HealthCare News

Refund Request Letters

Issue: #409 Jul2019

Topic: Education


Blue Cross Blue Shield of North Dakota (BCBSND) would like to make providers aware of refund request letters that they may be receiving for claims adjusted in the legacy system. Historically, refunds would be automatically deducted from future provider payments, however the weekly payment amounts have been significantly less due to fewer claims being processed. The legacy system will still attempt to auto deduct, however, if there is not enough money in the weekly provider payment, a refund request letter will be sent. Claims that were adjusted in the legacy system that resulted in a refund cannot be offset in the new platform.

When providers receive a refund request letter from BCBSND, the amount of the refund must be sent to BCBSND rather than waiting for the automated deduction process to happen. Providers will receive a first and second refund request and then a final notice. When the final notice is received, providers have 15 days before being sent to an outside collection agency.