Working with Anthem Subject Specific Webinar Series

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1 Working with Anthem Subject Specific Webinar Series Provider Claim Submission and Adjustment Request Tips and Tools Access audio conference: Conference code: # Please Mute Your Phone Use the mute button or press *6 This presentation contains proprietary information of Anthem Blue Cross and Blue Shield. It is intended for Anthem providers. Any redistribution or other use is strictly forbidden.

2 Provider claim submission and adjustment request tips and tools Agenda Housekeeping and announcements Claim submission Initial, corrected and secondary Medicare crossover Guidelines Medical policy and clinical UM guidelines Customized claim edits Reimbursement policies 2

3 Provider claim submission and adjustment request tips and tools Agenda continued Claim processing Remittance advice Claim adjustments Complaints and appeals Learn more links Questions and answers 3

4 Working with Anthem Subject Specific Webinar Series Navigation Entry Page 1. Chose an audio option 2. I Will Call In displays call in telephone numbers 3. You are able to send questions to panelists (presenters) 4

5 Working with Anthem Subject Specific Webinar Series Navigation Screen Tools 1. Panel zoom in 2. Panel zoom out 3. Fit to viewer 4. Full screen 1. Panelist (presenter) can send links to presentations to Attendees through Chat. 2. Attendees can chat with panelist (presenter) 5

6 Claim submission - initial Claims should be submitted in the same manner as you would to any other payer following national correct coding guidelines Complete member ID number including alpha prefix NPI and Tax Identification Numbers required Referring provider name in box 17 with type 1 NPI box 17b Rendering provider NPI should be present in box 24j on professional claim forms Billing (Organizational/Billing Type 2) NPI should be present in box 33a 6

7 Claim submission - initial Claims should be submitted in the same manner as you would to any other payer following national correct coding guidelines Billing address under 5010 must be a physical location not a PO Box o Submit PO Box in the Pay To Loop on electronic claims Submit with Taxonomy codes for practitioners with dual specialties Facility claim requirements o Present on admission (POA) indicators 7

8 Claim submission - initial WI Administrative Services Only (ASO) Groups National Processing System Submit claims to Anthem as you do today for all Blue members Benefits and claims administration on a national account processing system Claims priced according to your Anthem contract no change Different look for paper provider remittance advice 8

9 Claim submission Ancillary providers Independent Clinical Lab File to the Plan in whose service area the specimen was drawn Determined by zip code associated with NPI Durable/Home Medical Equipment File to the Plan in whose service area the equipment and/or supplies were delivered, shipped to, or the location of the retail story where the equipment and/or supplies were purchased or rented Specialty Pharmacy File to the Plan in whose service area the ordering provider is located (physician address) Determined by zip code associated with NPI 9

10 Claim submission Ancillary providers Applies to all Commercial and Medicare Advantage Blue Plans Does not apply to Federal Employee Program (FEP) members More information under o Link: Ancillary Claim Filing Requirements FAQs September

11 Claim submission - ASCs An Anthem Difference Ambulatory Surgery Centers Facility services submitted on a professional claim form consistent with Medicare Do not include a rendering physician as these charges should be submitted separately by the physician. 11

12 Claim submission corrected Submit the entire claim as a replacement claim if you have omitted charges or changed claim information (i.e., diagnosis codes, procedure codes, dates of service, etc.) including all previous information and any corrected or additional information. Type Professional Claim Institutional Claim EDI Paper To indicate the claim is a replacement claim: In element CLM05-3 Claim Frequency Type Code Use Claim Frequency Type 7 To confirm the claim which is being replaced: In Segment REF Payer Claim Control Number Use F8 in REF)! and list the original payer claim number is REF02 To indicate the claim is a replacement claim: In Item Number 22: Resubmission and/or Original Reference Number Use Claim Frequency Type 7 under Resubmission Code To confirm the claim which is being replaced: In the right-hand side of Item Number 22 under Original Ref. No. list the original payer claim number for the resubmitted claim. To indicate the claim is a replacement claim: In element CLM05-3 Claim Frequency Type Code Use Claim Frequency Type 7 To confirm the claim which is being replaced: In Segment REF Payer Claim Control Number Use F8 in REF)! and list the original payer claim number is REF02 To indicate the claim is a replacement claim: In Form Locator 04: Type of Bill Use Claim Frequency Type 7 To confirm the claim which is being replaced: In Form Locator 64: Document Control Number (DCN) list the original payer claim number for the resubmitted claim. 12

