You’ve submitted your claims to Blue Cross. Now what?
Here are tips for checking the status of your claims, finding and understanding your Provider Detail Advisories, and correcting the most commonly rejected claims.
Use Online Services (available in the eTools section of our website) to check the status of your claims. When you need more details about how your claims have processed, you can use Payspan.
|If you need to||Then|
|Request an adjustment to your claim||Click the Adjustment Request link (as shown in the example below).
Note: This link only shows when this feature is available for your claim. Also, we can’t accept attachments when you use this feature.
|Submit a replacement claim (for a claim that fully denied)||Follow our replacement claim process.|
|See more details about your claim. For example, if your claim rejected and you want to know why, or you want to understand why a claim only partially paid||Go to Payspan and view your Provider Detail Advisory.|
Online Services example of a claim status inquiry. In this example, the status says, The claim/line has paid. Go to Payspan to get details on your payment.
With Payspan, you get access to both your Provider Payment and Provider Detail Advisories. Click on the blue, underlined text (a hyperlink), to open both and toggle between the two.
When you get your Provider Detail Advisory on Payspan, you’ll notice different sets of messages to help you understand how your claim paid.
There are HIPAA-compliant messages and additional ones that we create to help you understand how we’ve processed your claims. The Blue Cross Blue Shield of Massachusetts messages start with words and have a message code at the end. Look at these first because they include additional details to help you. See the example below.
Want to learn more?
For our Payspan quick tip, log in and go to eTools>PaySpan.
You found out your claim rejected and now you need help understanding why. We’ve put together a list of the most commonly used reject messages that you’ll see on your Provider Detail Advisory and steps you can take to understand what happened.
If you need to submit a replacement claim to make a change to your claim, learn about replacement claims we accept and how to submit them on our Claim Submission page. Or, get answers to frequently asked questions about replacement claims.
You can find quick start guides and tips on our Online Services and Payspan pages in eTools.
Still have questions about your claims? Call Provider Service:
1-800-451-8124 (Ancillary Providers)