High call volumes
Our member and provider services may be experiencing higher than normal call volumes from 12/22/25-1/9/26 due to a large number of staff being out of office. We encourage you to utilize alternative forms of communication including secured messaging through online Member Services and Availity Essentials Provider Portal.
BCBSND district offices will be closed to the public on Friday, Dec. 26.
This includes Bismarck, Grand Forks, Jamestown and Minot. Need help? We’re here for you! Log in at BCBSND.me or call 844-363-8457.
We are unable to accept walk-ins on Friday, Dec. 26, and Friday, Jan. 2., due to short staffing.
Providers receive results of reviews on their Electronic Remittance Advice (ERA). Search by selecting categories Claim Adjustment Reason Codes (CARC) or Remittance Advice Remark Codes (RARC) and the corresponding code below.
Reason | Corrective Action |
|---|---|
Service billed with inappropriate modifier or anatomical modifier | Claim correction to change or remove modifier |
Service billed with global modifier, but is not within a global period of another procedure | Claim correction to remove modifier |
If a provider disagrees with a payment determination and a claim correction is not the next step, request a Reconsideration using the Appeal form. Reconsideration timelines for request align with the respective appeal timelines for commercial and Medicaid Expansion.
A reconsideration is not an appeal as it’s a payment dispute and not an adverse benefit determination; it does not use the member’s appeal rights. A reconsideration of a payment determination is a provider right only. When completing the appeal form, select Provider on behalf of self.
Providers will receive a reconsideration notification within 45 days of receipt of the request. If a provider disagrees with the determination, they will have the option of requesting a second reconsideration within 45 days. Providers will receive a reconsideration notification of their subsequent request within 45 days of receipt of the request.
