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Page Updated: May 5, 2008
On May 5, 2008, the following letter was mailed to all WELS VEBA health plan members. This letter outlines the progress made to resolve the claims paying issues at Anthem National Accounts as described in the previous letter dated April 10, 2008. The letter dated April 10, 2008 can be viewed by clicking this link.
Additional updates as necessary will be posted on the BPO website.
Dear WELS VEBA Member,
This letter is providing an update on the claims paying issues outlined in my letter of April 10, 2008 related to the move last January to Anthem Blue Cross Blue Shield National Accounts.
Wisconsin network claims which were originally paid incorrectly or were held for payment have been processed by Anthem over the last week. If you haven’t already received your Explanation of Benefits for these claims, you will over the next few days. The system issue causing the incorrect network payment was corrected on Monday, May 5. This will allow for the return by May 15 to normal processing times on claims which are properly submitted with accurate information.
A system modification was made on April 25 which provided for accurate payment of out-of-network provider claims. All out-of-network claims that were processed against the incorrect fee schedule will be reprocessed by May 15 and revised Explanation of Benefits sent to affected members. If you need to have a claim reprocessed sooner, please call the Anthem customer service center at the number below. Please be aware that payments related to non-network services are sent to members who then must remit payment for these charges to the appropriate provider.
A revised process for payment of vision claim charges has been developed and is posted on the WELS Benefit Plans Office website, www.welsbpo.net. Vision claims will now be manually processed within the Anthem customer service unit dedicated to assisting WELS VEBA members. This should eliminate the problems related to lost claims and delayed payment of these benefits.
We are very grateful for the help of the Anthem National senior leadership team who took ownership of these on-going issues on April 18. They quickly identified the problems and developed solutions related to these matters and then committed the resources needed to bring proper resolution to the issues.
For future reference, you may access this letter on the Benefit Plans website. As you receive revised Explanation of Benefit Payments in these matters, you are encouraged to contact the dedicated Anthem customer service team from 7:00am to 7:00pm Central Time, Monday through Friday, at 1-877-512-7875 with questions.
Finally, I want to apologize to you for the problems these issues may have caused both you and your service providers. Thank you for patiently letting us resolve these matters. Again, the entire WELS Benefit Plans staff, in partnership with Anthem Blue Cross Blue Shield, is committed to providing you the quality service levels that you have come to expect as a WELS VEBA Plan member.
In His Service with you,
Jon M. Flanagan, WELS Director of Benefit Plans
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