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Updated pre-payment review of inpatient claims
October 26, 2018

This article is for acute care hospitals caring for our members.

Last April, Blue Cross partnered with Equian, a nationally known payment integrity vendor, to review a select subset of inpatient facility claims prior to payment, to help continue managing the cost of health care and improve the accuracy of claim payments.

As of January 1, 2019, this pre-payment inpatient claim review will include all Blue Cross products. Equian will continue to conduct reviews of your itemized bills prior to payment to ensure that claims comply with rules, regulations, industry standards, and Blue Cross contract provisions.

You can find additional details about the program here: