financial hardship. Those medical practices facing financial hardship should contact Susan Menendez at BCBSNC via 919-765-4035 or susan.menendez@bcbsnc.com. BCBSNC has a team of Network Management staff in place to monitor phone and email messages from physician practices. All calls and emails will be rapidly triaged; those requiring additional research will be sent to the company’s Strategic Provider Services unit for research with outreach to physicians within 1-2 business days.

Please continue reporting problems to NCMS at ncms@ncmedsoc.org or 919-833-3836 x142 and to the Department of Insurance at 855-408-1212 or to Commissioner Goodwin directly at wayne.goodwin@ncdoi.gov.

 
 

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