Guidelines for Billing BCBS Illinois (HCSC) and Blue Shield of California

According to the Office Ally notification dated 01/13/2025, when submitting claims to the following two payers, the "Service Facility Information" on HCFA/UB claims does not require the Service Facility NPI if it is the same as the Billing Provider NPI.

Payer IDs

BCBS Illinois (HCSC): Payer ID 00621
Blue Shield of California: Payer ID BS001

This help article provides detailed instructions on how to properly handle these fields to avoid common errors.

NPI Requirements for BCBS Illinois (HCSC) and Blue Shield of California

For claims submitted to BCBS Illinois (HCSC) and Blue Shield of California, clinics are not required to use the same NPI number in both Box 32a (Service Facility Location Information) and Box 33a (Billing Provider Information). You have the following options:

Use Different NPIs:
- Use two different NPIs in Box 32a and Box 33a
Leave Box 32a Blank:
- Leave Box 32a blank and use your billing provider NPI in Box 33a

Important Billing Notes

Do Not Submit Identical NPIs for Both Billing and Service Facility: Providers should not submit the same NPI in both the Billing Provider NPI and Service Facility NPI fields (Boxes 33a and 32a). If you do, you will receive the following error message from Office Ally:
“Service Facility NPI cannot be the same as Billing Provider NPI.”
Error Resolution: If this error occurs, ensure that the NPIs in both fields are different, or follow the guidance above to leave Box 32a blank if using the same NPI for both.

How to Leave Box 32a Blank

If you need to leave Box 32a blank when using the same NPI for both Box 32a and Box 33a, you can update the settings in zHealth software as follows:

1. From the zHealth Dashboard, hover over your name at the top right corner. Select "Update Info" from the dropdown menu.

In the Update Info section, click on the Insurance tab.

2. Select Blue Shield of California (Payer ID BS001) or BCBS Illinois (Payer ID 00621) from the list of payers. Click the edit icon (pencil icon) next to it.

In the edit settings, check the box that ensures Box 32a is left blank when the same NPI is used for both Box 32a and Box 33a.

After checking the box, Click "Save" to save your changes.

By adhering to these billing guidelines, you can help ensure smoother claim submissions and avoid unnecessary claim rejections.

If you encounter any issues or have questions about this process, please contact the zHealth Support Team at support@zhealthehr.com for assistance.