Medical Billing Forum

General Category => General Questions => : cflorez February 19, 2019, 10:04:20 PM

: Blue Shield - California
: cflorez February 19, 2019, 10:04:20 PM
I am a Medical Biller, I recently signed up  two separate Provider Practice in California. Both for Oral Surgery. I submitted claims to Blue Shield for both providers. Both providers claims got rejected from the clearing house. The clearning house stated I needed to contact blue shield regarding the doctor's NPI and information. I verified information with Blue shield that both NPI and information was correct. Provider was enrolled as a out of network provider. However, my claims still will not clear the clearing house. So I must drop to paper to Blue shield. Any suggestions as to what is the problem.
: Re: Blue Shield - California
: PMRNC February 20, 2019, 02:37:00 AM
The clearning house stated I needed to contact blue shield regarding the doctor's NPI and information. I verified information with Blue shield that both NPI and information was correct. Provider was enrolled as a out of network provider. However, my claims still will not clear the clearing house. So I must drop to paper to Blue shield. Any suggestions as to what is the problem.


What rejection are you getting?? if these are for oral surgery, might you need to contract with dental?