Want to avoid claim rejections and denials? Be sure to include the rendering provider information.

The Blue Cross^® Blue Shield^® of Arizona (BCBSAZ) claim processing system looks for a valid NPI/TIN combination for the rendering provider.

Tip: If you need to update our systems with your current NPI/TIN information, use the online Provider Information Change Form, available in the secure provider portal at “azblue.com/providers > Provider Resources > Forms > Provider Information Change.”

We love “clean” claim submissions

We can accept and adjudicate “clean” claims quickly without further information from you or a third party (except when we need to review medical records). You can avoid most claim processing delays by including the rendering provider information and other data elements on this checklist:

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Accurate and complete information identifying the patient and policyholder (if different from patient) with correct and complete names, identification numbers, and dates of birth

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Date and place of service

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Identification of the service(s) provided by appropriate diagnosis code(s), procedure code(s), and appropriate modifiers

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Evidence that any required prior authorization was obtained

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Identification of the servicing/rendering and referring provider, including the NPI number as indicated in the following table:

Questions?
For more information about BCBSAZ claim submission, check out Section 19 of the BCBSAZ Provider Operating Guide. You can also reference the HIPAA Transaction Standard – BCBSAZ Companion Guide.

In This Issue

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May news: Executive summary

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Inpatient care: Notification and authorization updates

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Billing clarification: Inpatient and observation visits

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Include the rendering provider for "clean" claims

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Behavioral health inpatient discharge and follow-up

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BCBSAZ fee schedule updates

May is Mental Health Awareness Month:

The need for support is real every day

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