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May 2017

Reminder: How to file replacement and void claims electronically

As you read in the March 2017 issue of The Record, professional providers will be required to submit claims electronically, starting June 30, 2017. To assist them with billing replacement and void claims electronically, we’ve put together a summary of the process. The following applies to Blue Cross Blue Shield of Michigan and Blue Care Network professional claims.

Background
Many of the paper claims we continue to receive fall into one of the following two categories:

  • Replacement claim
    • Corrects information (charges, diagnosis or procedure codes, quantities, etc.) reported in a previously submitted claim
  • Void or cancel claim
    • Cancels claims billed in error
    • Voids claims with patient or provider demographic errors
    • Tells us you don’t want the original submission to be processed

Process to follow
Send your electronic 837 transaction replacement or void claims with the following information:
In Loop 2300, CLM05-3, use frequency code 7 for a replacement claim.

  • Report all the changes you want to include on the replacement claim.
  • The replacement claim replaces the previously reported claim in its entirety.

In Loop 2300, CLM05-3, use frequency code value 8 to void or cancel a claim.

  • You must submit a void claim if your original submission incorrectly reported:
    • A patient’s name or contract number
    • The National Provider Identifier or taxonomy code
    • The date of service
  • The previously reported claim will be voided in its entirety, so don’t make any changes to the claim.
  • It must be coded exactly like the claim you want to void.

Whether you submit a frequency code value of 7 or 8, you must report the ICN (internal control number) of the original claim in Loop 2300, REF segment, along with qualifier F8. Note: If you’re requesting an adjustment against a previously adjusted claim, report the ICN of the last adjusted claim.

  • For BCN: Report the 12-character ICN.
  • For Blue Cross Blue Shield of Michigan: Report the 14-digit or 17-digit ICN.

No portion of this publication may be copied without the express written permission of Blue Cross Blue Shield of Michigan, except that BCBSM participating health care providers may make copies for their personal use. In no event may any portion of this publication be copied or reprinted and used for commercial purposes by any party other than BCBSM.

*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2016 American Medical Association. All rights reserved.
Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and
independent licensees of the Blue Cross and Blue Shield Association.