Insurance Claim Rejection
Answered

I received a rejection from Blue Cross Blue Shield of Illinois that I've never seen before and not sure how to fix.  It says: (A3) Missing or invalid information. DUPLICATE FILE ID-CANNOT USE TWICE IN 12 MONTHS (21)

 

I've gotten so few rejections that I'm not sure where to start, though I expect to be on hold forever if I call BC.  Any clue as to what this means? Not even sure what File ID refers to  And is "A3" or "21" referencing a certain section of the claim form?  Box 21 is the dx code...but that doesn't seem like File ID...and it's a typical code.

 

Would greatly appreciate any help in sleuthing this one.  Thanks.

30 comments

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    Lauren Zerbst

    I also received this notice for two claims. Hoping to get some clarification to fix it and prevent it in the future!

     

    I also received this notice for two claims. Hoping to get some clarification to fix it and prevent it in the future!

     

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    Lauren Zerbst

    Here is a notice from the BCBS Website:

     

    Due to a system problem, some electronic claim files that had already been accepted and processed were re-processed.

    This issue resulted in the following “Duplicate File” rejection message on electronic claim reports to providers: R^^1SG - Duplicate File ID-Cannot Use Twice in 12 months^^

    If you received the above message, please note that no action is needed on your part.

    We apologize for any inconvenience this issue may have caused your practice. If you have any questions regarding this notice, please contact our Electronic Commerce Center at 800-746-4614.

    Here is a notice from the BCBS Website:

     

    Due to a system problem, some electronic claim files that had already been accepted and processed were re-processed.

    This issue resulted in the following “Duplicate File” rejection message on electronic claim reports to providers: R^^1SG - Duplicate File ID-Cannot Use Twice in 12 months^^

    If you received the above message, please note that no action is needed on your part.

    We apologize for any inconvenience this issue may have caused your practice. If you have any questions regarding this notice, please contact our Electronic Commerce Center at 800-746-4614.

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    Ruth

    Hi Michael and Lauren, I'm happy to clarify this for you. As Lauren mentioned, this system error occurred on BCBS's end and has since been resolved. You won't need to do anything for these claims to be processed correctly. 

    Hi Michael and Lauren, I'm happy to clarify this for you. As Lauren mentioned, this system error occurred on BCBS's end and has since been resolved. You won't need to do anything for these claims to be processed correctly. 

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    Mark Vaughan

    Thank you for this info! Can I just go ahead and delete the rejected claim from SP? 

    Thank you for this info! Can I just go ahead and delete the rejected claim from SP? 

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    Ruth

    Hi Mark - You won't want to delete these claims. If you're enrolled in Payment Reports through SimplePractice, these claims' statuses will update from "Rejected" to "Paid" when the Payment Report is issued. If you typically add insurance payments manually, you'll want to leave the claim as is until you receive a corresponding insurance payment and then add the payment as you normally do. This will update the claims' statuses from "Rejected" to "Paid."

    Hi Mark - You won't want to delete these claims. If you're enrolled in Payment Reports through SimplePractice, these claims' statuses will update from "Rejected" to "Paid" when the Payment Report is issued. If you typically add insurance payments manually, you'll want to leave the claim as is until you receive a corresponding insurance payment and then add the payment as you normally do. This will update the claims' statuses from "Rejected" to "Paid."

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    Eloise Terry

    I just got this same rejection for 6 claims filed 10/9/2020. Is it the same situation as above? I do nothing and BCBS will resolve the issue?

    I just got this same rejection for 6 claims filed 10/9/2020. Is it the same situation as above? I do nothing and BCBS will resolve the issue?

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    Sonya G Edwards, LCSW, LCDC, SAP

    I jut received the same notice for 5 claims, claims that usually pay within 3 days.

    Should I contact BCBS? It appears the problem has not been resolved.

     

    I jut received the same notice for 5 claims, claims that usually pay within 3 days.

    Should I contact BCBS? It appears the problem has not been resolved.

     

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    Anna Padgett

    I too received about 40 of these rejections last night. Please advise if any actions is required on our end.

    I too received about 40 of these rejections last night. Please advise if any actions is required on our end.

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    Patricia B. Jones

    Same here: "DUPLICATE FILE ID-CANNOT USE TWICE IN 12 MONTHS (21)" for 5 claims. I saw that this happened to some back in January of this year. How are we going to know if those claims will be paid?

