Fall 2009

Enhancements made to Claim Reconciliation Tool (CRT)

The Claim Reconciliation Tool (CRT) is a web-based tool built by Blue Cross and Blue Shield of Florida, Inc. (BCBSF) to enable providers to view a summary of claims that have previously been paid, rejected or pended. The CRT is offered exclusively by BCBSF and accessed through the Availity^®1 Health Information Network. It provides additional information that is not available on the standard HIPAA-compliant Availity claims status capability, allows providers to view multiple claims on multiple members, provides our proprietary reason codes and descriptions.

Since the implementation of CRT, providers have identified various improvement opportunities. We have recently expanded the patient responsibility column to include Patient Co-Ins (coinsurance). We will also populate the Amount Paid and Allowed Amount columns for claims paid to the subscriber. There are additional enhancements scheduled for December and details will be provided in the next issue of BlueLine.