How is an 837 claim that has more than 28 lines handled within BCBSRI?
We accept the HIPAA limits – 50 lines for Professional claims and 999 lines for Institutional claims. If a claim greater than 28 lines is encountered, we route it to the Claims Department via paper, where it is manually split into separate claims, then entered into our system. The claim is entered into multiple claims with the Repository, Split Claim Indicator, Patient Control Number, and Line Indicator being entered on the claims. The Line Indicator will show the original number of the line it had (e.g., If line 30 on the original claim dropped to paper, 30 will be entered on the line level Line Control Number field). From that point, the pieces are independent claims in our system. Parts of the original claim could be paid in different settlements. However, the provider’s original control information – including the provider-submitted original line number – will be returned in the 835s.
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- How is an 837 claim that has more than 28 lines handled within BCBSRI?
