PARS will provide claims information June 30

Beginning June 30, 2017, you can get claims information or benefits and eligibility when calling the Provider Automated Response System, or PARS.

Claims information is available through PARS 24 hours a day, seven days a week.

If you choose benefits and eligibility, you’ll continue to receive the current information for your patient.

If you choose claims, you’ll receive claims information, including:

• Status of a claim, payment and rejection details
• Check information
• Member liability

PARS will ask if you’re checking the status of your claim. If you have submitted a claim, but you haven’t received a remittance, answer “yes.” If you have received a remittance for your claim, but you need additional assistance, answer “no.”

You’ll need to provide the following information to obtain assistance with claims:

• Provider information billed on the claim
• Facility Code or Professional Provider ID, or National Provider Identification
  Note: You must authenticate with your provider information to obtain any claims information. We’re unable to provide protected health information without this verification.
• Patient contract number
• Patient name
• Patient date of birth
• Date of service billed
• Charged amount on the claim

Claims Status

If you’re checking on the status of a claim, PARS will find the claim in the system and provide applicable information.

For finalized claims, the following information is available:

• Paid claims
• Internal claim number, or ICN
• EFT Trace number (for electronically paid providers) or the check number
• EFT payment date or the check date and check posting date
• Total amount paid on the claim
• Member cost share applied
• Deductible
• Coinsurance
• Copay
• If the claim was processed to the subscriber, PARS will speak this in addition to providing the payment date (if a payment was made).
• Rejected claims
• ICN
• Denial reason
• Date the claim was finalized

Specific, detailed information is also available for each claim line. You'll be asked to provide the procedure code or revenue code. PARS will then provide the following at claim-line level:

• Charged amount
• Allowed amount
• Payment amount
• Rejection/denial reason
• Member liability (deductible, coinsurance, copay), if applicable

A hardcopy of this claims status information will also be available upon request. This hardcopy will include applicable payment or rejection/denial information, but it’s not intended as a replacement for provider vouchers. Hard copies won’t be available for the Federal Employee Program^® or Blue Care Network.

For pending claims, the following information is available:

• ICN
• Date claim was received
• Message indicating the claim is pending
• If the claim has been pending less than 30 days, allow additional time for the claim to finalize.
• If the claim has been pending for more than 30 days, you’ll have the option to transfer to a call center for assistance.

If there is no claim found, that means there is no claim on file. In that case, you'll need to resubmit.

Claims Inquiry

If a remittance has already been received, but more discussion is needed, PARS will offer the following options:

• Payment other than anticipated
• Clarify a rejection/denied claim
• Discuss account receivables/account payables
• Follow up on a previously submitted inquiry/dispute
• Obtain status on a previously submitted medical-surgical preauthorization request (only for Blue Cross Blue Shield of Michigan policies)
• Preauthorization requests aren’t handled through the call centers but, if a medical-surgical preauthorization request has already been submitted in writing, the status of this request will be available
• Initiate a recovery (for Blue Cross and Medicare Advantage policies only)
• Check status (only for BCN policies)
• Appeals (only for BCN policies)

PARS will provide claims information for the following lines of business:

• Professional
• Facility
• Vision
• Dental (FEP only)
• Hearing

The following products will be available for claims information on PARS:

• Blue Cross Commercial
• Blue Cross Medicare Advantage
• BCN Commercial
• BCNA
• FEP

The following claims information won’t be available on PARS:

• Pharmacy
• Dental (FEP Dental claims information will be available)
• Payments made via manual check writing
• MESSA paid claims

Beginning June 30, 2017, the current PARS benefit phone numbers should be used for both benefits and eligibility, and claims information.

PARS professional providers.....................................................................1-800-344-8525
PARS facility providers.................................................................................1-800-249-5103
PARS vision and hearing............................................................................1-800-482-4047
PARS Federal Employee Program...........................................................1-800-840-4505
PARS Medicare Advantage.........................................................................1-866-309-1719
PARS Medicare Advantage dental.............................................................1-888-826-8152