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June 21, 2012, reposted Feb. 24, 2016

Attention New York Customers: Important information regarding expanded editing

HealthNow is only responsible for processing FEP (Federal Employee Program) claims for part of New York State, and HealthNow is only responsible for handling Blue Card Host claims from providers that are in our BlueCross servicing area.  

Effective 6/24/12, a new set of edits have been put into place to reject these claims up front at ASK which will eliminate HealthNow from handling the claim, as well as reject the claim back to the provider faster and more efficiently.  This will allow the provider to submit to the correct plan in a timely manner.

ITS Host edits:

  • Professional
     A7:116 / A7:126:85 (Bill local plan - location checked at the billing provider zip code)
     A7:116 / A7:126:77 (Bill local plan – location checked at service location zip code)

  • Institutional
     A7:116 / A7:126:85 (Bill local plan – location checked at service location zip code)

FEP edits:

  • Professional
    A7:116 / A7:126:85 (Bill local plan – location checked at the billing provider zip code)
    A7:116 / A7:126:77 (Bill local plan – location checked at the service location zip code)

  • Institutional
    A7:116 / A7:126:85 (Bill local plan – location checked at the billing provider zip code)

  • Dental
    A7:116 / A7:126:85 (Bill local plan – location checked at the billing provider zip code)
    A7:116 / A7:126:77 (Bill local plan – location checked at service location zip code)

HealthNow FEP Institutional Zip Code List

HealthNow FEP Professional and Dental Zip Code List

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