An Important Reminder About Submitting Claims

Horizon Blue Cross Blue Shield of New Jersey encourages you to submit your claims electronically to help expedite the claim process. Remember to carefully submit your claim to avoid the claim being rejected.

If a claim is rejected, you will receive an error report, either the 999 or the 277CA Claims Acknowledgement Report that explains why the claim was rejected.

What the reports show
The 999 report shows:

  • Claims with incomplete information
  • Invalid codes
  • Non-compliance with the 837 implementation guide.

The 277CA report will show:

  • Claims with invalid ID/member not found
  • Dependent coverage rejections
  • Duplicate claims

When you receive an error report you must:

  • Review the report to see why your claim(s) was rejected
  • Work with your clearinghouse to resolve any error reports
  • Correct the claim and resubmit for processing

Submitting claims
To be sure a claim is accepted when submitted, always include the patient and insured’s name and address, and the ICD-10 diagnosis codes for dates of service October 1, 2015 and later.

If you must submit a professional claim on paper, please use the standard, government approved red-lined CMS1500 claim form. To help expedite your hard copy claim submissions:

  • Do not use black and white, or photocopies of the CMS1500 claim form.
  • Do not handwrite your claims. 
  • Use a laser printer instead of a dot-matrix type printer to ensure better quality.

You will receive a letter for any paper claims that are unable to be entered into the claims processing system. Please review the letter carefully and submit a new claim with all of the required fields necessary for processing.

It’s important to review the claim report with your clearinghouse first, or the Horizon BCBSNJ-issued letter before calling.

Published on: November 7, 2017, 06:53 AM ET
Last updated on: November 7, 2017, 07:13 AM ET