Blue Cross and Blue Shield of Montana (BCBSMT) is using McKesson ClaimsXten™ code auditing software for all lines business including professional and facility claims.
The ClaimsXten tool offers flexible, rules-based claims management with the capability of creating customized rules, as well as the ability to read historical claims data. ClaimsXten can automate claim review, code auditing and payment administration, which BCBSMT believes will result in improved performance of overall claims management.
Related Resource: ClaimsXten Rule Descriptions
This software will continue to allow efficient, consistent claims processing to evaluate the accuracy and adherence of reported services to accepted national reporting standards. Please refer to the BCBSMT Compensation Policies for related information about reimbursement guidelines.
To help determine how coding combinations on a particular claim may be evaluated during the claim adjudication process, you may continue to utilize Clear Claim Connection™ (C3). C3 is a free, online reference tool that mirrors the logic behind BCBSMT’s code-auditing software, which can be accessed through the Secure Provider Portal.
For updates on the ClaimsXten implementation and other BCBSMT news, programs and initiatives, refer to the BCBSMT Provider website at bcbsmt.com/provider. Additional information also may be included in upcoming issues of the Blue Review.
Clear Claim Connection™ (C3) is the provider resource that allows disclosure of claim auditing rules and clinical rationale to the BCBSMT independently contracted provider network.
ClaimsXten, ClaimCheck and Clear Claim Connection are trademarks of McKesson Information Solutions, Inc.
McKesson Information Solutions, Inc., is an independent third party vendors and are solely responsible for their products and services. BCBSMT makes no representations or warranties regarding the products or services provided by any of these vendors. If you have any questions regarding the products or services provided by these vendors, you should contact the vendor directly.