Precision Service Type (PST) allows the Patient Payment Estimator (PPE) product to deliver a more accurate estimate. PPE, in part, calculates payment estimates utilizing benefit information received in the eligibility response. If the standard eligibility response does not return the benefit information related to the service being estimated, a subsequent PST or service-specific eligibility request is submitted using embedded logic , resulting in a more precise eligibility response and an even more accurate payment estimate.
Passport developed the Precision Service Type (PST) functionality in response to many payers decisions to now require specific service type eligibility transactions instead of returning bundled benefit information in a single response.
All current Patient Payment Estimator customers will be turned on for this functionality on Friday, August 16th. If you wish to make changes to your settings for this functionality, please see the instructions provided below which allows you to manage your settings by user or for your entire organization via the Self-Service Portal.
Please note that subsequent transactions are considered a new transaction (or transactions) and will be billable if a valid response is received. It is not guaranteed that an additional transaction(s) will be processed for the payers currently configured for PST and should only be triggered if PPE does not receive the benefit information they need from the payer in the initial response. It is possible, however, that two or more additional transactions will be required to get the benefit data that PPE needs for an accurate calculation. We have listed the payers (below the following SSP instructions) that are currently available for this functionality below and will be adding additional payers as necessary over the next several months.
Instructions for configuring Patient Payment Estimator Precision Service Type (PST) on Self-Service Portal
- Go to self-service portal
- Click on Manage Users tab
- Click on RQA/PPE tab
- Go to PST column to the right of the Nebo User ID column
- Change a single user’s access by toggling Yes (turns off PST and changes link to No) or No (turns on PST and changes link to yes)
- Change all users access to PST by clicking either Enable All or Disable All below the list of users
Aetna
Aetna Better Health (IL)
Anthem Midwest (IN, KY, OH)
Anthem Northeast (CT, ME, NH)
Anthem Southeast (VA)
Anthem West (CO, NV)
Blue Cross Blue Shield of Alabama
Blue Cross Blue Shield of Arkansas
Blue Cross Blue Shield of Florida
Blue Cross Blue Shield of Georgia
Blue Cross Blue Shield of Illinois
Blue Cross Blue Shield of Kansas
Blue Cross Blue Shield of Massachusetts
Blue Cross Blue Shield of Michigan
Blue Cross Blue Shield of Minnesota
Blue Cross Blue Shield of Missouri
Blue Cross Blue Shield of Nebraska
Blue Cross Blue Shield of New Mexico
Blue Cross Blue Shield of Oklahoma
Blue Cross Blue Shield of Rhode Island
Blue Cross Blue Shield of South Carolina
Blue Cross Blue Shield of Tennessee BlueCare
Blue Cross Blue Shield of Tennessee Commercial
Blue Cross Blue Shield of Tennessee TennCare Select
Blue Cross Blue Shield of Texas
Blue Cross Blue Shield of Wisconsin
Blue Cross of California
Blue Cross of Northeast Pennsylvania
Blue Shield of California
CIGNA
Coventry Health and Life OKlahoma
Empire Blue Cross Blue Shield
Health Net National
Highmark BCBS
Horizon Blue Cross Blue Shield of New Jersey
Horizon NJ Health
Humana
Kaiser Permanente of Southern California
Medicare A and B
Molina (OH)
Mountain State Blue Cross Blue Shield
PacifiCare (CA) – Ingenix
PHC DEMO (Commercial)
Regence Blue Cross Blue Shield of Oregon
Regence Blue Cross Blue Shield of Utah
UnitedHealthcare
