CBA does not process claims directly but is completely integrated with BlueCross BlueShield of South Carolina's claims processing system.
Behavioral health claims passed through BCBS of SC take advantage of all integrated components.
These integrated components include:
- Eligibility database/system
- Benefit determination system (benefit maximums, deductible, per occurrence deductibles, coinsurance, covered/non-covered limitations, frequency limitations, etc.)
- Provider database (provider information and pricing)
- Utilization management/case management (CM) (pre-certification)
- 36 months of claims history (summary and aggregated)
- Financial systems and notification systems (generation of provider and member payments, explanation of benefit (EOB) statements, provider remittances, and letters)
BlueCross BlueShield of South Carolina is an independent licensee of the Blue Cross Blue Shield Association.