Specific Claims

Specific claims are processed in our Brooklyn Center, MN office. Claims can be submitted by mail or electronically at bpiclaims@bpire.com.

Advanced Funding

All advanced funding requests must be received by BPI no later than 30 days prior to the end of the policy year.  Claims received during the last 30 days of the policy year must be funded by the employer.

Required to Process Specific Claims

The following items are required to process specific claims.

Specific Claim Request Form

Eligibility:

Enrollment

Provide copies of all enrollment materials for the plan participant including updates, changes and HIPAA certificate.

Extension of Coverage

Provide documentation of extension of coverage for the plan participant including COBRA enrollment, proof of COBRA payments, leave of absence information and current work status if claimant is the employee.

Other Coverage 

Provide documentation of other coverage for claims on dependents or injury related claims (i.e., auto accident, liability, etc.).

Accident Details

Provide accident details including police report and subrogation reimbursement, if applicable.

Claim Payments

Provide the following documentation for each paid claim submitted. The submission should be arranged in check date order.

Claim Worksheet or EOB 

Itemized Bills

UB92s are acceptable if the total charges are less than $75,000.

PPO Repricing

If PPO repricing is performed electronically this information will not be needed. 

Claim Payment Corrections or Recalculations

Provide the following documentation for the corresponding claim.

• Original bill, copy

• Original EOB/check, copy

• Explanation of the recalculation

Utilization Review

 Provide copies of utilization review certifications.

          Pre-Existing Investigation

Provide documentation of the pre-existing   investigation.

          Case Management Vendor

Provide copies of the Case Manager’s reports, and payment recommendations.