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When submitting a corrected claim for a BlueCard member, the member’s name must be entered exactly as it appears on their member ID card. If your corrected claim is rejected due to a mismatch in the member's name, you'll receive a response in the Claim Acknowledgement 277CA Loop 2200D > STC segment. This response will include the following codes:

• STC01-1: A3 (Acknowledgement/Returned as unprocessable claim - The claim/encounter has been rejected and has not been entered into the adjudication system.)
• STC01-2: 34 (Subscriber and policyholder name not found.)
• STC01-3: PR (Payer)

For claims submitted on or after April 1, 2025, if your claim is rejected

1. Compare the patient data on your claim with the information on the Electronica Remittance Advice (ERA) and resubmit your claim with the information shown on the ERA.

2. Confirm whether:

   • A hyphen is present in the first or last name
   • A middle initial is included in the first name or middle initial field
   • There's a space between names in any field
   • A suffix is present in the last name or suffix field

Following these steps ensures your corrected claim is submitted accurately, reducing the risk of further rejections.

Learn more about corrected claims and BlueCard claims submission.

5/27/2025

Q2 2025 reimbursement schedules will be available in Availity Essentials by the end of May 2025.

Q1 2025 files are available in Availity Essentials. When accessing these files, please remember to select 1/1/2025 as the date. The system defaults to today's date and will return an error if the date is not changed.

Thank you for your patience as we work to provide you with more comprehensive fee schedule information.

5/15/2025