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41 11/2005
Electronic Claim Acceptance/Rejection Validation
Important information to validate acceptance/rejection status for submitted electronic
claims:
• For each electronically submitted batch of claims, Medical Data Delivery
(MDD) reports are provided by BCBSGa. The MDD reports should be
available in the provider/vendor electronic mailbox approximately four
hours after transmission.
• Providers should note the date of transmission and access these reports
after each transmission to:
Ensure that Blue Cross and Blue Shield of Georgia has received the
transmitted batch.
Reconcile the submitted batch’s total number of claims and total
dollars to the MDD reports for completeness and accuracy.
Identify errors and/or rejected claims for timely correction and
resubmission.
Types of MDD Reports and their Use:
• Accepted Batch Summary: This report lists summary totals that should be
reconciled to the submitted batch’s total number of claims and total dollars
to ensure completeness and accuracy.
• Accepted Batch Report: This report provides a detailed listing of all claims
received within an accepted batch.
• Rejected Batch Report: This report is produced when an entire batch is
rejected. The reason for the rejection of the batch and individual claims are
indicated on this report. The batch and the individual claims should be
corrected for timely resubmission.
• Claims Error Report: This report individually lists claims that were rejected
within an accepted batch. The reasons for the rejection of these claims
should be corrected for timely resubmission.
• It should be noted that vendor supported sites should first contact their
respective vendor when encountering transmission problems with EDI
claims.
• Providers may also contact the following phones numbers for questions
pertaining to electronic submissions: