Blue Cross Newsletter

July 12, 2010



To: All Blue Cross Contracting Providers

Cindy Garrison, CPC – Education/Communication Coordinator
Institutional Relations
Blue Cross and Blue Shield of Kansas, Inc.
An Independent Licensee of the Blue Cross and Blue Shield Association


Claims Submitted with Invalid Identification Numbers

In the past, when Blue Cross and Blue Shield of Kansas received a claim that had an incorrect identification number, sometime BCBSKS staff would attempt to reconcile the information without returning the claim to the provider.  Due to HITECH (Health Information Technology for Economic and Clinical Health Act), BCBSKS will no longer be able to search for patient information in order to process the claim.

When BCBSKS receives an electronic claim with an invalid identification number, the claim is returned to the Trading Partner in a proprietary report called "Claims Confirmation Report".  An explanation of any rejected claims is given on this report.  Rejected claims must be corrected and resubmitted.  Providers should check with their vendor/clearinghouse as to when this report is available for them to review.

When BCBSKS receives a paper claim with an invalid identification number, the claim will be denied and your remittance advice will reflect a Claim Adjustment Reason Code 31

31 Patient cannot be identified as our insured.

and a Remittance Advice Remark Code MA61.

MA61 Missing/incomplete/invalid social security number or health insurance claim number.

Questions regarding this change should be discussed with your provider consultant.