Rejected and Denied BlueCard Claims

Ensure Your Directory Information Stays CurrentHighmark Blue Shield of Northeastern New York (BSNENY) is experiencing an increased volume of incorrect BlueCard claims.

The following tips can help you ensure a successful BlueCard claim submission:

  • If the BlueCard claim is REJECTED OUTRIGHT, providers should make any necessary corrections and resubmit as a new claim.

  • If the claim is PARTIALLY DENIED, providers should follow these guidelines when resubmitting.

    • Reference the original claim number.
    • Make changes to what was originally reported on the claim (i.e., procedure code, diagnosis code, place of service, total charge, total units, or additional modifier if needed).
    • Address the denial reason via the correction being made.

Checking Claim Status

In NaviNet® , providers can check the status of BlueCard claims via BlueExchange®. Once logged into NaviNet, select BlueExchange® (Out of Area) from the Workflows for This Plan menu on the left.

 

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