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Claim Editing Issue Being Addressed

Horizon Blue Cross Blue Shield of New Jersey is aware of a claim processing system issue that is resulting in the inappropriate application of claim editing rules to codes included on certain professional claims processed since March 1, 2018.

This system issue resulted in both the application of claim editing rules where they should not be applied, as well as the failure to apply claim editing rules where they should have been applied.

We are currently addressing this issue and expect to have it corrected on or around April 22, 2018.

Following the system correction, Horizon BCBSNJ will identify and correct all impacted claims to ensure that claim edits are applied appropriately. There is no need to submit claim appeals or to resubmit claims. We will provide notice prior to adjusting impacted claims.

Thank you for your patience as we work to correct this issue.

Published on: March 29, 2018, 13:54 p.m. ET
Last updated on: March 29, 2018, 14:22 p.m. ET