OSP News

Blue Cross Complete is Introducing A New Solution, Clinical Insights to Support Providers

Posted: 09/26/2025

Blue Cross Complete (BCC) has contracted with Edifecs to enable a pre-adjudication claims completeness examination solution called Clinical Insights (CI). CI is designed to alert providers when diagnosis codes are potentially missing from a claim. To learn more about how the CI process will work, BCC has created a FAQ Reference Tool sheet. 

CI validates gaps within the existing claims submission process utilized today without any new software installed or additional portal logins. As part of its care optimization programs, Blue Cross Complete is placing more focus on the upfront claims submission process to drive more complete and accurate clinical documentation and coding of chronic conditions. This is within the provider’s existing billing workflow and channel of submission.

Click here to read the full announcement sent out by Blue Cross Complete. 

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