Provider Central

Claim status

Here are some options for checking claim status for both local and out-of-state BCBS Members:

• Use ConnectCenter
• Get a Direct Connection for ANSI 276/277 transactions
• Use Payspan for details on processed claims

 Quick Tip: Checking Claim Status (medical providers)

Quick Tip: Checking Claim Status (dental providers)

  Video: Checking claim status (2 min)

Claim filing timelines (timely filing requirements)

For HMO and PPO plans: Within 90 days of the date of service
For Indemnity plans: One year from the date of service

 Timely Filing Guidelines

Claims submitted through ConnectCenter

ConnectCenter provides you with Claim Search and Claim Status features for tracking your claims. Learn more in our Checking Claim Status Quick Tip.

EDI Claim Reports

If you or your clearinghouse submit claims as HIPAA-compliant 837 files, we recommend that you retrieve and review your:

• File Detail Summary Report (277CA Report)
• Batch and Claim Level Rejection Report (the “Submitter PDF report”)
  • The report will tell you the number of claims that were:
    • Submitted
    • Accepted
    • Rejected and why.
• Functional Acknowledgement (999 Report)
• Interchange Acknowledgement (TA1)

For more information on these reports, refer to our direct connection resource, 837 Transactions - Companion Guide for Health Care Claims.

Tips

• Retain all reports you receive from your electronic claim submission to track receivables and identify potential problems.
• Resubmit corrected claims electronically. Note: Do not use frequency code 7 for claims adjudication/resubmission of claims that were rejected on the EDI front end. You must resubmit this type of claim as a new-day claim, with claim frequency = 1 (CLM05-3).