13 Claim submission corrected continued Professional claim examples: 1. A claim was previously submitted with procedure codes 99213, and The should have been An electronic replacement claim should be submitted for the line that needs to be corrected, along with the appropriate frequency code: 7, 99213, and This indicates to Anthem that all charges need to be deleted, and the claim will then be processed with 99213, and A claim was previously submitted with procedure codes 99214, and Procedure codes and were submitted in error and need to be removed. An electronic replacement claim should be submitted with frequency code 7 and procedure code This claim will then be adjusted to remove and 36415, and it will be processed with Professional Note: If a charge was left off the original claim, please submit the additional charge with all of the previous charges as a replacement claim using frequency code 7. All charges for the same date of service should be filed on a single claim. Facility Note: Late charges should be submitting on a new (not replacement) claim with 5 as the third digit of the Type of Bill Code. 13

14 Claim submission corrected continued There may be times when providers find that a claim was billed to a payer in error. When this occurs, submit the entire claim as a void/cancel of prior claim. Type Professional Claim Institutional Claim EDI Paper To indicate the claim was billed in error (Void/Cancel) In element CLM05-3 Claim Frequency Type Code Use Claim Frequency Type 8 To confirm the claim which is being void/cancelled: In Segment REF Payer Claim Control Number Use F8 in REF)! and list the original payer claim number is REF02 To indicate the claim is a void/cancel of a prior claim: In Item Number 22: Resubmission and/or Original Reference Number Use Claim Frequency Type 8 under Resubmission Code To confirm the claim which is being void/cancelled: In the right-hand side of Item Number 22 under Original Ref. No. list the original payer claim number for the void/cancelled claim. To indicate the claim was billed in error (Void/Cancel) In element CLM05-3 Claim Frequency Type Code Use Claim Frequency Type 8 To confirm the claim which is being void/cancelled: In Segment REF Payer Claim Control Number Use F8 in REF)! and list the original payer claim number is REF02 To indicate the claim is a void/cancel of a prior claim: In Form Locator 04: Type of Bill Use Claim Frequency Type 8 To confirm the claim which is being void/cancelled: In Form Locator 64: Document Control Number (DCN) list the original payer claim number for the void/cancelled claim. 14

15 Claim submission secondary Commercial payers Electronic Submit claims including remittance information from the primary payer electronically with COB information populated in Loops 2320, 2330A-I, and/or 2430 Balancing is performed at both the claim and service line levels o Loop 2300 CLM02 (Total Claim Charge) must equal the sum of Loop 2400 SV203 (Line Item Charge) o Loop 2320 AMT02 (COB Payer Paid Amount) must equal the sum of Loop 2430 SVD02 (Line Adjudication Information) less the sum of Loop 2300 CAS (Claim Level Adjustments) o Loop 2400 SV203 (Line Item Charge Amount) must equal the sum of Loop 2430 SVD02 (Line Adjudication Information) plus the sum of Loop 2430 CAS (Claim Level Adjustments). 15

16 Claim submission secondary continued Commercial payers Paper Submit claims with a copy of the primary payers remittance advice. o The total amount paid by the primary payer should be included in field 29 on professional claim forms and field 54 on facility claim forms Balancing is performed at both the claim and service line levels o o o o Total Claim Charge must equal the Total Claim Charge on the Primary payers remittance advice Line item codes and charges on the claim must match those appearing on the primary payers remittance advice. Primary payers payment and/or reduction codes and amounts must be present on the copy of the remittance advice. The amount paid by the primary payer must equal the amount appearing in field 29 on professional claim forms and field 54 on facility claim forms. 16

17 Claim submission Medicare crossover Submitted directly to the secondary payer electronically by Medicare Indicated on the Medicare Explanation of Medicare Benefits (EOMB) Payment made directly by the secondary payer Submitting a paper claim before or immediately upon receiving your Medicare EOMB may cause: Rejected claims Delayed payments Duplicate denials Double work for your payment posters 17

18 Claim submission Medicare crossover When a Medicare claim has crossed over, providers are to wait 30 calendar days from the Medicare remittance date before submitting the claim to the local Blue Plan to avoid claim returns. Providers should continue to submit services that are covered by Medicare directly to Medicare. Even if Medicare may exhaust or has exhausted its benefits, continue to submit claims to Medicare to allow for the crossover process to occur and for the member s benefit policy to be applied. Local Blue Plans will reject provider submitted claims received within 30 calendar days of the Medicare remittance date or any claims received without a Medicare remittance date on the claim. 18

