EXL Health Is Reviewing Complex Claims

Jan. 21, 2022

As we told you in May, EXL Health is conducting post-payment reviews of complex claims from providers and facilities on behalf of Blue Cross and Blue Shield of Montana (BCBSMT).

Reminder: This means that for commercial claims filed after June 30, 2021, EXL Health will contact you if your claim was incorrectly paid. Watch for reviews from EXL Health starting in March 2022.

EXL Health is reviewing claims for:

If a claim is determined to be reimbursed incorrectly, EXL Health will tell you how to repay the funds or appeal the decision. BCBSMT may recoup payment for any claim that doesn’t meet our policies. For more information, refer to our Provider Manuals.

Questions? Contact your BCBSMT Provider Network Representative.

EXL Health is an independent company that has contracted with BCBSMT to provide medical claim audits for members with coverage through BCBSMT.

BCBSMT makes no endorsement, representations or warranties regarding third-party vendors and the products and services offered by them.