HealthCare News

Rounding Discrepancies

Issue: #397 NOV2017

Topic: Reimbursement

Blue Cross Blue Shield of North Dakota (BCBSND) will occasionally reimburse a service at a rate that may differ by a penny when compared to the published fee schedule rates. This difference is due to rounding when the claims processing system uses a multiplier to compute the reimbursement rate. This rounding affects reimbursement both ways, sometimes resulting in a higher payment and sometimes in a lower payment. Due to the immateriality of these rounding discrepancies and the costs associated with reprocessing claims for both BCBSND and providers, BCBSND will not reprocess claims for rounding discrepancies.

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