Blue Cross Blue Shield of North Dakota (BCBSND) has identified the top reasons for prospective Payment Integrity Program rejections and created a guide to assist providers in determining why the claim was denied and the next steps.
The Denial Resolution table contains the top Claim Adjustment Reason Codes (CARC) and Remittance Advice Remark Codes (RARC) pairings rejected through the payment integrity program. Each pairing contains a reason why the claim or line was rejected along with examples, if applicable, and the recommended corrective action.
To learn more about the Payment Integrity Program, visit our newly updated BCBSND Payment Integrity Program Webpage. New code pairings will be added to the webpage table as new top rejections are identified in order to build out a more comprehensive list. The provider can view the list here.