Healthy Blue, an Anthem Company Nebraska Providers

Nebraska Providers

Known Issues


Review this page for information on known issues.

Claims related to any of the issues listed here that have either rejected or denied appropriately will not change when the issue is resolved.

Contact Provider Services if you have questions or concerns related to the issues listed here.

Open Projects

No open projects.

Completed Projects

Rejection or denial code
Rejection

Impacted provider specialty
N/A

Estimated claims reprocessing
N/A

Actual claims completion
N/A

Project number
N/A

Note
Healthy Blue EDI and Secure Provider Portal teams identified that a market prefix [FGM] is required on claims preceding the Member Medicaid ID or Healthy Blue Member ID.  Without the addition for the market prefix [FGM], claims may reject.

Healthy Blue EDI and Secure Provider Portal teams are resolving the need for the market prefix [FGM] for the Member Medicaid ID, but will always be required for the Healthy Blue Member ID.

The Project team is updating training and provider materials for updates.

Rejection or denial code
N/A

Impacted provider specialty
N/A

Estimated claims reprocessing
N/A

Actual claims completion
N/A

Project number
N/A

Note
Healthy Blue Nebraska does have a process for providers to confirm eligibility, request authorization and ultimately bill claims for Unborn members. Some key points to confirm eligibility are as follows:

  • The Date of Birth will always be a default date of 1/1/2000
  • Gender will always be “U” for Unborn
  • First Name will always be “Unborn”
  • Last Name will always match the mother’s Last Name
  • All of the above bulleted elements will be on the member’s card.

Rejection or denial code
N/A

Impacted provider specialty
N/A

Estimated claims reprocessing
N/A

Actual claims completion
N/A

Project number
N/A

Note
Healthy Blue Nebraska providers should be aware that the Billing Group Taxonomy Number is a required field when submitting claims to Healthy Blue Nebraska. Failure to include the provider’s Billing Group Taxonomy Number will result in claim rejections. The Billing Group Taxonomy Number should match the provider’s Nebraska Medicaid enrollment profile.

Healthy Blue Nebraska providers are encouraged to visit Maximus to review their Medicaid enrollment profile to ensure all data is correct.

Rejection or denial code
N/A

Impacted provider specialty
N/A

Estimated claims reprocessing
N/A

Actual claims completion
N/A

Project number
N/A

Note
Healthy Blue Nebraska providers should be aware that the rendering provider’s Clinical Laboratory Improvement Amendment (“CLIA”) Number is a required field when submitting claims to Healthy Blue Nebraska. Failure to include the rendering provider’s CLIA Number will result in claim denials.

Provider Tools & Resources

Interested in becoming a provider in the Healthy Blue network?

We look forward to working with you to provide quality service for our members.