ARKANSAS BLUE CROSS AND BLUE SHIELD TO PROCESS AND PAY MEDICARE CLAIMS IN RHODE ISLAND
The Centers for Medicare & Medicaid Services (CMS) today announced that Arkansas Blue Cross and Blue Shield will replace Blue Cross and Blue Shield of Rhode Island (BCBSRI) as the Medicare claims processing contractor for Rhode Island.
As a Part A plan under subcontract with the Blue Cross and Blue Shield Association, Arkansas Blue Cross and Blue Shield will process claims for hospital care, skilled nursing services, and other provider services in Rhode Island. As a Part B contractor under direct contract with CMS, the Arkansas company will process claims for physicians, licensed practitioners and suppliers in Rhode Island. BCBSRI has processed Part A and Part B Medicare claims for the state of Rhode Island since the inception of the Medicare program in 1966.
Health care for seniors, disabled and other Medicare beneficiaries will not be affected by this change. Medicare claims will continue to be paid promptly.
By law, private insurance companies process claims for hospitals and other providers and pay claims for physicians and other medical services under contracts with CMS, which runs the Medicare program.
In June, BCBSRI informed the Blue Cross and Blue Shield Association that it was not renewing its Medicare Part A plan agreement and also informed CMS that it was not renewing its Part B carrier contract. BCBSRI said it wanted to focus its core business in areas other than fee-for-service contracting.
Arkansas Blue Cross and Blue Shield will serve approximately 170,000 beneficiaries in Rhode Island. Under the new contracts, the company will process claims for 125 providers and more than 9,300 physicians, suppliers and licensed practitioners in Rhode Island. The company has extensive experience in processing Medicare claims as the Part A plan for Arkansas and the Part B contractor for Arkansas, Louisiana, Oklahoma, New Mexico and eastern Missouri.
The transition will be completed by Feb. 1, 2004. Arkansas Blue Cross and Blue Shield will maintain the existing Medicare operation in Providence, R.I., and will make offers of employment to all BCBSRI non-management staff.