Submission of Claims

General
Policy Number: GP-X-010

Last Updated: May 24, 2022 

Providers are responsible for submitting clean claims for all services. Claims submission should be prompt and, in the format, requested by Blue Cross and Blue Shield of Nebraska (BCBSNE), regardless of whether there are other sources of payment or reimbursement.  

The provider agrees that charges for covered services provided to their BCBS members will be at the same rate as is charged to their other patients.  

The provider also agrees to provide BCBSNE with any additional information that is reasonably necessary to determine benefits and to verify performance under their agreement. Such information will be provided without charge and in a timely manner.  

The provider agrees to follow all policies on authorization, verification, precertification and preauthorization of benefits where required by BCBSNE or the member’s primary Blue plan. This includes working with vendors used by BCBSNE or the member’s primary Blue plan to perform said services.  

Nothing in the agreement shall convey to BCBSNE the right to release or obtain information which is declared to be confidential or privileged communication, or otherwise restricted, by federal or state statutes or regulations. BCBSNE requires strict compliance with applicable disclosure requirements.