Understanding Corrected Claim Form BCBS Requirements

To get a corrected claim form from BCBS, you'll need to understand the requirements. BCBS requires a corrected claim form to be submitted within 60 days of the original claim submission.

The corrected claim form should include the corrected claim number, which is a unique identifier assigned to each claim. This number is usually found on the original claim form or on the BCBS website.

BCBS also requires a clear explanation of the correction being made, including the reason for the correction and the corrected amount. This explanation should be concise and easy to understand.

The corrected claim form should be signed and dated by the provider, just like the original claim form. This ensures that the correction is official and can be verified by BCBS.

Claims Filing Requirements can be a bit tricky, but don't worry, I've got you covered.

Effective August 1, 2023, Blue Cross NC will begin rejecting corrected claims submissions for three specific scenarios. If the original claim ID number submitted can't be located in their system, resubmit as an original claim or validate the corrected claim submitted has the correct original claim ID number.

You must also void the original claim submission and resubmit a new claim using the correct form type. For example, if you submitted an original claim on a CMS-1500, you must first void the original claim and resubmit a new claim on the correct claim form type using the CMS-1450.

Submitting an incorrect claim ID number after a claim has been adjusted can also cause issues. If you submit a corrected claim after a claim has been adjusted more than one time, you must file the most recently assigned claim ID number and not the original claim ID number.

Here are the coding guidelines for filing corrected claims:

Corrected claims are a necessary part of the claims process, but they can be tricky to navigate.

To submit a corrected claim, you must first determine if the claim has already been processed. If it has, you'll need to file a corrected claim electronically.

Some examples of when you would submit a corrected claim include changing a Current Procedural Terminology (CPT) code, changing a diagnosis, or adding a modifier.

To electronically submit a corrected claim, you'll need to place a value of 7 (replacement of prior claim) or 8 (void/cancel of prior claim) in Loop 2300 Segment CLM-Claim Information Field 05-3-Claim Frequency Type Code.

You'll also need to enter the original claim number assigned by Blue Cross and Blue Shield of Nebraska (BCBSNE) in Loop 2300 Segment REF*F8 - Payer Claim Control Number Field 02-Reference Identification.

Claims submitted and processed under an incorrect patient and/or member identification (ID) number will need to be voided before a new claim is submitted.

Here's a step-by-step guide to voiding a claim:

If you're not able to file your corrected claim electronically because your claim will include attachments, you must file your corrected paper claim to BCBSNE with the attachments.

A corrected claim can also be submitted through My Insurance Manager℠ (MIM), where you'll need to select the Replacement of Prior Claim option and enter the prior claim number.