Claim Correction Change

Blue Cross Blue Shield of North Dakota (BCBSND) wants to inform providers of the new claim correction process change to become effective Nov. 1, 2024. This change will apply to both professional and institutional corrected claims.

Providers will submit an initial frequency type of 7 or type of bill XX7 claim correction/adjustment the same way. However, how BCBSND processes the adjustment will change.

Currently, BCBSND processes all correction submission changes on the original claim. When a provider submits a claim correction, it uses the original claim number in the replacement claim’s reference ID field. Once BCBSND receives and processes the corrected claim, it would be processed to show a CO129 denial on the remittance, referring a provider back to the original claim for processing, which is where all changes were made.

When this change goes live, the above process will change, and the remittance will show all corrected claim changes submitted on the corrected claim. The original claim will now show the denial. The provider should refer to the recently submitted corrected claim number for processing details.

If an additional correction is needed, the provider will want to utilize the most recently processed corrected claim number in the reference ID field when submitting the frequency 7 or type of bill XX7 claim. This is a change from the previous process where the original claim was always referenced.

This same logic of utilizing the last claim number processed will apply to frequency 8, type of bill XX8, void requests as well.

Another change regarding the correction process: Providers who submit BlueCard claims will be able to submit more than one correction.

The BlueCard correction process will follow the same guidelines as all other claims submitted to BCBSND.

Recap of upcoming changes effective on the Nov. 1, 2024 date:

• BCBSND will process any correction/adjustment request changes on the newly submitted correct claim number.
• The original claim number will deny, directing providers to look at the adjusted claim.
• Any additional adjustment requests will need to refer to the previously processed corrected claim number (not the original claim number that was processed initially).
• BlueCard claims will be allowed more than one claim correction going forward.
• For information on how to submit a corrected claim, refer to the applicable provider manual.

Questions?
Contact the Provider Services phone number on the back of the BCBSND member ID card.