19 Claim submission Medicare crossover Submitted directly to the secondary payer electronically by Medicare Indicated on the Medicare EOMB MA18 Alert: The claim information is also being forwarded to the patient's supplemental insurer. Send any questions regarding supplemental benefits to them. N89 Alert: Payment information for this claim has been forwarded to more than one other payer, but format limitations permit only one of the secondary payers to be identified in this remittance advice Payment made directly by the secondary payer 19

20 Claim submission Medicare crossover Anthem will reject Medicare primary provider-submitted claims with the following conditions Medicare advice remark codes MA18 or N89 that indicate Medicare crossover has occurred Received by provider s local Blue Plan within 30 calendar days of Medicare remittance date Received by provider s local Blue Plan with no Medicare remittance data 20

21 Claim submission Medicare statutorily excluded services Providers who render statutorily excluded services should indicate these services by using GY modifier at the line level at the service line level of the claim. Providers required to submit only statutorily excluded service lines on a claim (cannot combine with other services like Medicare exhaust services or other Medicare covered services) Provider s local plan will not require Medicare EOMB If providers submit combined line claims (some lines with GY, some without) to their local plan, the provider s local plan will deny the claims, instructing provider to split the claim and resubmit. More information: August 2013 Network Update Newsletter - BCBSA initiative addresses secondary payer Medicare claims beginning on page 11 21

22 Claim submission - electronic Why submit claims electronically? No postal delays Transmit claims 24 hours a day, seven days a week Electronic claims are faster and more accurate Electronic claims are acknowledged by Anthem through notification and error reports that are placed in your electronic mailbox Accepted directly from providers (direct submitters) or through billing services, vendors and clearinghouses. 22

23 Claim submission - electronic Submit in 5010 format Initial Claims Secondary Claims Corrected Claims Wisconsin Payer IDs: Professional Institutional (facility) Anthem EDI Help Desk Telephone: Website: Live Chat 23

24 Claim submission - electronic Why submit claims electronically? Accuracy Time Money Source: CAQH 2016 Index Report: 24

25 Guidelines Medical Policies, Clinical UM Guidelines and Customized Claim Edits Available on our public provider website at Reimbursement Policies Available via Availity web portal On Availity, select My Payer Portals Choose Applications tab Select Provider Portal (Anthem) Content on Availity in 2017 Administrative Support Policies & Procedures Reimbursement Policies Availity is an independent company providing a wide variety of online tools that allow providers to access real-time information from multiple payers via one secure sign-on 25

26 Guidelines - Medical policy and clinical UM guidelines Accessed through the Medical Policy, Clinical UM and Precertification Guideline router Information available for local and out-of-state Blue plans Precertification requirements Medical policies o Searchable by term and code 26

27 Guidelines Customized claim edits Accessed through the Anthem Customized Claim Edits link under Self Service and Support on the Provider Home page of our website Edits contain, the subject, the edit number, the rationale and if available the reference for the claims edit Google search by term or by code Default includes Medical Policies, Medical Coverage Guidelines and 10 results 27

28 Guidelines - Reimbursement policies Accessed through Availity to MyAnthem Payer Portal Select Administrative Support Policies & Programs o Procedures for Professional Reimbursement o Recommended for immediate review Bundled Services and Supplies Policy 0008 Frequency Editing Policy 0016 Content on Availity in

29 Guidelines - Reimbursement policies Accessing via Availity Content moved to Payer Spaces Applications Tab The connection to the secure Anthem Provider Portal moved from the More menu to the applications tab in Payer Spaces for Anthem 29

30 Guidelines - Reimbursement policies Accessing via Availity Access professional and facility reimbursement policies: Select Payer Spaces Applications tab and Provider Portal (Anthem) Click I Agree to be navigated to MyAnthem Provider 30

31 Guidelines - Reimbursement policies Accessing via Availity Select Administrative Support from the horizontal menu Select Procedures for Professional Reimbursement OR Select Procedures for Facility Reimbursement Content on Availity in

