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February 2018

Clear Claim Connection™ getting new look, new data fields

In the first quarter of 2018, Blue Cross Blue Shield of Michigan will launch an upgrade for ClaimsXten. This upgrade will bring a new look to Clear Claim Connection, along with new data fields on the Claim Entry and Audit Results screens.

Claim Entry updates
You’ll be able to add 10 more lines to the Claim Entry screen by clicking the Add More Procedures >> line (which will be directly under the procedure code entry field). But it might be necessary to group category of services together for claim-line entries greater than 20. New fields are shown here:

Audit Results updates
The following new fields will affect the ClaimsXten recommendation:

  • Claim Type — It’ll indicate if the claim is professional or facility.
  • Qty. — If the quantity exceeds the allowed maximum, the RECOMMENDATION field will show DISALLOW. A line with the maximum allowed quantity will appear with the recommendation, ALLOW-ADD.
  • RVU — Relative value units will return on a pay-percent recommendation only.

About Clear Claim Connection
C3 is a web-based solution for Michigan professional and outpatient facility providers. It mirrors the clinical editing software we use to evaluate code combinations for medicine, surgical, laboratory and radiology services. And it allows you to view the clinical rationale behind clinical edits.

To launch C3:

  1. Go to bcbsm.com and log in to your provider account.
  2. Click Login to Secured Services, and enter your ID and password.
  3. Click Clear Claim Connection. Note: If your ID has access to other features, you may need to scroll down to see it.

If you don’t have access to web-DENIS, call our help line at 1-877-258-3932 from 8 a.m. to 8 p.m. Monday through Friday. Or complete the Provider Secured Access Application and the Use and Protection Agreement forms available on bcbsm.com and fax them to 1-800-495-0812.

Related article: ClaimsXten™ multiple radiology procedures edit rescheduled for 1Q 2018

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*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2017 American Medical Association. All rights reserved.
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