Electronic solutionsImportant news
Notice: Effective October 1, 2009, Blue Cross and Blue Shield of North Carolina (BCBSNC) to require all appropriate CPT and HCPCS at the line level of the UB-04.In a move consistent with industry claim submission standards, Blue Cross and Blue Shield of North Carolina (BCBSNC) will begin requiring all appropriate CPT and HCPCS codes be included at the line level of the 837 Institutional claim when used to report outpatient and ambulatory surgery center services. 837 institutional outpatient claims [loop 2300, segment/element CLM05-1 plus CLM05-3; no qualifier] must be billed with both revenue codes and appropriate CPT or HCPCS codes when applicable codes exist. Appropriate revenue codes must be placed in Form Locator 42 [loop 2400, segment/element SV201; no qualifier] for each line item. CPT and HCPCS codes are assigned in Form Locator 44 [loop 2400, segment/element SV202-1; when SV202-1 = HC]. Outpatient hospital and ambulatory surgery centers must include CPT/HCPCS codes in Form Locator 44 to describe specific procedures, when and if, appropriate codes are available. If multiple CPT or HCPCS codes are necessary to reflect multiple, distinct, or independent services matching a single revenue code, claims should be coded to repeat that revenue code as necessary. 837 Institutional filers should note that absence of an appropriate HCPCS, CPT or revenue code on an outpatient claim could likely result in a rejected claim or affect processing time. This change will become effective October 1, 2009. Fee Schedule and Electronic Funds Transfer (EFT) Available OnlineBeginning April 19, 2009, participating providers will be able to enroll for EFT via Blue e. The EFT transaction allows health care providers to have their claim payments directly deposited into a bank account. Questions related to EFT should be directed to BCBSNC Provider Customer Support at 1-919-765-2293. Beginning in the 2nd quarter 2009, BCBSNC will provide complete fee schedule information to participating physicians electronically. Participating physicians with access to Blue e will have the ability to view their fee schedules online. Participating physicians who do not have Internet access, or need to request a special or supplemental fee schedule, may contact their Network Management service representative to request a CD or hard copy of the requested fee schedule. Blue e Hours of ServiceBlue e hours of availability are organized by transaction below:
Occasionally, service may be interrupted for system backups or maintenance. To keep inconvenience to users at a minimum, maintenance is performed at the least critical business hours, usually 1–5 a.m. Monday through Friday, or Saturday nights, once a month. Correct your Professional (837) Claims ElectronicallyCorrected Professional 837 claims should be submitted electronically using one of the Frequency Type Codes in the 2300 CLM05:3 element that are listed below. Submitting corrected claims electronically improves turn-around time and relieves you of the need to file paper. Remember - electronically corrected 837 Professional claims do not need to be submitted on paper.
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Notice: Effective October 1, 2009, Blue Cross and Blue Shield of North Carolina (BCBSNC) to require all appropriate CPT and HCPCS at the line level of the UB-04.