Name of Manual - Blue Cross and Blue Shield of Minnesota

Claims with
Attachments
(continued)
Claims with
Coordination of
Benefits
Claims Filing
4. If I have the Other Insurance Carrier payment information
in the 837 electronic claim transaction, do I also have to
send the EOB in an attachment or notify Blue Cross that it
is in my office?
No. Per the AUC Guidelines, you should submit the Other
Insurance Carrier payment information within the 837. HIPAA
regulations forbid populating the claim record with Other
Insurance Carrier information and sending the same
information in an attachment. They further forbid sending data
in an attachment that can be codified within the claim record.
5. Can I send the attachment before I send the 837 claim
transaction?
Yes, provided you complete the PWK segment on the 837 with
the appropriate information from the AUC Uniform COVER
SHEET For Health Care Claim Attachments. The PWK
segment must include the Report Type code, Report
Transmission Code and the Transaction Control Number (the
Attachment Control Number on the AUC Uniform COVER
SHEET For Health Care Claim Attachments). Failure to
include this information on the 837 will cause delays in
processing and payment and may result in a denial of your
claim.
Blue Cross accepts electronic claims with previous payer payment
information populated per the requirements in the Minnesota
Uniform Companion Guides. For proper adjudication claims must
contain all previous payer group codes, ANSI Claim Adjustment
Reason Codes and Remittance Advice Remark Codes as you
received them from the previous payer. These claims do not
require an attachment when populated within the claim record.
Refer to the Minnesota Uniform Companion Guides, section
4.2.3.5 for more information.
Blue Cross has compiled a list of questions and answers in
response to provider inquiries regarding the electronic submission
of Coordination of Benefits information.
Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual (05/10/12) 8-7