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Provider Update August 2026
Jump to section:General information | Medicare Advantage | Medical: Commercial and FEP | Quality and Risk | Dental | Security Corner
Welcome to your Provider Update Newsletter, bringing together important updates for our medical, dental and Medicare Advantage products in one convenient publication.
General information
Claims submission update: Payer ID standardization and 277CA enhancements
To simplify claims submission and improve consistency across our systems, Blue Cross and Blue Shield of Nebraska (BCBSNE) is standardizing payer ID usage and aligning claims acknowledgment processes across Commercial, Dental and Medicare Advantage lines of business.
Payer ID updates
Effective with upcoming clearinghouse updates, providers should use the following payer IDs when submitting electronic claims.
Commercial and Dental
Payer ID: 77780
- 77780 will become the standard payer ID for all BCBSNE Commercial and Dental claims
- Providers and clearinghouses currently using payer IDs 00760 or 00260 should begin transitioning to 77780 immediately
- Effective Jan. 1, 2027, payer IDs 00760 and 00260 will no longer be accepted
Medicare Advantage (P3 Health)
Payer ID: A6492
- Submit all Medicare Advantage/P3 Health claims using payer ID A6492 beginning Jan. 1, 2027
- Claims with dates of service before Jan. 1, 2027, should continue to be submitted to BCBSNE using payer ID 77780
- Beginning Jan. 1, 2027, Medicare Advantage claims will use a separate payer ID from Commercial and Dental claims. Failure to use the correct payer ID may result in processing delays
What providers need to do
- Review payer ID configurations with your practice management system vendor or clearinghouse.
- Update any claim submission rules currently using payer IDs 00760 or 00260 for BCBSNE Commercial and Dental business.
- Ensure staff responsible for electronic claims submission are aware of the payer ID changes.
- Ensure all Medicare Advantage claims with dates of service on or after Jan. 1, 2027, use the correct payer ID.
Important update: Claim acknowledgment process changing
BCBSNE is transitioning to the 277CA Claim Acknowledgment transaction and will retire the custom Claim Confirmation Report (CCR).
What you need to know
- The 277CA will replace the CCR as the sole claim acknowledgment method
- This change applies to all providers and trading partners and is not optional
Key dates
- Now through Dec. 31, 2026: You will continue to receive CCRs as you do today
- Effective Jan. 1, 2027:
- CCRs will no longer be generated or sent
- You will begin receiving 277CA transactions only
Key processing consideration: Multiple 277CAs per submission
Providers and direct submitters should be aware that:
- A single inbound claim submission, such as an 837 file, may result in one or more 277CA transactions
- This may occur because claims are routed internally based on line of business.
Implications
- Systems must support aggregation and reconciliation across multiple 277CAs
- Claim tracking should rely on control numbers, such as TRN, ST/SE and BHT, and claim identifiers rather than file-level assumptions
- Ensure downstream provider reporting reflects complete acknowledgment status across all returned 277CAs
Action required
To avoid disruption in your claim submission and reconciliation processes:
- Ensure your system or clearinghouse is configured to receive and process 277CA files
- Work with your vendor, clearinghouse (such as Availity) or IT team to validate 277CA readiness
- Update any internal workflows or reporting processes currently dependent on CCRs
Why this change is happening
- The 277CA is the long-established method for claim acknowledgments
- It provides more detailed and standardized acceptance and rejection information
- It improves accuracy, consistency and timeliness of claim status feedback
- It supports broader EDI modernization efforts and alignment with clearinghouse processes.
Support
If you have questions or need assistance preparing for this change, contact your:
- Clearinghouse or vendor representative
- BCBSNE EDI support team through the Provider Advanced Inquiry in NaviNet
- A new Claim Acknowledgment Support dropdown option will be available soon
Sign up for Navinet®
Registration is free; all you need is a Federal Tax ID. All participating Blue Cross and Blue Shield of Nebraska (BCBSNE) health care and dental providers can enroll for access.
If your office is already using Navinet, please contact your Security Officer to create a NaviNet account for you. If you do not have a NaviNet account, please visit Register.NaviNet.net to begin the registration process.
Stay informed with BCBSNE provider communications
Medicare Advantage
P3 Health payment integrity communications
- These communications are legitimate and aligned with BCBSNE
- Please review and act on any instructions provided
- Ensure your teams are informed (billing, clinical, administrative)
- No need to contact BCBSNE to validate these notices
For questions, please follow the contact information included in the communication.
Medical: Commercial and FEP
New medical policies effective July 1, 2026
As announced on June 29, 2026, on Happening Now and NaviNet Plan Central, new medical policies are effective July 1, 2026.
The policies listed below include links to complete details, including clinical criteria and coverage guidelines.
Policies included:
- Quantitative electroencephalography as a diagnostic aid for attention-deficit/hyperactivity disorder, cognitive impairment or autism spectrum disorder
- Compression pumps for treatment of lymphedema and venous ulcers
- Postsurgical home use of limb compression devices for venous thromboembolism prophylaxis
- Ophthalmologic imaging techniques for glaucoma and anterior eye segment evaluation
- Scintimammography and gamma imaging of the breast and axilla
Coming soon: Site-of-care policy for colonoscopy services
Quality and Risk
CMS RADV Initiative: Retrospective documentation requests underway
The Centers for Medicare & Medicaid Services (CMS) has expanded its Medicare Advantage Risk Adjustment Data Validation (RADV) audit activity through a multi-year “catch-up” initiative focused on completing overdue audits and improving payment accuracy across Medicare Advantage (MA) plans.
As part of this effort, MA Organizations (MAOs) may increase requests for medical records and documentation supporting diagnoses submitted for risk adjustment purposes.
The CMS RADV program is designed to verify that diagnosis codes reported to CMS are supported by accurate and complete medical record documentation.
The CMS RADV catch-up project includes audits for multiple MA payment years (DOS 2019-2023). Providers may receive requests for medical records associated with dates of service from prior years as part of retrospective audit activity.
Please note that records may still be required even if the patient is deceased, no longer attributed to the practice or has not been seen recently. CMS requires supporting documentation for all audited diagnoses regardless of the member’s current status.
Dental
New dental FAQs now available in Provider Academy
We’re excited to share that new dental FAQs are now available at Provider Academy. These resources give you quick, easy access to answers to common questions so you can support your patients more efficiently.
The Provider Academy FAQ section lets you browse topics by category and expand questions to view clear, concise answers. The new dental FAQs follow this same user-friendly format, making it simple to find the information you need when you need it.
You can explore the new dental FAQs at any time by visiting Provider Academy.
View dental FAQs in Provider Academy
Be sure to bookmark the page and check back often as we continue to add new content to support your practice.
Security Corner
Security Fatigue
All of the security policies in the world cannot protect sensitive information if your staff is over-burdened by complex, manual security requirements.
Combat “Security Fatigue” amongst your workforce, while allowing them to maintain secure behavior:
- Limit the number of security decisions that staff need to make on their own.
- Make it simple for staff to choose the right security option(s). Design
- Design for consistent security decision-making whenever possible.
In the end, the goal should be to make it easier for your staff to be secure than not secure. For more information, visit NIST.gov and search for keyword Security Fatigue.