After submitting a claim to BlueCross BlueShield of South Carolina, you may notice that a change is needed. In this instance, you will need to submit a corrected claim for processing. As a reminder, it is important to submit corrected claims properly to avoid receiving a duplicate denial due to the previous claim having already been filed.
To properly submit a corrected claim, the following four items are needed:
- Frequency Code 7 (indicating an adjustment) should be placed in Box 22 of the CMS-1500 form (Resubmission Code).
This corresponds to the CLM05-3 segment in the 2300 Loop of the electronic claim file.
- The BlueCross original claim number (“ICN” or “DCN”) should be placed in Box 22 of the CMS-1500 form (Original Ref. No.).
This corresponds to an REF segment with an F8 qualifier in the 2300 Loop of the electronic claim file.
- A brief description for the reason of the adjustment (e.g., new service line, added modifier, etc.) should be placed in Box 19 of the CMS-1500 form (Additional Claim Information).
This corresponds to an NTE segment in the 2300 Loop of the electronic claim file.
- ALL claim lines that need to be processed, including existing lines, corrected lines, or additional lines.
If filing a corrected claim through My Insurance Manager℠ (MIM), do the following:
Under the Patient Care menu, select Professional Claim Entry.
- Select a plan and indicate whether the plan is the primary payer.
- Select the billing location, rendering provider and/or referring provider when prompted. You can opt to choose a patient or manually enter the patient’s information on the Patient Information page.
- On the Claim Information page, select Replacement of Prior Claim from the Claim Type menu. Enter the prior claim number in the required filed.
- Enter the new information from the line of your claim.
- Include ALL lines that need to be processed, including existing lines, corrected lines, or additional lines.
- Once completed, select Continue.
- Confirm the claim information is accurate, then click Submit.
If you have any questions, be sure to contact Provider Education using the Provider Education Contact Form located on www.BlueChoiceSC.com.