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 Availity.
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.
ClaimsXten and Clear Claim Connection are trademarks of Change Healthcare, an independent company providing coding software to BCBSMT. Change Healthcare is solely responsible for the software and all the contents. Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSMT. BCBSMT makes no endorsement, representations or warranties regarding any products or services provided by third party vendors such as Change Healthcare and Availity. If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly.
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.