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Electronic claim submission: coordination of benefits reminders
July 27, 2021

This article is for dentists and oral surgeons caring for our members

To ensure that we process your electronic submissions correctly, please make sure that you are using the most up-to-date version of your practice management software. In addition, we’d like to remind you about the coordination of benefit requirements for electronic claims submissions.

As you do for all claims, before submitting claims electronically you must determine the primary payer and submit the claim to that payer first. When Blue Cross Blue Shield of Massachusetts is the secondary payer, you must report:

  • the primary insurer’s name and address
  • the insured member’s ID number for that insurer
  • and if the claim was
    • paid by the other insurer, report the amount paid at the claim’s line level. We recommend contacting your practice management software vendor to ensure each claim line being reported has either the primary insurance paid amount or reject reason.  Your claim may be rejected if this data is not supplied.
    • denied by the primary insurer, report the reject reason.

You can learn more on our dedicated coordination of benefits page, including a member fact sheet and information about:

  • Determining which payer is primary
  • Submitting claims when there is more than one payer
  • Handling rejected claims
  • Submitting claims when Medicare is primary