March 13, 2015
Area(s) of Interest: Commercial Payors Payor Issues and Reimbursement
In early February, the California Medical Association (CMA) began receiving reports from practices of missing Anthem Blue Cross remittances. CMA escalated the issue to the payor and has since learned that a system issue is to blame for the missing electronic remittance advices (ERA).
Anthem reports that the problem began in mid-December and affected ERAs for exchange/mirror and Federal Employee Program (FEP) claims. Somehow, the ERA function was turned off in the Anthem system for these product types. So, while practices received the money for the affected claims through electronic funds transfer (EFT), they have not yet received the detailed claims information in order to post to individual accounts.
A system fix was put into place on February 16 to fix the issue going forward. Practices can obtain missing ERAs through the ProviderAccess portal on the Anthem website or can contact Anthem customer service:
- For missing FEP remittances: (800) 322-7319
- For missing Covered California remittances: (855) 854-1438
CMA had also received some reports of missing CalPERS ERAs; however, Anthem reports the CalPERS issue was unrelated to the issue affecting exchange/mirror and FEP ERAs. Rather, it was due to a recent change in CalPERS claims processing that resulted in a several week delay in processing of ERAs. Physicians who are still missing CalPERS remittances can call (800) 677-6699 to request them.