Error Message

Subscriber and Subscriber id not found

Description

This error appears as a rejection in the Electronic Module for Blue Cross Blue Shield (BCBS) claims. This means that BCBS does not recognize some type of information about the client, including (possibly) their name, ID, address, DOB, etc.   

Resolution

1. Go to the Electronic Module.
2. Click the blue Batch link to view the rejected report.
   • ​Verify the client's information (name, DOB, Group ID, Policy ID, etc.) for accuracy. 
     • ​If something is incorrect, update in the Client Module, and resend the claim.
     • If everything appears correct, proceed to step 3.
3.  In the Batch Reports screen, Hold down Ctrl + F.
   • This will open the find tool.
4. Type in the client's name to find the rejection on the report.
5. Below the client's name, find the Payer Claim # for the rejected claim.
   • Keep record of it, you will use it shortly. 
6. Call BCBS (do not use any web portals).
7. Explain that you have submitted a claim, and the claim was rejected by BCBS before it was accepted into their adjudication system for processing.
8. Provide the BCBS agent with the payer claim number they assigned to the rejection. The rep may call it a Repository Number or ODS Number.
9. Ask them to verify why this has rejected. 
   • They should be able to tell you which data point (the client name, DOB, ID, etc.) is causing the problem.
10. ​With an explanation, you will now be able to resolve the issue. 
11. If all data points match with BCBS, record the reps name, phone number, and call reference number.
12. Submit a ticket to Procentive with this information and invoice number.