Name of Manual - Blue Cross and Blue Shield of Minnesota

Claims Filing
Duplicate Claims Duplicate billing adds millions of dollars each year to health care
administrative costs. Many providers operate under the erroneous
assumption that frequent rebilling leads to faster payment.
Unnecessary rebilling increases your overhead costs as well as
ours. Below are several ways you can help reduce duplicate claims
costs:
When you file the claim, be sure to tell your patients not to bill
on his/her own.
Eliminate ‘‘automatic’’ rebillings. Wait 30 calendar days for us
to process your claim.
Before you rebill use provider web self-service, call
BLUELINE ® , use a 276/277 transaction or call provider
services for claim status information.
Don’t submit previously billed claims with new claims “just to
be safe.” This only delays payment of all new claims.
If you receive a Medicare RA showing that the claim has
electronically been ‘‘crossed over’’ to us, do not submit the
paper RA as a claim.
If a claim has been denied, resubmitting the paper RA will only
result in a second denial. Either correct fields on the claim and
submit a replacement claim or submit an appeal as appropriate.
Submission of Claims Our goal is to pay your claims as quickly as possible. By following
the above suggestions, you can help hold down everyone’s
administrative costs.
To ensure the proper administration of benefits by Blue Cross,
providers shall submit claims to Blue Cross even when their claims
have been paid in full by other third parties such as Medicare.
When submitting claims in these cases, the provider shall populate
the previous payer’s payment information within the claim.
Providers shall submit claims to Blue Cross for all services
provided, even in cases when the provider suspects a service will
not be covered except charges identified in chapter 9, page 9-5.
This will ensure the proper administration of benefits and take
advantage of changes in coverage that may occur after the provider
checks benefits.
Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual (05/10/12) 8-27