Name of Manual - Blue Cross and Blue Shield of Minnesota

Questions and Answers
(continued)
12. What does the claim number represent?
Reimbursement / Reconciliation
The claim number is a sequence of numbers that identifies each
claim. Knowing what the claim number consists of may assist
you in better understanding the claim. The information below
describes a claim number.
Example: Claim number 5109361034020
5109= Julian date the claim was entered into our claims
processing system. i.e., 109th day of 2005
361034= the sequence number for claims entered on that date
020= The first and third positions reflects a claim has been
split. If a claim is split, we are unable to process a claim as one
claim so we process it as two. Two main reasons to split a
claim are when benefits have changed in the middle of the
claim or there are too many lines for us to process it as one
claim.
The second position reflects if the claim has been adjusted (i.e.,
0= original claim, 1= claim adjusted the first time, 2= claim
adjusted the second time, etc.)
13. How do I request an adjustment or inquiry?
An adjustment should be requested when you notice the
adjudication error. Please remember that if data on the claim
needs to be changed, you must send a complete replacement
claim rather than request an adjustment.
You can request an adjustment by:
Submitting a request through provider web self-service
Fax in the Provider Services Inquiry fax form to:
(651) 662-2745
Mail in a request to:
Blue Cross and Blue Shield of Minnesota
P.O. Box 64560
St. Paul, MN 55164-0560
For inquiries:
Provider web self-service is found at:
www.providerhub.com
Call BLUELINE at (651) 662-5200 or 1-800-262-0820
Call provider services at (651) 662-5200 or
1-800-262-0820. Please wait 30 days before checking the
status of a claim or adjustment.
Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual (11/02/11) 9-9