*Use of Frequency Type 7 for Out-of-State Members

Blue Cross Blue Shield of North Dakota (BCBSND) previously issued guidance regarding the claim correction process used for claims processed on the new claims processing platform. If a Frequency Type 7 claim adjustment is submitted on an original claim for out-of-state members, providers cannot submit another Frequency Type 7 claim adjustment on that claim because the intended changes will not be made. Instead the corrected claim will reject stating, “The Adjustment Request received from the Provider has been processed. Your original claim has been adjusted based on the information received.”

When a second corrected claim needs to be submitted, the original claim with previous corrections will need to be voided as billed in error (Frequency Type 8) and a new claim (Frequency Type 1) with the corrected changes will need to be submitted.

*This article is a revision and replacement to the article of the same name in HealthCare News Issue #410.