BCBSM Update 1/24/2012 PO Box on 4010 Commercial claims

Attention ONLY billers using PO Box or Lockbox addresses.  If you are not getting rejected on your BCBSM Commercial claims in 4010 format, this update does not apply to you.



BCBSM still can not take Commercial claims in 5010 format, but a number of Commercial insurance companies are taking only 5010.  This means you can only bill in the old 4010 format today causing some claims to reject.  Some examples of these companies are HAP, Mail Handlers, OmniCare, Molina, Coventry, Harrington, Macomb Health Plan, PHP, UMR and Alliance Health and Life.

When you bill in the old 4010 format the clearinghouse tries to "upgrade" your claims to 5010 for the companies that require it. Unfortunately the old 4010 does not require both the physical and pay-to loops that 5010 requires when you use a non-physical address.

We have worked with BCBSM and at 4:40 pm 1/23/2012 we released an update for dTHOMAS, and at 9:15 1/23/2012  that will allow 4010 claim files to include physical and pay-to loops. Hopefully this will allow you to continue to bill Commercial claims in the old format and still get paid.  If you have not updated after those times, you need to AutoUpdate now to get this change.

Unfortunately we have never reported this information in the old 4010 format before, and it can take a long time to get a rejection or payment to prove it works or not.  We have tested with BCBSM's HIPAA Validator, and had several billing locations submit claims.  So far no problems, but I'm hesitant to strongly recommend updating right away.

If you use a PO Box/LockBox as your billing address and have Commercial claims rejecting you should consider AutoUpdating your  program and sending some.  Waiting a week or two for others to test it out more is also an option.

We expect to email updates on how well it is working as we learn more.

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 586-751-9080 Attention Mark before calling.

I hope to have an update on BCBSM's progress on Medicare this week, but for now Commercial and Medicare must still go in the old 4010 format.