White Crane Billing Solutions
When a claim has been processed, either by White Crane or by a payer, some information is typically sent back regarding what was done with the claim. This information is the means by which you can track the claims that you have submitted and determine what, if anything, was done with them.
For claims that White Crane has printed to paper and mailed directly, White Crane will send you a list of the clients, dates of service, procedures, amounts charged, and the payer(s) to whom the claims were mailed.
For BC, BCN, FEP, and/or Medicare response files are generated according to the HIPAA standard and are transmitted to White Crane from BC or WPS Medicare. White Crane translates these files into a readable form and sends them to you. These response files serve the same purpose as, and often replace, the Explanation Of Benefit (EOB) forms that you may have been used to getting along with your reimbursement checks. This is increasingly true as BC and WPS Medicare move forward with their efforts to reduce their paper handling by posting EOB information only online.
The response files should provide you with most of the information you need to determine the dispositions of your claims, including which moneys were paid on which of your clients' accounts, for which dates of service and, if applicable, why a specific claim was rejected. White Crane Flyer #22 provides more detailed information regarding the response files you will receive from White Crane.
For other payers, including but not limited to Magellan, Value Options, and Aetna (we call them the "commercial" carriers), response information is not typically sent to White Crane, but is instead mailed directly to you. For this reason, White Crane may have difficulty tracking a claim sent to the commercial carriers until you can fax or mail us a copy of the response information you have received from them for that claim.