Name of Manual - Blue Cross and Blue Shield of Minnesota

Reimbursement / Reconciliation
Questions and Answers
(continued)
14. What do I do with interest payments?
Interest payments that you receive should be posted to a
miscellaneous account. This is money that is yours and should
not be posted to the account of the member it pertains to. By
posting this money to a member’s account they may end up
with a credit.
15. Are there any limits for making adjustments?
Blue Cross may make, and providers may request, corrective
claim adjustments (recoupments or additional payments) to
previously processed claims for services within 12 months of
the date a claim is paid or denied unless the adjustment is made
for the following circumstances (and thus are not limited to this
12-month period):
One or more insurer is involved, whether primary or
secondary (i.e., Medicare secondary payer, no-fault
automobile coverage, subrogation, coordination of benefits,
workers’ compensation, TEFRA, etc.)
The adjustment is required due to provider error (i.e., the
provider should not have billed for services, a claim was a
duplicate of a claim previously paid, fraud, incorrect
billing, etc.)
The adjustment is required pursuant to applicable law,
regulation, rule, order or contractual requirement (i.e.,
BlueCard claims); or
The adjustment is required as part of a contractual
settlement obligation with the provider.
Note that provider errors or data changes require a
replacement claim or cancel claim be submitted within six
months of the last adjudication date.
Corrective adjustment requests must be received within 12
months from the date the claim was last paid or denied by
Blue Cross.
9-10 Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual (11/02/11)