32 Claim processing A picture Paper Claim Received Claim Imaged Claim keyed Data submitted to Claim Processing System Is Member Local? Yes Member Eligibility & Benefits Medical Policy Clinical UM Guidelines Provider Indentification Provider Pricing Including Reimbursement Policies, Clinical Claim Edits Claim Adjudicated Electronic Claim Received No Provider Indentification Provider Pricing Including Reimbursement Policies, Clinical Claim Edits Provider Remittance Advice Data sent to member s (home) plan Member Eligibility & Benefits Medical Policy Clinical UM Guidelines Claim Adjudicated Data sent to provider s (host) plan 32

33 Claim processing Status Electronically 276/277 Transactions (5010 format) Availity Multi-payer portal All lines of business Telephonically Ready Reference Guide o Found under Contact Us on the public provider website Availity is an independent company providing a wide variety of online tools that allow providers to access realtime information from multiple payers via one secure sign-on 33

34 Claim processing Status Availity Inquiry Recommendations Start with Member Eligibility Inquiry Under the Claims menu, select Claim Status Inquiry o Change the provider if not the same as organizational (billing) o Enter date of service range Availity is an independent company providing a wide variety of online tools that allow providers to access real-time information from multiple payers via one secure sign-on 34

35 Claim processing Status Availity Inquiry Recommendations continued o Click on From-To Date of Service to expand o Questions Send a Secure Message Availity is an independent company providing a wide variety of online tools that allow providers to access real-time information from multiple payers via one secure sign-on 35

36 Remittance advice Paper and Electronic Electronically 835 ERA Electronic Funds Transfer (EFT) Payments EFT and EFT+ERA Enrollment via CAQH EnrollHub ERA only Anthem EDI at On Paper In the Mail Online copies via Payer Spaces on Availity Available on the Provider Education Page 1. Anthem EFT ERA Brochure 2. Provider Remittance Advice Example 3. National System Provider Remittance Advice Example 36

37 Remittance advice Paper and Electronic Payer Spaces on the Availity Web Portal To access the Payer Spaces page, select Payer Spaces, located on the right side of the Availity Web Portal s top menu bar. Choose Anthem Blue Cross Blue Shield from the Payer Spaces drop down menu. Availity is an independent company providing a wide variety of online tools that allow providers to access real-time information from multiple payers via one secure sign-on 37

38 Remittance advice Paper and Electronic Payer Spaces on the Availity Web Portal o Remittance Inquiry Application Select the Remittance Inquiry application. 38

39 Remittance advice Paper and Electronic Payer Spaces on the Availity Web Portal o Remittance Inquiry Application Search by check or EFT number NPI not required New Check/EFT Number Search Match is required for Tax ID and Check/EFT number Will not support zero pay remits where the check number is all 9 s or all 0 s. Error message remit not found by data entered. 39

40 Remittance advice Paper and Electronic Payer Spaces on the Availity Web Portal o Remittance Inquiry Application Search by date range without check or EFT number New Check/EFT Number Search NPI is required for Issue Date Range search Will support zero pay remits where the check number is all 9 s or all 0 s Search range is limited to 7 days 40

41 Remittance advice Paper and Electronic Payer Spaces on the Availity Web Portal o Remittance Inquiry Application Search results Remittance Inquiry Results sort options include: Provider Name Issue Date Check/EFT Number Check/EFT Amount. Select the View Remittance link to access the imaged version of the paper remit. 41

42 Remittance advice Paper and Electronic Payer Spaces on the Availity Web Portal o Remittance Inquiry Application Remittance images available for most Anthem Inc. members Remittance available will include Medicare Crossover claims if the member s home plan is part of Anthem Images can be saved to the user s PC or printed Ability to search for a check or EFT number without billing NPI View past remittance back 15 months Access to Remittance Inquiry is associated with Availity roles of Claims or Claim Status 42

43 Remittance advice Healthcare Exchange member grace period Grace period for individual health plans purchased on Exchange that are eligible for a governmental premium subsidy. 3 month grace period applies after the individual has paid at least one month s premium Premium non-payment Anthem will process claims for services received during the first month Anthem will pend claims for services received during the second and third months of the grace period, until the full premium is received After the third month, if the premium is not received, the member s health plan will be terminated and the claims for services received during the second and third month will be denied Providers will be notified of denied claims on their remittance advice The member will be responsible for payment of services 43