    Same here: "DUPLICATE FILE ID-CANNOT USE TWICE IN 12 MONTHS (21)" for 5 claims. I saw that this happened to some back in January of this year. How are we going to know if those claims will be paid?

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    Joseph McNally

    I also received many rejected claims with this  rejection notice. Should we reach out to BCBS?

    I also received many rejected claims with this  rejection notice. Should we reach out to BCBS?

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    Kimberley Wagner

    I've received 10 claims with the same error message, has anyone received a resolution or spoke to BCBS?

    I've received 10 claims with the same error message, has anyone received a resolution or spoke to BCBS?

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    Brenda Henning

    Looking forward to an answer to this question, as I have this same rejected notice. 

    Looking forward to an answer to this question, as I have this same rejected notice. 

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    Margaret E. Dunne

    So glad to hear that I'm not the only one this happened to!  

     

    So glad to hear that I'm not the only one this happened to!  

     

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    Brittney Roberts

    Same boat over here, I of course tried to call them and ended up screaming at the automated system unable to get to anyone since I don't have a claim number to reference. I guess will just wait and see and follow this thread... 

    Same boat over here, I of course tried to call them and ended up screaming at the automated system unable to get to anyone since I don't have a claim number to reference. I guess will just wait and see and follow this thread... 

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    Tom Herman

    I got 11 of these today. Looking at Lauren Z's and Ruth's posts when this happened in January, I feel like we're good and BCBS will take care of it on their end?

    I got 11 of these today. Looking at Lauren Z's and Ruth's posts when this happened in January, I feel like we're good and BCBS will take care of it on their end?

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    Tom Herman

    Of course, as therapists, we know how challenging it can be to cope with rejection!

    Of course, as therapists, we know how challenging it can be to cope with rejection!

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    Tom Herman

    We want to know: Why? How did this happen? Is it something I did? And most compelling of all, what do I need to do to get it changed into acceptance? 

    We want to know: Why? How did this happen? Is it something I did? And most compelling of all, what do I need to do to get it changed into acceptance? 

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    Margaret E. Dunne

    Hope this helps eveyone....on the BCBS website its explained in a paragraph dated 10/8/20 "HFS IMPACT File Discrepancies Causing Claim Rejections for BCCHP", and talks about what and why.  I just want to make sure I do what's correct within SP, since stated above we should simply leave it alone and things will reconcile on their own.

     

     

    Hope this helps eveyone....on the BCBS website its explained in a paragraph dated 10/8/20 "HFS IMPACT File Discrepancies Causing Claim Rejections for BCCHP", and talks about what and why.  I just want to make sure I do what's correct within SP, since stated above we should simply leave it alone and things will reconcile on their own.

     

     

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    Patricia B. Jones

    Thank Margaret, I am wondering if someone from SP could help us by letting us know how they can track if those claims will be corrected and paid.

    Thank Margaret, I am wondering if someone from SP could help us by letting us know how they can track if those claims will be corrected and paid.

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    Anna Padgett

    For what it's worth, I checked status on Availity for some of my rejected clients...looks like we don't have to do anything. 

    Status as of 10/13/2020
    • Pending: Adjudication/Details This is a generic message about a pended claim. A pended claim is one for which no remittance advice has been issued, or only part of the claim has been paid
    • Claim has been adjudicated, awaiting payment cycle

    For what it's worth, I checked status on Availity for some of my rejected clients...looks like we don't have to do anything. 

    Status as of 10/13/2020
    • Pending: Adjudication/Details This is a generic message about a pended claim. A pended claim is one for which no remittance advice has been issued, or only part of the claim has been paid
    • Claim has been adjudicated, awaiting payment cycle
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    Ruth

    Hi Everyone, thank you all for your patience during our investigation. We found that this is an issue on our clearinghouse's end, they're currently working on changing their scrubbing error logic. Once they've done this, you'll be able to resubmit the rejected claims! I'll keep you all posted on when this issue is solved! 

    Hi Everyone, thank you all for your patience during our investigation. We found that this is an issue on our clearinghouse's end, they're currently working on changing their scrubbing error logic. Once they've done this, you'll be able to resubmit the rejected claims! I'll keep you all posted on when this issue is solved! 

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    Alysha Roll

    Thank you Ruth.  Will you let us know on this thread so we can all make sure we resubmit?

     

    Thank you Ruth.  Will you let us know on this thread so we can all make sure we resubmit?

     

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    Eloise Terry

    My rejected claims are trickling in and getting paid a few at a time. Hopefully the same is happening for all of you as well!

