7 Claims and Payment - Premera Blue Cross

Premera Dental Reference Manual
Premera Blue Cross Blue Shield of Alaska
handwritten claims forms)
Confirm print is dark. Change toner cartridge or ribbon when needed
Be sure information lines up correctly within the respective fields. (OCR equipment
cannot accurately read data that overlaps another field/box.)
Do not highlight. (Highlighted information appears “blacked out” when read by OCR
equipment)
Avoid using white correction fluid
X-Ray Films and
Photos
X-ray films or photos will not be returned to the dental office unless specifically
requested at the time of submission.
If you are requesting their return, please indicate the patient’s name, account number or
other identifier on the envelope or mounting.
We will not be responsible for lost x-rays or photos. The dental office should maintain
the original copy of the x-ray films or photo in the patient record.
For more information on submitting x-rays or photos electronically please visit the
FastAttachTM web site at fast-attach.com.
Returned
Claims
Corrected
Claims
Claims with incomplete, unclear, or incorrect information (e.g. procedure code, date of
service, etc.) will be returned. Returned claims must be resubmitted with correct
information. Please resubmit with correct information to process claim for payment.
Correcting previously process claims is necessary when the original claim was submitted
with incorrect information. To facilitate prompt payment for a resubmitted claim,
remember to:
Submit a new, corrected claim
Attach a completed “Correct Claim –Cover Sheet”
Indicate this is a corrected bill
Include additional information such as a narrative, chart notes or claim remarks to
document the change, if applicable
To obtain a “Corrected Claim –Cover Sheet” access the Forms section of
premera.com/provider. Printable versions of the form are available.
Send the corrected claim to:
Dental Review
P.O. Box 91059
Seattle, WA 98111-9159
Claims
Status
You can obtain the status of a claim:
1. Online: A convenient method to check the status of a claim is to visit
premera.com/provider. Information is available 24 hours a day, seven days a week.
Each dentist receives a PIN to log on to our secure Provider Portal (see Chapter 2,
Online Services).
2. Customer Service: If you don’t have Internet access, contact Customer Service using
the phone number that can be found on back of member’s ID card.
3. Interactive Voice Response Unit (IVR): Available 24 hours a day, seven days a week.
IVR provides claims information (see Chapter 6, Member Eligibility and
Coverage).
Claims and Payment Chapter 7 Page 4