BCBS Federal Phone Number; Ambetter Claims address and Phone Number; Healthfirst Customer Service-Health First Provider Phone Number-Address and Timely Filing Limit; Kaiser Permanente Phone Number . Once the IQ is returned, all claims are reviewed and processed based on the information supplied. Seattle, WA 98104 YDZ SG OFF Exchange Designed by Elegant Themes | Powered by WordPress. A required waiting period must pass before we can provide benefits for this service. The NPI replaces all proprietary (payer-issued) provider identifiers, including Medicare ID numbers (UPINs). We use cookies on this website to give you the best experience and measure website usage. BCBS Provider Phone Number. Blue cross Blue Shield association cannot accept Guest Membership claims electronically. Use only red CMS-1500 forms (no photocopied forms). DHB Empire BCBS CZV BCBS of Alabama Be on . DKD Wellmark BCBS Iowa/South Dakota, HPS Gordmans Inc. (formerly 1/2 Price Stores), How to Identify Members 3.1.1 Member ID Cards. . ), Tel:800-562-1011Fax: 877-239-3390 (Claims and Customer Service)Fax: 877-202-3149 (Member Appeals only)Fax: 866-948-8823 (FEP Care Management - prior auth/pre-service requests), Premera Blue Cross - FEPPO Box 33932Seattle, WA 98133, Retail Pharmacy Program DKB Highmark BCBS You can recognize Managed Care/POS members who are enrolled in out-of-area networks through the member identification card as you do for all other BlueCard members. ** PPOB in a suitcase logo, for PPO members with access to the BlueCard PPO Basic network If you are a clinic or hospital-based physician or other qualified healthcare provider, use a CMS-1500 (02-12) form for claims for professional services and supplies related to: This includes claims for outpatient services and services performed by a hospital-based physician or other qualified healthcare provider. If you're a medical biller or a provider and going to submit BCBS plan member claim to the insurance, make sure to submit member ID including prefix. Phoenix, AZ 85072, Retail Pharmacy Program Electronic Transactions and Claim Payer ID, Resource-based relative value scale (RBRVS), Claims from Non-credentialed contracted providers, federal and Washington state civil rights laws, Subscriber's number and patient suffix number (including plan prefix) assigned by plan as shown on the member's identification card, Number assigned by the clinic for patient. | Call customer service and web support at 800-607-0546 between 8 a.m. and 6 p.m., Monday through Friday, Pacific Time. The protection of your privacy will be governed by the privacy policy of that site. BCBS Provider Phone Number. Find the correct address listed under the type of service received (see explanation). The plan doesn't cover cosmetic services. Prompt Pay interest is currently calculated monthly for the previous month's paid claims. There is a balance due to us at the end of the payment cycle. New York, New York 10008-3876. Modifiers. We abide by the following COB standards to determine which insurance plan pays first (primary carrier) and which pays second (secondary carrier). Alaska contracted and non-contracted Payment of this claim depended on our review of information from the provider. Practitioners who arent credentialed may have their claims returned until they submit a complete credentialing application. Always use the alpha prefix on the members current ID card. Please review the terms of use and privacy policies of the new site you will be visiting. | CZP Anthem BCBS of Ohio In this health insurance plan, alpha prefix is assigned to national accounts. DJE BCBS of Alabama ** The empty suitcase logo AEO MI BC MI, POB 1618 , Detroit , MI , 48231 800-462-7237, AFM PA BC PA, 5th Ave Pl Ste 2012L , Pittsburgh , PA , 15222 800-489-4484 All people who have BCBS health insurance policy have to make copies of their ID front and back and keep such records on hand. Unclean claims will begin to Web: Regence BlueShield. Professional Services are performed by a doctor or other healthcare professional. ABR Carefirst BCBS Maryland The charges for this service have been combined into the primary procedure based on the provider's contract. This service is considered a standard exclusion. AFB BCBS of South Carolina If it is, call the BlueCard Eligibility line 800-676-BLUE (2583) to verify the ID number. Also its not a sequential order hence its hard to find unless we check with first 3 alpha prefix. ACD BCBS of Michigan Click on the Submit a Preauthorization Request link. 553 46 any missing required substantiating documentation or particular