Q: What is(are) the procedure(s) in question? A: Any bilateral procedures.
Q: What BCBSNC plans are impacted? A: Individual and Small Group.
Q: What is the timeframe of the affected claims – from when to when? A: Onset was over a year ago - addressed in March of this year.
Q: What was the cause of the overpayment? A: Configuration issue on Facets platform.
Q: Is the problem fixed? A: It was addressed in March.
Q: What is BCBSNC’s plan going forward regarding the overpaid claims? A: We will request the overpayments back via adjustments to the claims.
Q: What notices have been sent to physicians/practices regarding the problem? A: No notices have been sent to my knowledge.
Q: Is the problem confined to ENT? A: Any provider who renders bilateral services.
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