Name of Manual - Blue Cross and Blue Shield of Minnesota

Claims Filing
Claims Filing
Timely Filing Most member contracts contain a time limit for claims submittal.
The limit is usually six (6) months after the date of service, with a
few exceptions. Timely filing for Federal Employee Program
(FEP) members can be found in Chapter 5- ID Cards/Coverage
Options. Participating providers are required to submit original
claims within six (6) months of the date of service. The provider is
liable for claims not submitted within the timely filing limit.
Claims Crossover for
Medicare and Medicare
Supplement
For medical care that involves follow-up, such as surgery and
routine postoperative care, it is most efficient to bill us after all
services have been completed, as long as it is within the time limit.
Replacement Claims
Blue Cross’ requirements for timely filing of replacement claims is
six calendar months from the process date of the predecessor claim
There is no timely filing limit on cancel claims (claim frequency
code of 8).
Provider-Submitted Appeals
Blue Cross’ requirements for timely filing of provider-submitted
appeals is 90 days from the process date of the claim
The claims crossover system reduces your paperwork by using the
Medicare claim form to process both Medicare and Medicare
Supplement benefits. Through the crossover, Medicare generates a
second claim automatically for members who have secondary or
supplemental benefits with us. Providers have only one claim form
to submit—the 837P for Medicare Part B or the 837I for Medicare
Part A.
While Blue Cross can only accept changes from the member, we
encourage providers who are aware of Health Insurance Claim
Number (HICN) changes to assist their patients in communicating
this information to us.
Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual (05/10/12) 8-25