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Pacific Blue Cross Troubleshooting and Error Codes

  1. Insurance Billing (Canada)
  2. Pacific Blue Cross Troubleshooting and Error Codes

    3. 12 min read

This guide is a compilation of some of the most frequently asked questions around Jane’s Pacific Blue Cross (PBC) integration, errors and troubleshooting tips.

If you haven’t seen them already, we do have a few other dedicated guides that may come in handy on setting up your integration, submitting claims and reversing submissions.

You can browse through the various topics at your leisure, or go directly to a specific topic that interests you 🤓

General Integration Questions

Errors and Troubleshooting Questions

Can I coordinate benefits through the integration?

Yes, for patients where both the primary and secondary policies are Pacific Blue Cross. You’ll want to make sure to only add the primary policy to the patient’s visit. PBC takes care of the rest and will add the secondary policy to the visit on your behalf.

For more information on coordination of benefits with other Canadian insurers, you can check out our Coordination of Benefits and Secondary Claims (CA) 🇨🇦 guide for more details.

Can I manually record a claim if it was submitted outside of Jane?

Yes, if your clinic has a Pacific Blue Cross integration set up, but has submitted the claim directly on the portal, you can disable electronic submission on that individual claim and record it manually.

To start, head over to the Schedule tab and select the appointment. Within the Appointment Panel, scroll down to the Insurance Info section.

An image of the navigational steps

Next, click on the dropdown arrow to the right of the Insurer Name in blue and select Disable Electronic Submission from the menu options.

From here, you can manually enter the total amount that Pacific Blue Cross is covering either in the Eligible or Max Amount field.

An image of where to update either the eligible amount or max amount

Lastly, click the dropdown arrow to the right of the Insurer Name in blue again and select Mark as Submitted, Pay & Approve, or Record Payment in Detail.

An image of where to select one of the options

In general, there can only be one Pacific Blue Cross connection set up per integration. This means that if your clinic has multiple locations and multiple Pacific Blue Cross accounts, you’ll need to contact PBC directly to consolidate the accounts together.

Let’s walk through some of the most common scenarios!

Scenario #1: Multiple locations in Jane but one PBC login

You’ll want to contact PBC to add your other Jane location to your current PBC account. In this scenario, both locations will use the same login, but each location is linked individually in Jane.

Scenario #2: Multiple locations in Jane and multiple PBC logins

You’ll want to contact PBC to add your other Jane locations to one PBC account. All of the locations will use the same login, but each location is linked individually in Jane.

Scenario #3: One location in Jane but multiple PBC logins

This scenario is most common with independent contractors who have their own PBC accounts and are paid directly by the insurer. For all staff to be able to use the integration, all PBC accounts need to be consolidated under one login. It’s important to note that this means all deposits are made to one bank account. You’ll need to reach out to PBC to inquire about payments into different accounts.

Alternatively, you can create separate locations for each staff member. All of the locations will use the same login, but each location is linked individually in Jane.

How can I contact Pacific Blue Cross?

  • Email: [email protected]
  • Phone (Lower Mainland): 604-419-2000
  • Phone (Toll-free): 1-877-722-2583

How can I add a new practitioner to my existing Pacific Blue Cross Integration?

To start, you’ll want to ensure that you’ve set up a Pacific Blue Cross account for the new staff member under the clinic login. This needs to be done directly through the Pacific Blue Cross portal before you add them in Jane.

After registration is complete, you can head over to the Settings tab > Integrations > 1Integration on the Pacific Blue Cross section. Next, click on the blue Edit button and find the new staff member’s name in the list under Staff Members. You can use the dropdown menu to the right of their name to link their PBC account to their Jane profile.

Lastly, make sure to hit the Save Integration button to confirm those changes.

Duplicate Claims Error

This error occurs when the Pacific Blue Cross claim is submitted through Jane and then reversed directly on the PROVIDERnet portal. Then, when you try to submit the claim again through Jane, you’re presented with this error message.

In this case, you’ll need to resubmit the claim directly on the Pacific Blue Cross portal. From there, you can manually record the adjudication in Jane by disabling the electronic submission.

