Avoid Paper Claim Rejections
- Use the proper version of the claim form
Professional providers should now be using the revised version of the CMS-1500 (version 08/05) claim form. Institutional providers should now be using the new UB- 04 claim form. BCBSTX is no longer accepting the old version of the CMS-1500 (version 12/90) or the UB-92 claim form.
- Include all required information
Paper claims that are received without valid NPI,* current Group Policy, and Three-Character Prefix Identification numbers in the appropriate fields will be returned to your office. *NOTE: Now that we are in the NPI Required phase, claims received with only a BCBSTX provider number are being rejected.
Paper claims that are rejected will be returned to the provider with a cover letter explaining the reason for the return. Follow the instructions on the form to properly resubmit the claim.