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Reminder: Claim filing time limitation

As a reminder and to ensure adherence to the claim filing limitations, your organization must submit claims within 180 days of providing the service. Please refer to the Provider Blue Book e manual located on the provider portal of our Web site at www.bcbsnc.com

While the intent of this notice is to ensure adherence to the 180 day claim filing limitation, we would like to take this opportunity to provide additional information as it relates to claims filing and reimbursement with BCBSNC:

  • Always file with the correct member ID number including the alpha prefix and member suffix, whenever applicable. This information can be found on the member's ID card.
  • For the fastest claim processing, file electronically! If you are not currently filing electronically, visit BCBSNC electronic solutions on the Web at: http://www.bcbsnc.com/providers/edi/ to find out how your practice can become an electronic filer.
  • Do not submit medical records unless they have been requested by BCBSNC.
  • If BCBSNC is secondary and you need to submit the primary payer Explanation of Payment (EOP) with your paper claim, do not paste, tape, or staple the EOP to the claim form.
  • Always verify the patient's eligibility via Blue esm, RealMed or the Provider Blue Linesm. Providers with electronic capabilities can verify a member's eligibility and benefits immediately and from the convenience of their desktop computer. Providers without electronic resources should call the Provider Blue Linem at 1-800-214-4844.
  • File under the member's given name, not his or her nickname.
  • Watch for inconsistencies between the diagnosis and procedure code, sex, and age of the patient.
  • Use the appropriate provider/group NPI(s) that matches the NPI(s) that is/are registered with BCBSNC for your health care business.

Prompt processing and payment of claims is contingent upon proper claim submission. Please ensure your billing staff is aware of the 180 day claim filing limit, as well as, all BCBSNC claim filing requirements. To find out more about timely filing and claims filing and reimbursement with BCBSNC, please access our online Blue Booksm provider manual located on the Web at http://www.bcbsnc.com/content/providers/blue-book.htm or contact your local regional Network Management representative.

Charlotte (800) 754-8185 Hickory (877) 889-0002
Greensboro (888) 298-7567 Raleigh (800) 777-1643
Greenville (888) 291-1780 Wilmington (877) 889-0001