Provider Self-Service Tools and Payment Resources
Provider Self-Service Tools and Payment Resources
- My Insurance Manager℠
With My Insurance ManagerSM, you can:
• File professional, institutional and dental claims online.
• Make referrals, including the new HIPAA-compliant screens.
• Check eligibility and view benefits and coverage information.
• Ask Provider Services a question.
• Call us over the Web through STATchatSM.
• And more!
Visit My Insurance Manager now.
My Insurance Manager for Providers is a secure, online feature that allows you to access information about your claims and your patients.
- Online Claims Filing
Looking for a way to file claims electronically? For free? Want to get paid faster? We've got your solution. Here's your one-stop source for filing online to a variety of plans. File online with these secure tools and most claims with any amounts due will process in three to five days.
My Insurance ManagerSM
File institutional, professional and dental claims. Even file secondary and corrected claims.
File claims to BlueChoice HealthPlan, BlueCross® BlueShield® of South Carolina (including dental), the State Health Plan, the Federal Employee Program, Planned Administrators, Inc. (PAI), and more. PAI is a separate company that offers third party administration services on behalf of BlueChoice HealthPlan.
Log in to My Insurance Manager.
File professional TRICARE claims using the "XPressClaim" feature. Use XPressClaim and enjoy lightning quick filing. Receive any payment due in three to five business days, too.
Log in or register for XPressClaim.
Looking for a HIPAA claims filing solution? My Insurance Manager and XPressClaim will provide HIPAA-compliant formats by Oct. 16, 2003.
- Electronic Media Claims (EMC) Filing
Do you have the capability to file your claims electronically? If the answer is yes, do you know the percentage of claims you file electronically to BlueChoice HealthPlan? We do!
It is our objective to have all hospitals and physicians file at least 90 percent of their claims to us electronically. EMC filing is more efficient because it allows hospitals and physicians to receive payment five to seven days faster than claims that are filed hardcopy. EMC filing also ensures claims accuracy through system edits. Therefore, EMC filing is our preferred method of receiving claims from our network facilities and practitioners.
Look for your rates below.
Hospital EMC rates:
Professional EMC rates (only for practitioners with greater than 90 percent EMC rates):
- Electronic Funds Transfer
BlueCross BlueShield of South Carolina and BlueChoice HealthPlan have been accepting enrollment for Electronic Funds Transfers (EFT) since Aug. 1, 2002.
If you would like to participate in the EFT program, complete the following two forms and mail them to:
BlueCross BlueShield of South Carolina
Attn: EFT Coordinator (AF-326)
I-20 at Alpine Road Columbia, S.C. 29219
BlueCross® BlueShield® of South Carolina is an independent licensee of the Blue Cross and Blue Shield Association.
- My Remit Manager and Electronic Remittance Advice
For years, providers have asked us for the ability to build historical, member-specific remittances that would allow them to sort, view and print these remits through www.BlueChoiceSC.com. Now they can accomplish this using My Remit Manager!
We are offering My Remit Manager FREE to all providers who want payment faster via electronic funds transfer (EFT) and who will allow us to eliminate paper remittance advices. Of course, we will continue to update the images of the paper remits currently available through My Insurance ManagerSM daily.
My Remit Manager accepts 835s from all commercial BlueChoice HealthPlan lines of business. It works independently of your practice management system or clearinghouse.
You will be able to:
- View ERA information by file and see all details – Users have the option of viewing the specific ANSI details the payer sends or the standardized information in a conventional format.
- Instantly see patient errors and denials – My Remit Manager highlights any claims which have errors or have been denied.
- View information categorized by check numbers or by patient – My Remit Manager clearly lists the name of each patient whose EOB is associated with an individual check or EFT.
- Print individual remits for a single patient – Eliminate the need to remove or blackout other patient information on the remit.
- Print remits for selected patients – Print individual or group remits.
Get started by visiting My Remit Manager and following the steps to register. We will e-mail you the information you need to get started.
- Refund Process
Have you received an Overpayment Refund Request letter from us for a particular account? Have you received an overpayment on a claim you would like to voluntarily return to us? If so, please follow these guidelines to ensure smooth handling of your refund.
Unsolicited refunds are those you voluntarily submit as the result of a possible claims overpayment or a payment made due to a billing and/or processing error.
Information needed: Please complete all the information on the Overpayment Refund Form.
Processing: We will review the information to determine the validity of the unsolicited refund request. We'll then determine if we will either adjust the claim to process the unsolicited request, or return the request and check with a written explanation of our findings.
We request solicited refunds when we determine there is a claims overpayment or we made a payment in error.
Information needed: Please send the refund to us within the requested 30 days from the date of the letter. You must include a copy of the refund request letter for accurate and timely processing. Send your refund to:
Attn: Lockbox, AX-430
4101 Percival Road
Columbia, SC 29223
It is critical that you return the refund within the specified timeframe. If we do not receive the refund within 30 days of the date of the refund request letter, we will systematically offset the amount on a future remittance. The systematic offset is the preferred method for many providers to reconcile refunds. This approach reduces the administrative costs associated with paper processing and minimizes the potential for duplicate refunds.
If you still need more information about a refund, please log in to My Insurance ManagerSMand submit your question using "Ask Provider Services."
- HIPAA Critical Center
We've created a central location for all of the HIPAA information you need called the HIPAA Critical Center.
At the HIPAA Critical Center you can find information on how to apply for a National Provider Identifier (NPI) and how to register one with us. You can also find information on how to enroll for electronic claims filing, instructions on how to properly file electronic claims and links to other online HIPAA resources.
Visit the HIPAA Critical Center.
- Inpatient Non-Reimbursable Charge/Unbundling Policy
BlueCross and BlueChoice implemented a policy Oct 1, 2018 to address charges considered to be non-reimbursable, unbundled or are otherwise not allowed to be billed separately. This policy is applicable only to inpatient charges and is not intended to impact care decisions.
Read more about this policy here.
- Clinical Record Requirements
Find out what categories of claims generally require clinical documentation here.