This rejection message from the payer is reporting two possible rejection reasons: 1.) Invalid commercial payer ID and 2.) Invalid claim office number. If the payer ID was incorrect, then the payer would not have received it (and therefore would not have been able to send back this rejection message). Therefore, we have to assume that the reason for the rejection is for an invalid claim office number.
What is the claim office number?
In Therabill, we refer to this as the plan type on the insurance card. This code is used by some payers (especially Blue Cross Blue Shield of Michigan) to route claims internally, for example, for Medicare, BCN, or FEP claims.
Why did I receive this error?
Most likely, you are submitting to a payer that requires a valid (and correct) plan type (claim office number) and you have it entered incorrectly on the insurance card in Therabill.
How do I fix this?
You will need to edit the insurance card for the client in Therabill. On the edit insurance card form, choose the correct plan type (see image to the right, blue arrow).
How do I know what plan type to use?
Usually, at the time you choose the insurance company associated with the insurance card, Therabill will flip the plan type to the correct value for you. You should really only change the plan type if you know the plan type needs to be changed.
You may need to call the payer to find out what they are expecting for the plan type code (claim office number) on your EDI claims in Loop 2000B Segment SBR-05 (Insurance Type Code).
Blue Cross Blue Shield Of Michigan
Blue Cross Blue Shield of Michigan requires a valid plan type code based on where the claim will be routed. Therabill has split this payer up in to 4 different entries based on the known plan type codes for those types of claims. The codes are as follows.
|Payer Name in Therabill List||Plan Type Code|
|Blue Cross Blue Shield of Michigan||BL - Blue Cross/Blue Shield|
|Blue Cross Blue Shield of Michigan - FEP||FI - Federal Employees Program|
|Blue Cross Blue Shield of Michigan - Medicare||MB - Medicare Part B|
|Blue Cross Blue Shield of Michigan - BCN||HM - Health Maintenance Organization|