Back to dashboard
All PlansAdministrativeMedium impact

PAP104 - Contracting/Non-Contracting Providers - Clarified non-contracting payment direction

Blue Cross of Idaho·ID·Reimbursement
Effective date
Feb 1, 2024
We identified it
Jun 19, 2026
Days to comply

Summary

Blue Cross of Idaho clarified payment direction for non-contracting providers. Claims submitted by non-contracting providers adjudicated in the Legacy claim system will now be paid directly to the patient for reimbursement amounts less than $5,000, rather than to the provider.

Action Required

Action needed
Immediately: Non-contracting providers with Blue Cross of Idaho must update patient financial counseling processes to inform patients they will receive direct payment for claims under $5,000 processed in Legacy system. Update billing workflows to collect payment from patients after Blue Cross pays them directly. Verify contracting status and identify which claims system processes your claims.