BlueCard^® connection: Why are some of my BlueCard replacement claims denied?

All BlueCard claims must meet Blue Cross Blue Shield of Michigan claim reporting requirements. If you attempt to replace a claim that wasn’t valid or accurate, the Blue Cross denial message will advise you to send us a corrected original, not a replacement.

If you’re unsure why your original BlueCard claim was denied or if you disagree with the denial, contact our Provider Inquiry department for assistance before rebilling the BlueCard claim as a “frequency code 7” replacement claim. Rebilling the replacement claim may not change the outcome but rather delay resolving your claim. Instead, our Provider Inquiry representative can assist you by reviewing the claim and denial, and then contacting the plan, if appropriate.

For more information on the BlueCard program, including links and articles on online tools, reference the BlueCard chapter of the online provider manuals.

If you’re experiencing issues with the information provided in the BlueCard chapter of the online manual — or if you’d like more information on a particular topic — contact your provider consultant.

None of the information included in this article is intended to be legal advice and, as such, it remains the provider’s responsibility to ensure that all coding and documentation are done in accordance with all applicable state and federal laws and regulations.