Here are some tips for navigating PARS

Here are some tips and reminders for calling the Provider Automated Response System, known as PARS:

• You can’t bypass PARS for claims or eligibility and benefits, even if you need to speak with a representative; calls will be transferred from PARS to the appropriate call center for assistance.
• Pressing “0” at any point on PARS or saying “representative” won’t get you to a representative faster. Follow the prompts carefully when interacting with the interactive voice response system and listen for the prompts offering a transfer to a representative (played at the end of the options menus, where applicable). This applies to both claims and benefits and eligibility.
• You can enter information on PARS with your touchtone keypad as long as the information is completely numeric. Spelling of the member’s first name isn’t numeric and must be spoken. This applies to both claims and benefits and eligibility.
• PARS has changed. The first question you’ll be asked is if you’re calling for claims or benefits and eligibility. If you don’t answer this question, the call will be handled as if it were a benefits and eligibility call.
• For claims, PARS will ask two questions to determine whether BlueCard is involved. Providers in Michigan who provided services for a non-Michigan member won’t be able to use the IVR for claims status and, if these questions are not answered correctly, there may not be an offer to speak with a representative.
  
  Question 1: Are you calling on behalf of a Michigan member?
  Answer: Say “yes” if it’s a Michigan policy; say “no” if the member doesn’t have Blue Cross Blue Shield of Michigan.
  
  Question 2: Were the services rendered in Michigan?
  Answer: Say “yes” if you’re a Michigan provider; say “no” if the services weren’t provided in Michigan.
• For Michigan providers who saw non-Michigan members, the answers would be “no” and then “yes.” There will be an option to transfer to a representative.

• Claims status on PARS
• Claims status should only be selected if you’re inquiring on the initial outcome of your claim. It shouldn’t be selected if you already know the initial outcome of your claim but wish to discuss further.
  
  
• PARS will ask, “Are you calling in for a status on your claim?”
• If you’ve already submitted a claim, but you haven’t received a reply on web-DENIS or through your remittance/voucher, you should answer “yes.”
  
• If you’ve submitted a claim and you already obtained the initial outcome via web-DENIS or through your remittance/voucher, but you would like additional assistance, you should say “no.”
• After listening to claims status, PARS will ask: “Do you want to repeat that, hear the next claim, get details, get a hard copy, benefits and eligibility, or more options?”
• If you say “get details,” you’ll be asked to provide the procedure code or revenue code for the claim lines you’re checking. PARS will provide the claims information at line-level and then will ask: “Do you want to repeat the information, check other claims, get benefits or speak to a representative?”
• If you say “more options,” PARS will ask: “Would you like to inquire on another date of service, inquire on another member, inquire on another contract, request a hard copy or speak with a representative.”

• Non-claims status inquiries on PARS

• If you said “no” to claims status, PARS will ask if you’ve received a voucher for the claim you billed.
• If you’ve already verified claims information on web-DENIS or through your remittance/voucher, and you need additional assistance, you should answer “yes”
• PARS will ask what you would like to discuss about your claim: Payment other than anticipated, rejection/denial, accounts receivable/payable, follow up on a previous inquiry, etc...
• Regardless of your selection, PARS will be able to transfer the call to a representative. However, at this point, PARS will say, “If you are calling on a status of your claims say status, if you are calling for eligibility and benefits say eligibility and benefits, or if you would like to speak to a representative say representative.” This allows you to check other information through PARS before being transferred. Please listen to the end of this option menu to hear the offer to transfer to a representative.

• Claims inquiry options on PARS
• If you said “no” to claims status and “no” to receiving a voucher, PARS will ask if you’re calling about preauthorization or something else.
• If you say “preauthorization,” you’ll hear a message detailing the Blue Cross Blue Shield of Michigan preauthorization process. If you’re checking on a previously submitted request for medical-surgical preauthorization, you'll be offered a transfer to the appropriate call center. Initial preauthorization requests can’t be handled over the phone (whether through PARS or speaking to a representative).
• If you say “something else,” PARS will treat the call as though it’s for claims status and will ask for the member/claims information.
• PARS will provide the claims information, if a claim is found.
• After claims status is provided, PARS will offer the following options: “Do you want to repeat that, hear the next claim, get details, get a hardcopy, benefits and eligibility or more options?”
• If you say “more options,” PARS will offer the following: “Would you like to inquire on another date of service, inquire on another member, inquire on another contract, request a hardcopy, or speak with a representative?”

Your previous feedback on the new PARS Claims Status IVR helped us make these improvements.