Claim Filing

Claims, including revisions or adjustments that are not filed by a provider prior to the claim filing limit of one calendar year from date of service or discharge, will be the provider’s liability. 

The National Uniform Claim Committee approved a new version of the CMS 1500 Health Insurance Claim Form. Blue Cross and Blue Shield of Nebraska (BCBSNE) accepts the revised CMS 1500 claim form (version 02/12) and all claims must be submitted using this form. Use BCBSNE Medicare Advantage billing requirements, use CPT/HCPCS codes and diagnosis codes to the highest level of specificity, include National Provider Identifier (NPI) numbers on all claims and send claims to your local BCBS plan (see address below). 

Corrected Claim Filing 
When submitting a corrected claim, providers are required to complete field 22 of the CMS 1500 claim form. The provider must enter seven for Replacement of a prior claim or eight for Void/Cancel of a prior claim in the Resubmission portion of the field (found on the left-hand side of the claim form). The original claim number must be supplied in the Original Reference Number portion of the field (found on the right-hand side of the claim form). 

For more information on how to properly complete the new CMS 1500 (02/12) claim form, contact your provider executive or visit NUCC.org. 

Where to Submit a Claim

• For electronic claim submission, send claims to your local Blue plan.
  • Medical Electronic Claim IDs: Professional – 77780 and Institutional – 00260. 
• For electronic claim submission, please email the Electronic Data Interchange (EDI) help desk at ProviderServicesOperationsSupport@NebraskaBlue.com.   
• For Medical paper claim submission, send claims to:
  • Blue Cross and Blue Shield of Nebraska 
    P.O. Box 3248 
    Omaha, NE 68180-0001 
• For Pharmacy paper claims, send claims to:
  • Prime Therapeutics 
    P.O. Box 20970 
    Lehigh Valley, PA 18002-0970 

UB-04 Facility Claims 
Information regarding the national uniform billing data element specifications manual as developed by the National Uniform Billing Committee (NUBC) can be found by accessing their website at NUBC.org.