Claim Processing Timeframe Reminder

Blue Cross Blue Shield of North Dakota (BCBSND) wants to highlight providers of the claim processing timelines. 

While some claims may process within a short amount of time, on average, claims can take up to 30 days to process after they are received. We ask that providers wait to inquire on claims less than 30 days old, to allow BCBSND to process and finalize the claim. Claims that come in with submission errors may be held for manual review, this can cause delays in processing, which means it can take longer than 30 days to process. If it has been longer than 30 days and the claim(s) has not yet finalized, you can check claim status by utilizing the Availity Essentials direct messaging feature or contact the Provider Service Contact Center by calling the number on the back of the member ID card. 

Tips to avoid processing delays: 

  • Ensure the required billing and rendering provider information is correct on the claim. 
    • This includes name, location, and National Provider Identifier (NPI). 
  • Utilize the proper member details. 
    • This includes member UMI/ID, name, and date of birth. 
  • Verify the claim details are accurate for the service provided. 
    • This may include but is not limited to the type of bill, patient status, Current Procedural Terminology (CPT) code, modifier, units, and/or diagnosis code. 

Providers are also advised to contact the Provider Service Contact Center, whether by phone or Availity Essentials direct messaging, if they have further questions regarding corrected and/or voided claim questions. 

Federal Employee Plans (FEP) starting with an “R” will follow the same guidelines as above. For questions on an FEP member, contact the FEP Service Unit phone number as noted on the back of the member’s ID card.