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Info for billing agencies

Below, you’ll find information and resources that your billing agency may find useful in working with us on behalf of the provider offices that you serve.

 Tips for providers who use billing agencies

Quick Poll

Registering for our website

Billing agencies working on behalf of a participating Blue Cross Blue Shield of Massachusetts provider can register for Provider Central.

You can create an account and ask the provider organization to associate your registration with their organization (or practice).

 Registration Quick Start Guide

Once your Provider Central account is activated, you’ll have access to additional features on our site, such as fee schedules. The provider organization that you work on behalf of administers access to certain features, such as Online Services (used to check member benefits and eligibility, the status of your claims, and more).

Claim information

Refer to our Claim Submission pages for information on original claims, replacement claims, tracking claims, and other topics.

 Quick Tip: How to Correct Rejected Claims

Please remember: We don’t verify the status of your claims by phone since you can research them online.

Claim filing timelines (timely filing requirements)

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

 Timely Filing Guidelines

Fee schedules

Log into Provider Central and go to Office Resources>Billing & Reimbursement>Fee Schedules.

Electronic funds transfer and online payment remittances with Payspan

 Payspan Quick Start Guide

Contact information

How to reach us: Contacts & Sites

Before you call our Provider Service area, please have the following information ready:

  • Claim number
  • Denial reason of claim (we’ll need the Blue Cross denial reasons and the HIPAA-compliant reason)
  • Eligibility information for the member, including:
    • Name
    • Date of birth
    • Effective date of their health plan policy
  • Medicare cross-over claims: Please verify that the claim was submitted to us
  • NPI (or tax ID number) of the provider(s) you are calling us about
  • Other information about the claim (for example, CPT code or the amount you were expecting to receive)