DATE: June 9, 1997
SUBJECT: IDA Customer Service
FROM: Joseph Cicchelli, Vice President
In order to receive assistance with a claim, please consult the following process:
Accessing IDA's Customer Service Center
24 Hour Automated Interactive Voice Response System
(Touch tone phone required)
To Blue Cross Blue Shield To IDA ID cards & claim forms specify ID cards & claim forms specify where claims are to be submitted where clains are to be submitted. All Hospital & Facility claims Hospital/Facilty and Physician are to be directly submitted Claims for Pascack Valley and to Blue Cross Blue Shield, except Wayne General are to be for Pascack Valley & Wayne General. submitted to IDA for processing. Blue Cross Blue Shield will process All Physicians and other Medical all claims for Hospital & Facilities Claims (Blue Cross participating except for Pascack Valley & Wayne and non-participating) are to be General. submitted to IDA for processing. Should a claimant receive a denial Should a claim be submitted to from Blue Cross Blue Shield Blue Cross Blue Shield in error regarding Pascack Valley or Wayne and the claimant received a General the claim should be re- denial, then the claim (itemized submitted to IDA for consideration bill) and all appropriate in- and payment. All appropriate in- are to resubmitted to IDA for formation for processing should be processing by the Provider for provided Blue Cross Blue Shield, electronic claims only. Paper where possible, will internally Claim Submissions will be sent to forward to IDA any Physician or IDA by Blue Cross Blue Shield other Medical Claims received in before processing. These are sent error. (claims that have been to IDA weekly for processing. received by Blue Cross Blue Shield by hard copy) IDA will internally forward Claims received electronically by Hospital and Facility claims Blue Cross Blue Shield will received in error (except for generate an EOB of denial in- Pascack Valley and Wayne General) structing the claimant to resubmit directly to Blue Cross Blue all information and itemized bill Shield's team for immediate to IDA. processing.It is important that all participants in the Fund advise each provider at the time services are rendered where a claim is to be submitted by verbally telling the provider, showing their ID card and/or providing a claim form which also indicates the proper address for claim submissions.
It is also important for all participants to know and advise the participating Blue Cross Blue Shield provider rendering the services, that it is their understanding the provider is accepting assignment and no payment by the patient is due at the time services are rendered.
Billing is to be submitted directly to the appropriate Claims Processing Company, either Blue Cross Blue Shield or IDA (see ID card/claim form). Upon receipt of payment, the participaing Blue Cross Blue Shield provider can then bill for any additional payment, if applicable.