Sept. 19, 2018

After you submit a claim with BlueCross BlueShield of South Carolina and identify a change you need to make on the claim, be sure to file a corrected claim. If you resubmit without indicating it's a corrected claim, it could deny as a duplicate to the previously filed claim.

If you need to adjust (or correct) a previously paid claim, the adjustment must contain these four items:

1. Frequency Code “7” (Adjustment) in CMS-1500 Box 22 (Resubmission Code).
   This corresponds to the CLM05-3 segment in the 2300 Loop of the electronic claim file.
   CLM*436944*271***11:B:7*Y*A*Y*Y~
2. The BlueCross claim number (“ICN” or “DCN”) of the previously paid claim in CMS-1500 Box 22 (Original Ref. No.).
   This corresponds to an REF segment with an F8 qualifier in the 2300 Loop of the electronic claim file.
   
   REF*F8*6D2084558005~
3. A brief description of the reason for the adjustment (new service line, different tooth number, etc.) in CMS-1500 Box 19 (Additional Claim Information).
   This corresponds to an NTE segment in the 2300 Loop of the electronic claim file.
   
   NTE*ADD*SERVICE LINE 1 – ADD MODIFIER 59~
4. All claim lines you would like processed, including existing correct lines, corrected lines or additional lines.
   

To file a corrected claim through My Insurance Manager^SM:

1. Locate the Patient Care menu and choose Professional Claim Entry. The Plan Information page will list your profile information first.
2. Select a plan, and indicate whether the plan is the primary payer.
3. Select the billing location, rendering provider and/or referring provider when prompted. You can opt to choose a patient or manually enter the patient’s information on the Patient Information page.
4. On the Claim Information page, select Replacement of Prior Claim from the Claim Type menu. Enter the prior claim number in the required field.
5. Enter the new information from the line of your claim.
6. Be sure to include the previous claim information and claim lines, and not just create a new line.
7. When you are done, select Continue.
8. Confirm the claim information you entered. After reviewing your claim, select Submit.