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![]() #BCBS CORRECTED CLAIM TIMELY FILING LIMIT PROFESSIONAL#If you are a clinic or hospital-based physician or other qualified healthcare provider, use a CMS-1500 (02-12) form for claims for professional services and supplies related to: social security number, incomplete member number, transposed digits in member number). Incorrect member number: Provider billed with an incorrect member number (e.g.Date of current illness: The onset date was missing from box 14 in the CMS-1500 claim form.Codes: The person submitting the claim used invalid CPT/HCPCS, modifiers, or diagnosis codes.Physician Assistant: Supervising physician's name is missing for PA ( Note: A PA does not need to bill with a supervising physician if he/she is a Surgical Assistant and has completed the paperwork to be set up independently in our payment systems).Advanced registered nurse practitioner: Supervising physician's name is missing for non-credentialed and/or not contracted ARNP.Home IV drugs: NDC number and quantity is missing.Anesthesia time is billed in units to represent minutes and additional base units for the code. Anesthesia: The hours/minutes for anesthesia claims are not included.The claim rejects if records are not attached that support the change. Rebilling: Records are missing when rebilling with a different diagnosis or other change.Information doesn't match: Physician/provider information doesn't exactly match what is in our payment system.Here are common reasons why claims suspend or reject: For facility/institutional claims: segment NTE01 must contain “UPI” and segment NTE02 must contain the note, for example: NTE*UPI*CORRECTED LAB CHARGES (or whatever data element was corrected/changed on the claim)įor additional instructions on electronic corrected, replacement or voided claims, visit the online section “ Electronic Transactions and Claim Payer ID”, for additionalīe sure to submit a paper CMS-1500 claim form or electronic 837P claim form that is complete and accurately filled out. #BCBS CORRECTED CLAIM TIMELY FILING LIMIT CODE#For professional and dental claims: segment NTE01 must contain “ADD” and segment NET02 must contain the note, for example: NTE*ADD*CORRECTED PROCEDURE CODE (or whatever data element was corrected/changed on the claim). ![]() #BCBS CORRECTED CLAIM TIMELY FILING LIMIT FREE#
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