BCBSM 5010 Update 1/26/2012


This is on today's BCBSM EDI Broadcast Message:

Due to a system issue, some professional claims submitted on or after Jan 23 2012 have received an erroneous edit of A022 BLUE SHIELD PROVIDER CODE IS MISSING. This edit is a 277 edit and is on 5010 claims only.

BCBSM is in the process of correcting the issue and will be recovering the claims. Claims will be processed in time for this weeks check processing. DO NOT RESUBMIT THESE CLAIMS AT THIS TIME.

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I have updated the http://www.geniussolutions.com/5010 web page to include frequently asked questions I get.  Maybe you might find some answers you need there.

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Any eTHOMAS client getting SBR errors should AutoUpdate and rebill.  An update was released at 3pm 1/24/2012 that should resolve any situation.  If you have AutoUpdated after that and still get rejections, please call Mark.  dTHOMAS clients that have AutoUpdated after 11/7/2011 should not get these SBR rejections.

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We have been notified by BCBSM they added these edit/rejections as of 1/23/2012:

P917 ENTITY'S ADDRESS A3 126 85 PO Box Address Invalid

P920 ENTITY'S COUNTRY A3 680 Country Code Invalid Accident State Reported

P915 REFERRING CLIA NUMBER A3 630 CLIA Number Format Invalid

P918 AMOUNT MUST NOT EQUAL ZERO A3 694 CAS Amount Cannot Equal Zero.

P919 AMOUNT MUST NOT EQUAL ZERO A3 694 CAS Amount Cannot Equal Zero.

P912 INSURANCE TYPE CODE A3 578 IL Insurance Type Code Missing SBR05

P913 ENTITY'S NATIONAL PROV ID A3 562 82 Billing and Rendering NPI cannot be identical.

P914 INSURANCE TYPE CODE A3 578 IL Insurance Type Code Should not be present SBR05

P916 SOURCE OF PAYMENT IS NOT VALID A3 401 IL Other Insurance Invalid Source of Payment for FEP

If you get any of these rejections and you don't know how to fix them yourself, please try calling me directly at 586-365-4712 before calling Support.

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BCBSM has still not announced when they will be able to take Medicare, Commercial, or MADME DME.  I'm thinking it will be any day for the Medicare and maybe some time for the Commercial.

Last month BCBSM told me January 30th would be the last day they could take Medicare in 4010 according to WPS.  It should be interesting to see when BCBSM can take the 5010 Medicare and how long you will have to switch.  I'm hoping most of you have tried at least a couple Blue Shield claims in the new 5010 format already, have that working, and will be able to easily switch on Medicare when BCBSM says go.  Hopefully BCBSM will get another extension from WPS to give people more time to switch, but we'll see.

In any case, I recommend you be caught up on your Medicare claims BEFORE 1/31/2012 just in case.  Right now you can still bill them electronically in the old 4010 format.

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Our Support Department is continuing to take a high number of calls, I hope you can check our http://www.geniussolutions.com/5010 web page first and try calling me directly FOR 5010 ISSUES at 586-365-4712 before calling Support.  If you are getting rejections, please fax a few pages showing the rejections to 586-751-3016 Attention Mark before calling. I'm usually in a meeting until 11:45 Wednesday mornings, so please try after that.

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We expect to have a First Friday of the Month Conference Call February 3rd at 10:00.  I'll send an email invite out a few days before then.  If BCBSM does require people to switch Medicare to 5010 before then, I may have a "special edition" conference call when I find out.  Again I'll send an email invite and record the call for our http://www.geniussolutions.com/news page for those that can't make it.