On September 1, 2020, Blue Cross and Blue Shield of Minnesota (Blue Cross) implemented a new initiative to ensure inpatient services, items and/or supplies are billed correctly.
Summary
As the cost of health care continues to rise, Blue Cross is committed to improving the sustainability of care by ensuring high-quality, appropriate care is delivered at a fair price and billed appropriately for the services provided to our members.
To that end, Blue Cross has implemented a new policy which defines inpatient services, items and/or supplies that should not be unbundled and/or inappropriately charged.
This policy only applies to Commercial and Federal Employee Program (FEP) lines of business.
Blue Cross will request medical records and an itemized bill post-payment for certain inpatient claims reimbursed using a percent of charge payment methodology.
More information
Provider bulletin
A provider bulletin outlining this change was posted on July 1, 2020.
Provider bulletin on new reimbursement policy: inpatient non-reimbursable unbundling (PDF)
Reimbursement policy
This is not a change in medical policy or member benefits, but a change in reimbursement policy. Reimbursement policies are updated on an ongoing basis and used by Blue Cross to define if and how certain claims will be paid for various health care services.
Charges found to be billed not in compliance with this policy will be recouped.