Claims Editing, Blue Circle of Excellence Designation & More

Coming Soon: Advanced Claims Editing

Beginning in March of 2023, BCBSWY will be implementing advanced claims editing tools to ensure that claims are accurate and free of errors. These tools automatically review your claims to ensure they are properly coded. Over the next several months, BCBSWY will provide details on the types of errors these tools seek. Our intent is to provide you with this information ahead, so you have the opportunity to correct any issues before they impact claims next year.

Duplicate Services Policy

BCBSWY will reimburse only one technical component for the same service when billed by different providers.

BCBSWY will reimburse only one professional component code for the same service when billed by different providers.

BCBSWY will deny duplicate drug codes when the same code with the same units has been billed on a different claim by any provider for the same date of service.

Survey Reminder 

Providers should have received an email with survey instructions on Tuesday, Sept. 27. Your feedback helps us improve our programs and services. If you did not have a chance to complete it, please consider. Your cooperation will help us measure our progress. We look forward to hearing from you.

Blue Circle of Excellence Marks First Designation

Powder River Surgery Center in Gillette has been designated as the first BCBSWY Wyoming Blue Circle of Excellence Center for the Knee and Hip Replacement program.

Facilities designated as Wyoming Blue Circle of Excellence for Knees and Hips demonstrate expertise in total knee and total hip replacement surgeries with fewer patient complications and readmissions.

Wyoming Blue Circle of Excellence is a designation awarded by BCBSWY to health care facilities showing expertise in delivering high-quality patient safety and better health outcomes. Learn more at BCBSWY.com.

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