Blue Medicare Advantage (Professional/Institutional) Provider Alert

February 11, 2013

Effective Jan. 1, 2013, Blue Cross and Blue Shield of Texas (BCBSTX) was approved to offer a Medicare Advantage preferred provider plan that offers improved health care benefits for Medicare beneficiaries. This approval also allows for Medicare Advantage claims to be transmitted electronically to BCBSTX. 

Due to a system issue, Medicare Advantage claims received electronically from Jan. 1, 2013 through Feb. 5, 2013, were rejected in error. For rejected claims, the following error code and message was returned on the response report: “4MM - Claim must be submitted to payer CTXPPO.”

This issue has been corrected and we are now accepting Medicare Advantage claims electronically. If you received the above error code and message on your response report, please be advised that those claims were rejected and can now be resubmitted to BCBSTX.

If you have any questions regarding this notice, contact our Electronic Commerce Center at 800-746-4614.