Corrected Claim Request Alert: Changes Effective July
Posted May 27, 2016
Effective July 11, 2016, duplicate copies of paper PCSs will no longer be provided by BCBSIL. Additionally, corrected claim requests will no longer be accepted via phone or through the Claim Inquiry Resolution feature of our Electronic Refund Management tool. Rather, electronic corrected claims must be submitted as electronic replacement claims, and corrected paper claims must be submitted to our claims mailing address.
The BCBSIL claim system recognizes claim submission types based on claim frequency code submitted on professional (837P) and institutional (837I) electronic claims. Replacement claims (sometimes referred to as corrected claims) submitted electronically are identified by using claim frequency code 7; voided or canceled claims are identified by using claim frequency code 8. Please note that the electronic replacement claim will replace the entire previously processed claim. Therefore, when submitting a correction, send the claim with all changes exactly how the claim should be processed.
In June, we will be hosting online webinars for replacement claim submissions. To learn more about these changes, register today for an upcoming webinar.
Over 98% of the claims received from our providers are submitted electronically. BCBSIL encourages our providers to consider the web as the primary resources for administrative inquiry channel. There are several multi-payer web vendors available to our providers or they can visit www.availity.com to register for a no cost solution.
BCBSIL requires “corrected claim” to be indicated on the claim form or on the Claim Review Form when submitting corrections on a paper claim. Effective July 11, 2016, any changes to a claim that are indicated only on the Claim Review Form or via a letter will be returned with a notice advising resubmission on the appropriate professional (CMS-1500) or institutional (UB-04) paper claim form. The Claim Review Form is available in the Education and Reference/Forms section of our Provider website, under Post-Claim Processing Requests. Refer to the form for additional instructions.
Additional information will be included in upcoming issues of the Blue Review, as well as the News and Updates.