Payment

In-network providers agree to accept our reimbursement as payment in full, except for the following amounts when applicable:

• Deductible
• Coinsurance  
• Copayment  
• Charges for services and supplies which are not covered in the member’s contract and are not provider liability  

The reimbursement amount received by the billing provider may differ slightly from the contractual reimbursement amount due to system rounding.  

Note: The member is not responsible for non-covered charges for services and supplies that are deemed not medically necessary by Blue Cross and Blue Shield of Nebraska (BCBSNE). However, on an exception basis, if prior to the services being provided, you have advised the member of this fact, in writing, and the member has agreed, in writing, to be responsible for payment, you may bill the patient. This may not be done as standard practice.  

Note: Charges for non-covered services as well as any copay, deductible and coinsurance on covered services may be collected at the time of service. BCBSNE does not restrict providers from reducing charges to members on noncovered services.  

Contracting institutional and professional claims are finalized on Tuesday night. Payments and remittances (checks and 835’s) are distributed weekly on Wednesdays and the last day of every month.