44 Remittance advice Healthcare Exchange member grace period Grace period for individual health plans purchased on Exchange that are eligible for a governmental premium subsidy. Premium non-payment continued Providers notified on their remittance advice that the claim cannot be paid until the premium is received Members displayed with a status of "Health Insurance Exchange - HIX GRACE PERIOD." on Availity and ICR Providers notified on 271 transactions (enhanced detail) Health Exchange Information Page Link 44

45 Remittance advice Healthcare Exchange member grace period 271 Eligibility Transactional Response Enhanced Detail 2100C/D DTP: DTP01 ="343" (Premium Paid to Date End) DTP03 = This message provides the date for which the premium is paid through (the last day of coverage for which a premium payment has been received).this is the last day of the month before the beginning of the grace period. 2110C/D DTP (1 st iteration): DTP01 = "193" (Period Start) DTP03 = This message provides the date that represents the first day of the first month of the grace period. 2110C/D DTP (2 nd iteration): DTP01 = "194" (Period End) DTP03 = This message provides the date that is the last day of the third month of the grace period. 2110C/D MSG: MSG01 = "Health Insurance Exchange - HIX GRACE PERIOD." This message indicates that a member is in the second or third month of a grace period, and that claims for this member will pend until premium is paid. 45

46 Remittance advice Healthcare Exchange member grace period Grace period for individual health plans purchased on Exchange that are eligible for a governmental premium subsidy Premium non-payment continued After the third month, if the premium is not received, the member s health plan will be terminated and the claims for services received during the second and third months will be denied. Providers will be notified of denied claims on their remittance advice The members will be responsible for payment of services 46

47 Remittance advice Healthcare Exchange member grace period Grace period for individual health plans purchased on Exchange that are eligible for a governmental premium subsidy Premium non-payment continued ANSI 835 Codes passed on 835 Electronic Remittance Advice o Claim Adjustment Reason Code (CARC) 133 The disposition of the claim service is pending further review (Use only with Group Code OA) Start: 02/28/1997 Last modified : 01/20/2013 o Remittance Advice Remark Code (RARC) N617 This enrollee is in the second or third month of the advanced premium tax credit grace period Start: 07/15/2013 Paper Remittance Advice remark code information o See our Grace period for individual health plans purchased on the Exchange article on our Health Exchange Information Page 47

48 Claim adjustments Appeal vs. Complaint Guide to Provider Complaints and Appeals accessed under o Appeal A formal request to change a decision upheld through the complaint process or reverse an adverse Utilization Management decision. o Complaint any expression of dissatisfaction submitted by a provider concerning claim payments or member benefits Link: Guide to Provider Complaints and Appeals 48

49 Claim adjustments - complaints Administrative or operational in nature Your local Anthem Plan is responsible for the following: Claim processing, benefit interpretation and reimbursement Your local Anthem plan is responsible for these decision Not related to medical necessity, experimental or investigational or precertification decisions Send a Provider Adjustment Request Form Found under Answers@Anthem, choose Provider Forms, Provider Adjustment Request Form Send a Secure Message 49

50 Claim adjustments - complaints Administrative or operational in nature Provider Requests for Adjustment Local, BlueCard, Anthem Medicare Advantage and Federal Employee Program (FEP ) send to: Anthem Blue Cross and Blue Shield PO Box Atlanta, GA Voluntary provider refunds send to: Anthem Blue Cross and Blue Shield CCOA Lockbox PO Box Cleveland, OH

51 Claim adjustments - complaints Secure Message via Availity Under Claims Menu o Select Secure Messaging 51

52 Claim adjustments - complaints Secure Message via Availity Follow-up secure messages can be sent on a message that was previously answered. Those messages show as bolded unread messages. There is a column titled Messages Needing Attention and follow up messages will show Attention Needed in that column. When you respond back to or read the message, then you can delete the message or it stays in your inbox with the attention needed tag. 52

53 Claim adjustments - complaints Secure Message via Availity Use the Download Secure Message link to create a pdf of the entire secure messaging text. The pdf can then be saved and printed. This feature is available from the Inbox and the Outbox. 53

54 Claim adjustments - complaints Secure Message via Availity Immediate confirmation that inquiry was delivered successfully Sent to Anthem Provider Service based on line of business Tracking in Anthem Customer Service Call System Response sent to your Secure Message Mail box. Average response time o Federal Employee Program (FEP ) 10 days o Local 3 days o National 3 days o BlueCard 30 days 54

