Potential Duplicate Delivery of 835 ERA Files

March 31, 2014

Blue Cross and Blue Shield of Oklahoma (BCBSOK) has resolved a system issue that may have impacted your ability to post 835 Electronic Remittance Advice (ERA) files received March 11 through March 22, 2014. Please be advised that all ERA files during the identified time period will be recreated – this means you may see duplicate files in your Receiver mailbox.

Please review the information below to help determine if you need to take action. As a reminder, if you use a billing service or clearinghouse to receive ERA files on your behalf, please make sure they are aware of this information.

What was missing from the original 835 ERA files?

  • If a Reference Identification (REF) segment with a "6R" qualifier and a unique line item control number* was submitted in Loop 2400 of your electronic claim (837 transaction), that number was not returned on the 835 ERA during the identified time frame.
  • Additionally, if 837 data elements such as the submitted insured name or member ID were corrected during adjudication, that information was not included in the original ERA.

When will the recreated 835 ERA files be delivered?

  • Corrected 835 ERA files will delivered to Receiver mailboxes beginning March 28, 2014.
  • BCBSOK will process approximately 1 to 2 corrected files per day.
  • The delivery of recreated 835 ERA files will not impact the delivery of current files for that day.

How can posting of duplicate 835 files be avoided?

  • Please review the DTM*405*date and the TRN segment – these data elements will be the same in both the original and the recreated 835 ERA files.
  • This review will help you determine if you have already processed the original files that were available in your Receiver mailbox March 11 through March 22, 2014.

What if I have additional questions?

BCBSOK apologizes for any inconvenience this issue may have caused you and your staff. If you have any questions regarding the above notification, please contact the BCBSOK Electronic Commerce Center at 800-746-4614.

*Note: Providers are encouraged to routinely send a unique line item control number on all service lines, particularly if the line item control number gives the provider the capability to automatically post by service line. An example of a REF segment with 6R qualifier and line item control number is as follows: REF*6R*54321. When returned to the provider on the 835 transaction, the line item control number may be utilized by the provider for tracking purposes.