    My rejected claims are trickling in and getting paid a few at a time. Hopefully the same is happening for all of you as well!

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    Julie Scher

    Ah, thank you for this thread!  I also received the same  type of rejection.  Hoping it will be resolved soon.  Thanks, everyone!

    Ah, thank you for this thread!  I also received the same  type of rejection.  Hoping it will be resolved soon.  Thanks, everyone!

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    Patricia B. Jones

    Thank you, Ruth. I have all but one of my claims (Oct 9) that is still showing as rejected. Is there anything else we need to do?

    Thank you, Ruth. I have all but one of my claims (Oct 9) that is still showing as rejected. Is there anything else we need to do?

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    Ruth

    Hi Everyone, according to our Insurance Team, Eligible is currently working with the insurance payers ILBLS, TXBLS, and OKBLS on these rejected claims. Once the issue is resolved, we will be resubmitting them on your behalf. There was another issue with the payer ILMCR that caused the NPI to be missing from claims, which was resolved Friday, 10/16. Claims rejected between 10/1 and 10/7 by the payer ILMCR have been successfully resubmitted. If you have any more specific questions regarding rejected claims submitted to any of these payers, please reach out to our Insurance Team directly by submitting a Help Request

    Hi Everyone, according to our Insurance Team, Eligible is currently working with the insurance payers ILBLS, TXBLS, and OKBLS on these rejected claims. Once the issue is resolved, we will be resubmitting them on your behalf. There was another issue with the payer ILMCR that caused the NPI to be missing from claims, which was resolved Friday, 10/16. Claims rejected between 10/1 and 10/7 by the payer ILMCR have been successfully resubmitted. If you have any more specific questions regarding rejected claims submitted to any of these payers, please reach out to our Insurance Team directly by submitting a Help Request

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    Ruth

    Hi Everyone, I'm happy to report the "Duplicate File ID" BCBS rejection issue is now resolved. There is no action required on the provider's end and all rejected claims have been accepted on the payer's end. If you're enrolled in Payment Reports, the Payment Report will come through once the claim is processed and update the "Rejected" status. If not, you'll receive an EOB/ Remittance Advice as usual. When you manually add the insurance payment, the "Rejected" status will update! 

    Hi Everyone, I'm happy to report the "Duplicate File ID" BCBS rejection issue is now resolved. There is no action required on the provider's end and all rejected claims have been accepted on the payer's end. If you're enrolled in Payment Reports, the Payment Report will come through once the claim is processed and update the "Rejected" status. If not, you'll receive an EOB/ Remittance Advice as usual. When you manually add the insurance payment, the "Rejected" status will update! 

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    Kimberley Wagner

    Hello, I still have 2 claims with a REJECTED status (out of 10 originally). Should I resubmit these claims?

    Hello, I still have 2 claims with a REJECTED status (out of 10 originally). Should I resubmit these claims?

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    Patricia B. Jones

    I also have one that has been rejected even after I resubmitted it. Please advise.

    I also have one that has been rejected even after I resubmitted it. Please advise.

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    Ayelette R

    Hi Kimberley and Patricia,

    We'd be happy to help with your questions. Because these are specific to your accounts, I’ve created a help request for each of you so that a member of our Insurance group can investigate this for you further. They’ll be reaching out to each of you with more information over email.

    For future reference, the quickest way to get support for account-specific questions is to send us a help request by clicking the blue question mark icon on the lower right of your SimplePractice account > clicking Get Help. For more details, feel free to check out this Help Center guide: Logging in to SimplePractice and submitting help requests.

    Although we're periodically monitoring the Community Forum, this is also a place for customers to exchange ideas and engage with one another on how to best use our platform. Thank you for acting as resources for each other in the meantime.

    Hi Kimberley and Patricia,

    We'd be happy to help with your questions. Because these are specific to your accounts, I’ve created a help request for each of you so that a member of our Insurance group can investigate this for you further. They’ll be reaching out to each of you with more information over email.

    For future reference, the quickest way to get support for account-specific questions is to send us a help request by clicking the blue question mark icon on the lower right of your SimplePractice account > clicking Get Help. For more details, feel free to check out this Help Center guide: Logging in to SimplePractice and submitting help requests.

    Although we're periodically monitoring the Community Forum, this is also a place for customers to exchange ideas and engage with one another on how to best use our platform. Thank you for acting as resources for each other in the meantime.