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We are trying to send a corrected claim to BCBS TX. Like the other insurance companies, we send a corrected claim bu putting a "7" in the "frequency type" box of the claim. This works for the commercial insurance payers. However, when we do this for BCBS, we receive an EDI reject from Availity stating:

Payer Claim Control Number is required

Where does this information go and what are they asking for? The original insurance claim number?

Thanks,
Scott

this is the actual message:


RMSG: HIPAA R0x3938bda
Payer Claim Control Number is required.
Loop: 2300 Segment: REF Element:

This field comes from Case -> Medicaid and Tricare tab -> Original Reference.

On the EOB you got back there should have been a claim reference number that was generated by the insurance company. That is what they want on the resubmission.

SO, just for clarification, even if it is a commercial payer, go ahead and put the original claim number in that field on the medicare/tricare tab?

After my original post, my medisoft support person told me that this information should go under case>policy one>Document Control number? Not try to disagree, just trying to figure out what all the fields mean.

Thanks!

Yes, go ahead and enter it regardless of the insurance. If you are using Revenue Management, and you are using the standard 5010 Professional IGuide that came from McKesson, then Medicaid Original Reference Number is the field that is being used to populate the Claim Control Number in the ANSI file. Please report back your solution when you find it.

We are just using Medisoft Network Professional with OH PRo. V 17.2.2.173.

Just for clarification, you are recommending the Case -> Medicaid and Tricare tab -> Original Reference field, and not the document control number for my corrected claim issue?

Thanks

So are you doing print image instead of using Revenue Management?

yes, claim management >print/send button.

Using MegaEasy EDI Module that submits electronic claims thru Availity.

Mega-easy uses it's own processing logic, so it very well could pull information from a different fields than Revenue Management. I don't know much about Mega-easy, so please post back when you find a solution. You might help the next Mega-easy user that comes along.

[Medisoft V17] If you Using MegaEasy EDI Module that submits electronic claims thru Availity you
should go under Case->Policy 1->Claim Number and put the payer claim control number.

yes, thanks for the information!

I want to send multiple corrected claim from the same case, in this case how can we add previous Claim number for each corrected claim?