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BCBS – OUT OF STATE GUIDELINES & SPLIT PLAN SCFHP and SCCIPA
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bcbs
BCBSNY
BLUE CROSS BLUE SHIELD
claims routing tool
out of state
SCCIPA
SCFHP
SPLIT PLAN
HEALTH PLAN AND IPA GUIDELINES
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BSCAL
denial
denied by IPA and HP
denied by HP and IPA
guidelines
HEALTH NET
health plan
HMO
HP
IPA
medical group
INSURANCE TAGS OR FLAGS
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flags
Inspire
insurance tags
tags
COMMON TRA USED BY COLLECTORS
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appeal
BHP
BMG
CALLINS
CALLUS
CI
CLMSTAT
CMG
CORR
DENTRA
elig
EOB
LIMIT
NCOF
NOTE
R1
R1OA
R2
RFFA
RP
TERM
TRA
transaction code
AR LOGSHEET STATUS / DENIAL LIST
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applied to deductible
AR log sheet
bundled
CAP/Other Payer
Claim in process per insurance/we b
COB
deduct
denials
in process
ineligible
INFD
INFO
INFPROC
Invalid Diagnosis Code
Invalid Diagnosis Code / Req DX
MAX AUTH
MAX REQUEST
MAX RQ
MAXOUT
NCOF
no claim on file
No Ref/Auth
NONCOVERD
NONMED
Not a contracted provider / NONPARD
Overpayment recovery/ refund
Paid Claim- (Payment has been posted/ No more balance
PAID PER INSURANCE CALL/WEB
Paid To Patient
PATIENT RESPONSIBILITY
pr
Primary EOB Missing
REJECTED CLAIM
REQMED
REQUEST MEDICAL RECORDS
set to pay
TIMELY FILING LIMIT (TFL
wpayer
WRONG PAYER
INSURANCE CALLING FOR DENIAL MANAGEMENT (INSPIRE)
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calls
denial management
Inspire
insurance calling
INSURANCE CALLING FOR CLAIM STATUS (INSPIRE)
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called insurance
calls
CI
claim status
claim status calls
Inspire
EXPLANATION OF BENEFITS (EOB) AND ELECTRONIC REMITTANCE ADVICE (ERA)
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covid
electronic remittance advice
EOB
ERA
explanation of benefits
Inspire
ONESOURCE TUTORIAL (INSPIRE)
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Eligibility
Onesource
Passport
AVAILITY (INSPIRE)
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availity
claim status
Eligibility
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