Claim Notifications

Claim notifications are processed in our Minnesota office.  Claim notifications can be submitted by mail or electronically at bpiclaims@bpire.com.

BPI requires written notification within 30 days after claim payments made for any participant exceed 50% of the Specific Deductible.

Additionally, we require written notification immediately for any type of claim meeting the criteria listed in the Trigger Claim Notification.

Trigger Claim Notification Criteria

 Case Management Criteria

 Medications

·        Growth hormone therapy.

·        IV hydration/fluids, pain management, and medications.

·        Oral medications with claims greater than $2,000 per month.

·       Total parenteral nutrition/hyperalimentation.

Neonatal Related Conditions

·        Bronchopulmonary dysplasia.

·        Hydrocephalus.

·        Major or multiple congenital anomalies.

·        Meningiomyelocele.

·        Premature birth.

·       Respiratory distress and in ICU greater than one week.

Pregnancy Related Conditions

·        Hyperemesis.

·        Multiple births.

·        Premature labor.

·        Toxemia requiring hospitalization.

·        Uterine monitoring.

Therapy and Home Care Visits

·        Experimental or investigational therapy.

·        HHA/RN/LPN four or more hours per day or more than 40 hours per disability.

·        HHA/RN/LPN four or more visits per week.

·       Therapies (PT/OT/ST) or HHA/RN/LPN visits which are to continue for more than three weeks.

·       Therapies (PT/RN/ST) described as a full or partial day program.

Traumatically Injured Patients

·       Amputations.

·       Crushing injuries.

·       Multiple trauma, head injury, or spinal cord injury.

·       Serious burns involving more than 20% of the body.

  Conditions