Hi guys! I am wondering if anyone can help me out. I am getting BCBS claim rejections for subscriber ID not found or invalid. All info has been triple checked. EDI says that they don't even have the claims. Our clearinghouse is stating the rejection is coming from the payer. I am at an absolute loss on how to get this fixed or what the issue even is! ): Has anyone else been having these issues or know what to do. As far as I know, the claims are not going through Change Health clearinghouse.
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Wiki BCBS Claim Rejections
- Thread starter jaydenlynnturner@gmail.com
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- bcbs rejections
rthomas@impcna.com
Guru
We have had this issue before and it was due to the subscriber & relationship being entered incorrectly. Some insurance cards will have the patients name on them and not the subscriber. Example: My husband Anthem BCBS and my daughter in on his policy. She has a card with her name but my husband is the subscriber. Another way to tell if the patient is actually the subscriber look at the ID #, some of them end with 01,02,03 etc. If the ID # is not 01 then the patient is not the subscriber.
If this isn't the problem get the claim reference # from your clearinghouse and contact the payers EDI dept. Their EDI dept and they can look at the claim even though its not showing in their system when you do a claim inquiry. We have done this multiple times and they can tell you what is keeping the claim from entering their system.