Authorization has been Denied for this Request

To resolve this error, you’ll need to Reauthenticate the integration under the Settings tab and click on Integrations within the left sidebar menu. From there, click on the blue 1Integration button on the Pacific Blue Cross section.

Lastly, you can click on the blue Reauthenticate button.

User is not Authorized

If you’ve submitted the claim through Jane and have received this error, it likely means that the clinic’s Pacific Blue Cross PROVIDEDRnet account has been deactivated. A PBC account will be deactivated if there is no direct access to the PBC portal in 6 months.

Note📝: PBC considers “accessing the account” as actually logging into the PBC portal directly. Submitting claims via the integration in Jane isn’t considered “accessing” the account, so you’ll want to make sure to log into the PBC portal every few months to keep the account active.

A quick way to confirm this is by logging into the PBC portal directly and seeing if that gives you the same error message. If you’re unable to log in, then you’ll need to reach out to Pacific Blue Cross directly to have the account reinstated.

If you’re able to log in, then it could mean your clinic has two PBC accounts where one is active and the other is inactive. To resolve this, you’ll want to open an Incognito browser window and login to you Jane account. Once you’re back in the Settings tab, under Integrations and Pacific Blue Cross, you can Delete the existing integration by clicking on the trashcan icon in the bottom right.

Still in incognito mode, you can set up your Pacific Blue Cross Integration again. Once that’s complete, you can log out of Jane and close the incognito window.

Lastly, log back into your Jane account through a regular browser window and try resubmitting the claim.

The practitioner code does not belong to the provider office location

Most often this error message pops up when the clinic has multiple PBC locations and only one location in Jane. Currently, we can only link one Pacific Blue Cross account to a single integration.

Direct deposit information is not active or does not exist and is required for claim submission

This error message means that you’ll need to review the direct deposit information for your clinic in the PBC PROVIDERnet portal. Once you’re logged into the portal, you’ll want to click on the Account tab. From there, you’ll be able to add or review the direct deposit information.

Once that information is updated, you can head back into your Jane account and Reauthenticate your PROVIDERnet integration in Jane.

Patient Identifier is required

This error pops up when Lookup Member Number wasn’t clicked when the policy was added to the patient’s profile. To fix this, you’ll want to edit to policy and select the correct member from the dropdown menu options.

“Unhandled Server Error” when submitting to PBC

This likely means that Pacific Blue Cross is experiencing timeout issues and is down. If you’re receiving this error message after submitting claims through the Jane integration, you can also try logging into the Pacific Blue Cross portal and see if you receive the same error message. If so, the recommendation is to reach out to Pacific Blue Cross directly for updates on any planned outages.

Why Can’t I See Any Diagnosis Codes For My PBC Policies?

The PBC Integration uses the same Diagnosis Codes as the Teleplan Integration. To fix this, you’ll want to ensure both PBC and Teleplan Code Sets are set to enabled. To do this, you’ll want to head over to the Settings tab and click on Billing Codes within the left sidebar menu.

Next, under Code Sets, toggle on both Teleplan and Pacific Blue Cross. Make sure to click Save Billing Code Sets to confirm those changes and you’re all set!

Why did the secondary PBC coverage for this patient’s visit not come through?

Coordinating benefits through Pacific Blue Cross requires that only the primary PBC policy is added to the visit. Pacific Blue Cross is able to recognize if the patient has a secondary PBC policy and will automatically coordinate the benefits on your behalf.

You also want to make sure that for Pacific Blue Cross PROVIDERnet claims that you are not copying previous claims from visits. For that reason, the recommendation would be to add the default claim to a visit, rather than copying it from a previous appointment to avoid the risk of these types of errors.

If you’re receiving this error message, it’s likely that the primary and secondary policies were added to the patient visit. Other reasons for this could be related to the patient’s policies are not coordinated, or actually linked to one another. In these cases, the patient will need to reach out to Pacific Blue Cross directly to update the set up of their policies.

To resolve this error, you’ll want to reverse the claim and resubmit again, making sure that there is only the primary claim on the visit and nothing else.

As always, if you have any additional questions or concerns, you can contact our support team and we’ll be happy to help 💙
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