55 Claim adjustments - complaints Telephonic Service Call the service numbers indicated on the Ready Reference Guide or printed on your remittance advice If you do not feel your question or issue was adequately addressed o Ask to speak to a supervisor o If this does not resolve your issue Contact your Network Relations Consultant Provide the call reference numbers given by the telephonic service associates you spoke with 55

56 Claim adjustments - complaints Issue Escalation Secure Messaging o If you do not feel your question or issue was adequately addressed send a follow-up secure message requesting escalation to a supervisor Telephonic Service o If you do not feel your question or issue was adequately addressed, ask to speak to a supervisor Network Relations o If supervisor escalation does not resolve your issue Contact your Network Relations Consultant Provide the call reference numbers given by the telephonic service associates you spoke with Link: Provider Claim Issue Escalation to Network Relations 56

57 Claim adjustments - appeals Requests to change clinical decisions based on whether a service or supplies are medically necessary or experimental or investigational Always submitted secondarily to an adjustment/reconsideration request or complaint Applicable to Local Anthem member BlueCard Members Other Programs o Federal Employee Program (FEP ) o Medicare Advantage 57

58 Claim adjustments - appeals Local Anthem Members Submit a complaint first Submit appeals in writing with a copy of our response to your complaint Use the Provider Appeal Checklist to ensure all information needed is included Mail the information to: Anthem Blue Cross and Blue Shield Attn: Appeals Department PO Box Atlanta, GA For additional information see the Provider Complaints and Appeals Process under the Answers@Anthem menu 58

59 Claim adjustments - appeals BlueCard Program Members Clinical and benefit decisions are made by the members Home plan Your local Wisconsin plan is your single point of contact Use the Provider Adjustment Request Form Send to the local claims and correspondence address Anthem Blue Cross and Blue Shield Attn: Appeals Department PO Box Atlanta, GA Your local plan will facilitate the process with the on your behalf 59

60 Claim adjustments - appeals Other Program Members Federal Employee Plan (FEP) o Follow specified directions o Submit a verbal or written complaint first o Submit appeals in writing within 180-days of initial adverse action o Use the Provider Adjustment Request Form o Send to the local claims and correspondence address Anthem Blue Cross and Blue Shield Attn: Appeals Department PO Box Atlanta, GA o Appeals routed directly to FEP who will respond o Questions Contact FEP in Wisconsin at

61 Claim adjustments - appeals Other Program Members Anthem Medicare Advantage o Requirements and Process defined by Medicare o Link: WI Medicare Advantage Provider Home Page o Includes all Anthem Medicare Advantage plans Information found in the Medicare Advantage HMO and PPO Provider Guidebook Provider Service Anthem Medicare Advantage Appeals* Fax: Mail Information to: Medicare Advantage Appeals and Grievance 4361 Irwin Simpson Road Mason, OH

62 Provider claim submission and adjustment request tips and tools Learn more links Anthem WI public provider website Guide to Provider Complaints and Appeals Contact Us page Provider Forms page Provider Education page Electronic Data Interchange (EDI) On the web at o Select Wisconsin and enter EDI Registration Forms page o CAQH EnrollHub 62

63 Provider claim submission and adjustment request tips and tools Learn more links Availity On the web at > Web Portal Users Login o Select Get Trained under the Help menu to access live webinars, on demand recordings and more National websites National Uniform Billing Committee (NUBC) National Uniform Claim Committee (NUCC) Council for Quality Affordable Healthcare (CAQH): Availity is an independent company providing a wide variety of online tools that allow providers to access real-time information from multiple payers with a single secure sign-on. CAQH, a non-profit alliance, is the leader in creating shared initiatives to streamline the business of healthcare. Through collaboration and innovation, CAQH accelerates the transformation of business processes, delivering value to providers, patients and health plans. 63

64 Provider claim submission and adjustment request tips and tools Questions? 64

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66 Thank you for attending! Anthem Blue Cross and Blue Shield is the trade name of Blue Cross Blue Shield of Wisconsin (BCBSWi), Compcare Health Services Insurance Corporation (Compcare) and Wisconsin Collaborative Insurance Company (WCIC). BCBSWi underwrites or administers PPO and indemnity policies and underwrites the out of network benefits in POS policies offered by Compcare or WCIC; Compcare underwrites or administers HMO or POS policies; WCIC underwrites or administers Well Priority HMO or POS policies. Independent licensees of the Blue Cross and Blue Shield Association.