Frequently Asked Questions About the 837


Do you require the taxonomy code to be reported on any of the 837 formats and, if so, which ones?
No. The addenda version removed this as a requirement. We will accept taxonomy, but it is not a required field.

If applicable, are you going to continue to accept "J" codes?
Yes.

Are there any circumstances where you might require providers to use NDC codes on the 837? 
Yes, unclassified codes should be submitted with the NDC number.

Will you be able to accept 999 claim lines?
Yes.

Do you allow zero charges on claims?
Yes.

Do you allow negative charges on claims?
No.

Will you require a secondary identification number and, if so, what?
We need to receive either a 1A or 1B code qualifier, which is the BlueCross Provider Number. This number is the Tax Identification Number -- with or without a 3-digit suffix that identifies locations. We provided the 3-digit suffix to the providers during the provider certification process.

When receiving claims in a batch mode, if one claim contains an error will just that claim reject or will you reject the entire batch?
We perform edits at the batch level. So if there is a problem with one claim, we will return the entire batch.

What is your payer secondary identification qualifier and reference identification?
Here are the NAIC and carrier codes:

NAIC Codes
38520: BlueCross BlueShield of South Carolina 
95741: BlueChoice HealthPlan

Carrier Codes
400: BlueCross BlueShield State Health Plan
401: Blue CrossBlue Shield
402: FEP BlueCross
922: BlueChoice® HealthPlan

The following carrier codes are for those TPAs that use the Preferred Blue® network and are also accepted electronically. The carrier code is used to route these claims to the appropriate area, so it is imperative to use the appropriate carrier code for TPA members' claims.

886: Planned Administrators, Inc. (PAI)
315: Thomas Cooper
130: Employers Life Insurance Company
446: Employee Benefit Services dba Key Benefit Admin.
498: Carolina Benefit Administrators (CBA)

Do you require Patient Secondary ID#?
We do not currently require a secondary patient identifier.

Do you require contract information?
No.

Will you require submitters to report Payer Estimated Amount Due?
No.

Will you require submitters to report Patient Estimated Amount Due?
No.

Will you require submitters to report Patient Paid Amount?
No.

With regard to Release of Information CLM09 and OI06, in your opinion is an "N" a legitimate code based on Privacy regulations? (i.e., will you accept "l?")
Based on privacy guidelines, it does not seem appropriate for a provider to file with an "N."