Group Market News
Published July 27, 2020
Impacts your self-funded group clients who have purchased the extended recovery suite of services as well as all of your fully insured group clients.
Beginning September 1, 2020, validating claims through extended recovery service with Premera Blue Cross will be quicker and easier for your group clients! This is because the process for coordination of benefits service provided through The Rawlings Group (Rawlings) is going digital. Instead of manually filling out spreadsheets and forms, everything is handled online. The new process is streamlined, greatly improving both the efficiency and your clients' experience.
How benefits are coordinated
If your group clients have the extended recovery service through their Premera benefits, they likely already know that Rawlings reviews paid claims. They also identify potential updates needed to coordinate benefits information and related overpayment recovery opportunities.
When an overpayment is identified, Rawlings works with Premera, the group or member, and the other insurance carrier to recover the overpayment.
Occasionally, Rawlings may need information from your group client or their employee to make sure coordination of benefits is accurate.
Currently: We gather this information using a large spreadsheet, delivered to the benefit administrator in a secure email, and require that the spreadsheet be completed and returned. This can sometimes be a cumbersome process.
The new process
- If Rawlings determines that employment verification is needed, the benefit administrator will receive a secure email from ClientPortalSystems@rawlingscompany.com. This email will provide them with the instructions they need to quickly access the new Employment Verification Portal.
- Once logged in, the benefits administrator can quickly and easily select the appropriate drop-downs and submit their claims validation—and they’re all set!
Keep in mind: If your group client doesn't receive an email, nothing is required from them for Rawlings to review the claim.
Questions?
If you have any questions about this new process, please feel free to reach out to your Premera representative.