ANSI 837 - Florida Blue - BCBSF

More documents

Recommendations

Info

Florida Blue 837 P Companion Guide 2012D. Billing as an Individual Provider – OPTION 2If you are billing as an individual provider, the NPI must be the individual NPI (type 1)along with the appropriate Social Security Number. Do not enter a provider at all in therendering section when the billing and rendering provider is the same person.Submitting redundant information can cause a different provider correctable error.Correct Entry (THE MATCH):This example shows how the information entered matches data registered with FloridaBlue. Individual Name matches Individual NPI matches Individual Social SecurityNumber.Incorrect Entries (THE MISMATCH):Below are examples of information entered that will result in a mismatch of datacausing a delay in payment. The mismatch is highlighted in red.281 Availity, LLC Is a multi-payer joint venture company. For more information or to register, visit Availity’s website atwww.availity.com.900-3398-1112005010X222A1Florida Blue December 2012
Florida Blue 837 P Companion Guide 2012REMEMBER: Individual Name = Individual NPI = Individual Social Security NumberTo confirm how you are registered with Florida Blue, please call the Provider ContactCenter at (800) 727-2227, select option 5, and then option 2. If you would like toregister a different Tax ID number, please complete the Provider Information UpdateForm.(sections 1 and 6.) A completed IRS confirmation letter must be included.X. Tips for Sending Coordination of Benefits Information on Electronic Claims837 Professional Health Care ClaimsWhen Florida Blue is secondary, please remember to include coordination of benefits (COB)data on your claim as outlined below. All HIPAA mandated fields are required. The businessrequirements and corresponding 837 fields listed below are necessary to process COBinformation on Florida Blue claims.R =RequiredS=SituationalS837 Fields Business RequirementLoop 2320 CAS 01-19, asneededSubmission of other insurance payment information requiresclaim adjustment group codes and associated monetaryamounts. Please be sure to submit any differences betweenthe paid and charge amounts in the CAS segments. FloridaBlue requires the 837 to balance including the COB segments.R Loop 2320AMT 01AMT 02When Florida Blue is secondary, submit the primary insurerpayment information to support correct processing of COBinformation.RLoop 2430 CAS segmentsLoop 2430 SVD 02AMT01 – D is requiredAMT02 – Sum of all Line level Payment Amount minus anyClaim Level Adjustment amounts must balance to Claim levelPayment Amount.When Medicare is primary and Florida Blue is secondary,Florida Blue requires a line level adjustment reason code andpayment amount which must balance back to charge.291 Availity, LLC Is a multi-payer joint venture company. For more information or to register, visit Availity’s website atwww.availity.com.900-3398-1112005010X222A1Florida Blue December 2012
Page 1 and 2: Florida Blue 837P Companion Guide 2
Page 3 and 4: Florida Blue 837 P Companion Guide
Page 23 and 24: BC - Blue CrossA - AvailityIG - Imp
Page 25 and 26: Florida Blue 837P Companion Guide 2
Page 27: Florida Blue 837 P Companion Guide
Page 31: Florida Blue 837 P Companion Guide

ANSI 837 - Florida Blue - BCBSF

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?