Business ProfileforExcellus Blue Cross Blue Shield

Since Feb 2024, we have been submitting claims monthly to be reimbursed for ****** ****' mental health medical needs from the previous month. Almost every month there has been a problem being reimbursed correctly. January claim was underpaid because the wrong NPI was used from the superbill. February claim was not paid until 7/31/24 and the allowed amount equals the provider charge amount. March was paid and the allowed amount is about 55.6% of the provider charge amount. April claim was not paid until 8/5/24 and the allowed amount equals the provider charge amount. May claim was paid at $344.25 and an overpayment recovery amount of $568.24 was deducted from the total because **** sent a check to both us and the provider. June claim was paid at 55.8% of the provider charge amount. Another check was sent for Jan on 8/19 equal to the provider charge amount but an overpayment recovery amount of $568.24 was deducted again for presumably the same reason as May. We received a notice sent 8/15 that a claims overpayment exists for May's claim of $912.49 even though we only received a check for $344.25. We have called at least monthly since March because of these problems. **** representatives have tried to help resolve the problems. Some have offered to call me back until the issues are resolved but normally we get one call back and that is it even though there are outstanding problems. We are tired of calling and the issues persisting. At this point, we do not know what amount we should be reimbursed for each claim. We should not have had an "overpayment recovery amount" deducted at all for **** error sending a check to the provider and instead it has been deducted 2x. We request that **** immediately correct the claim processing issue, advise the amount we should be reimbursed, and immediately send out revised checks for the correct amount plus interest for the applicable claims.