What types of adjustments are not considered exception payments?

Adjusting claim payments on appeals that arise from the following situations will not constitute making an exception payment, and may be corrected for all groups:

  • Incorrect processing edits 
  • Group files not updated 
  • Incorrect benefit information loaded to the processing system 
  • Inaccurate information provided to the member in written communications 
  • Inaccurate or unclear benefit information given by a Blue Cross Blue Shield of Michigan or Blue Care Network representative to a member 
  • Services that are a benefit for the account but which cannot be processed by our internal systems 

Was this content helpful?

Rate it

Submit >

©1996-2014 Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. We provide health insurance in Michigan.

State and Federal Privacy laws prohibit unauthorized access to Member's private information. Individuals attempting unauthorized access will be prosecuted.

Site Map  |  Feedback  |  Important Legal and Privacy Information

Explanation of Level A Conformance
Better Business Bureau Online Seal of Reliability