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Claim must be billed direct to Blue Shield CA

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Rejection Message

Claim must be billed direct to Blue Shield CA

Rejection Details

The policy ID information submitted on your claim belongs to a Blue Shield CA plan.

Resolution

Resolution steps will vary depending on the cause:

  1. If the claim is submitted to the wrong payer ID, verify and edit the payer ID.
  2. If the patient demographics or policy is incorrect, verify the patient's eligibility.

When all corrective actions are completed, rebill and resubmit all affected claims.
Tip: Most subscription levels include access to a free eligibility check feature which can be used with many payers to verify a patient has active coverage. Utilizing this feature prior to submitting claims for a patient can help prevent this type of rejection.