In an effort to resolve your inquiry as quickly and efficiently as possible, we encourage providers to be prepared  to be asked questions regarding denials they are receiving on their Remittance Advices for all host claims (Blue Card claims). When your office calls the Physician and Provider Call Center and disagrees with a denial, we ask that you are prepared with your backup for your inquiry. The following questions may be asked in order to resolve your call in a timely manner:

•           Why do you feel this claim was denied incorrectly?

•           Did you check the members benefits or eligibility?

•           If this is regarding a Blue Card member, did you speak to the Home plan, and if so, do you have a reference number, the name of whom you spoke with and what details they provided when you called them.

If you can also include this additional information when submitting inquiries via Secure Web we would appreciate it.