Include All Original Correct Charges When Filing Corrected Claims

When filing a corrected claim, you should also submit all of the other valid, previously reported services and charges from the original claim, if payment consideration for those charges is still applicable.  If only one charge is resubmitted or only charge lines containing corrections are filed without all of the originally billed and correct charge lines, it will appear that you intend to remove the previously processed charges. As a result of omitting all original, valid charges from the corrected claim, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) may request a refund for the previously considered, correctly filed amounts.

If you are removing a charge, please don’t include it in the corrected claim submission. There is no need to submit a zero charge line.  

CMS-1500 claim filers

Just a reminder that 837 professional claims should be corrected electronically whenever the originally reported claim was filed electronically.

UB-04 filers

Claims filed on the UB-04 form can also be filed electronically.  The bill type (form locator “4”) must be adjusted to indicate a corrected or adjusted billing.

Claims that are mailed back

Remember, if a claim is mailed back, it is no longer active in our claims processing system.  If you receive a mailed-back claim from Blue Cross NC, the claim should be corrected based on the reason it was returned. We will treat the resubmission as a new claim and not as a corrected claim.

For more information regarding corrected claim submissions, please refer to the Blue Book^SM, which is our online provider eManual available at bluecrossnc.com/providers.

If you have questions, please contact the Provider Blue LineSM at 1.800.214.4844.