Name of Manual - Blue Cross and Blue Shield of Minnesota

Health Care Options
Workers'
Compensation, No-
Fault Auto &
Subrogation
(continued)
6. When does Blue Cross need chart notes to adjust claims?
The chart notes should indicate what the patient was treated
for. If the chart notes indicate the treatment was not related to
the work injury, the motor vehicle accident or the third party
accident, then claims can be adjusted. If chart notes are nonspecific
or treatment is similar to the accepted injury, a valid
denial is needed from the other insurance carrier.
7. If there is an intervention case does Blue Cross pay claims?
Depending on the circumstances surrounding the litigation,
Blue Cross may or may not pay claims. If you have case
specific questions you should contact the Special Services Unit
directly at 1-866-251-6691.
8. If the member has a pre-paid medical or MNCare group
can we bill them?
No. As a provider you need to bill the other insurance carrier.
If you do not know who the other insurance carrier is, then you
must try to contact the member three times for this
information. If you are unable to get a response from the
member, then Blue Cross will adjust claims to pay, under the
health benefit, once the documentation is received showing the
three attempts to contact the member.
9. What are the no-fault laws for Minnesota and surrounding
states?
Minnesota and North Dakota have mandatory medical pay
laws. This means all drivers insured in Minnesota or North
Dakota have medical pay on their auto insurance. Minnesota
has a $20,000 medical pay limit. North Dakota has a
$30,000.00 medical pay limit. South Dakota, Iowa and
Wisconsin are optional states which mean the member can
chose to either have or not to have medical pay on their auto
policy.
10. What are some uncommon injuries that may be covered by
the workers’ compensation carrier?
The workers’ compensation carrier may cover injuries that
occur when an employee trips or falls at work, is injured in the
parking lot, is hurt volunteering or is hurt when traveling for
work. If you have specific questions regarding a potential work
related injury contact the Special Services Unit.
5-30 Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual (12/27/10)