General News
Published August 17, 2020
For all fully insured groups and self-funded groups with the extended recovery suite of services
Beginning September 1, 2020, validating claims through extended recovery service with Premera Blue Cross will be quicker and easier! 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 efficiency and your experience.
How benefits are coordinated
If you have the extended recovery service through your Premera benefits, you likely already know that Rawlings reviews paid claims. Rawlings also identifies 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 you or your 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 the instructions needed 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 it’s all set!
Keep in mind: If you don’t receive an email, nothing is required from you 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 or producer.