circumstances requiring special treatment. or sexual orientation.Premera Blue Cross HMO complies with applicablefederal and Washington state civil rights lawsand does not discriminate on the basis of race, 1/2022) v1 INSTRUCTIONS FOR FILING A CLAIMIMPORTANT: Regence BlueShield Attn: UMP ClaimsP.O. Is there any way that I can download the contact# with prefix. A member is primary on the plan in which he/she is the subscriber versus the plan in which he/she is a dependent. View your credentialing status in Payer Spaces on Availity Essentials. UMP administered by Regence BlueShield (Medical only) (UMP Achieve 1, UMP Achieve 2, UMP High Deductible, UMP Plus) Online: Uniform Medical Plan for school employees. We are now processing credentialing applications submitted on or before March 14, 2023. CVA Anthem BCBS of Ohio How do I determine if a diagnosis or procedure code needs preauthorization? Box 21267 M/S S518 Seattle, WA 98111-3267 Claims appeals, balance billing or pricing disputes The process for submitting an appeal depends on your issue. . Where do I determine if a code is covered? https://drive.google.com/file/d/0Bzbk78qiF4H_ZU9NTmxSenJwb0U/view?usp=sharing, Nice to know, this should be useful as a reference, I'm just looking for the alpha prefix reference list for OHIO but all I keep getting is other states. We use cookies on this website to give you the best experience and measure website usage. If you get the plan specific alpha prefix, then the first two characters in this prefix are used to identify your plan. We're here to help (651) 662-5200 1-800-262-0820 . Claims determinationsThe plan will notify you of action taken on a claim within 30 days of the plan receiving it. REGENCE BLUE CROSS BLUE SHIELD OF OREGON - 12 Reviews - 100 SW Market Str, Portland, Oregon - Health & Medical - Phone Number - Yelp Regence Blue Cross Blue Shield of Oregon 12 reviews Unclaimed Health & Medical Write a review Add photo Photos & videos Add photo You Might Also Consider Sponsored TLC Laser Eye Centers 29 Insurance Denial Claim Appeal Guidelines. providers: We process your claim as soon as we receive them. YUV SG ON Exchange Carpenters Retirement Plan Individual Account Pension Plan Pre-Retirement Planning Your Balances & Accruals. Service not a benefit of subscriber's contract, Investigational or experimental procedure. AHW BCBS of MA ID cards for the following products and programs do not have an alpha prefix: ** Stand-alone vision and pharmacy when delivered through an intermediary model*, ** The BCBS Federal Employee Program (FEP) The letter R appears in front of the ID number.*. Blue-Cross Blue-Shield of Tennessee. AAQ Anthem BCBS of Ohio CVT Anthem Blue Cross of California Please treat these members the same as domestic Blue Plan members. Lewiston, ID 83501 . Centers of Excellence Program administered by Premera Phone: 1 (855) 784-4563 TRS: 711 Business hours: Monday through Friday 7 a.m. to 5 p.m. (Pacific), Puget Sound High Value NetworkPhone: 1 (855) 776-9503TRS: 711Business hours: Monday through Friday 7 a.m. to 7 p.m. (Pacific), UW Medicine Accountable Care NetworkPhone: 1 (888) 402-4237TRS: 711Business hours: Monday through Friday 5 a.m. to 8 p.m. (Pacific). Bellevue, WA 98004, Terms of Use | Privacy| Disclosure Notice Patient Protection Surprise Billing, An Independent Licensee of the Blue Cross Blue Shield Association Serving Select Counties in Washington. Phone: 844-380-8838, 800-863-5488 (TTY) All Blue Plans replaced Social Security numbers on member ID cards with an alternate, unique identifier. Every user of BCBS health insurance is assigned an alpha prefix that contains three letters. Sometimes an office returns a check to us that represents multiple claims because a portion (see Threshold below) of the payment may be incorrect. This standard is called the "Birthday Rule.". AFY BCBS of IL Lack of credentialing can be grounds for termination from Premeras network. To ensure prompt and accurate payment when Premera is the secondary carrier, we encourage you to send the secondary claims with the primary processing information as soon as you receive it. *Follow instructions on these ID cards to verify eligibility, submit claims and obtain health plan contact information. information. Company Description: Regence BlueCross BlueShield of Oregon provides health insurance products and other managed care services to some 750,000 members in Oregon and Washington's Clark County. We accept electronic claims through Availity using payer ID RGA01. Review our pricing disputes and appeals information to ensure you are following the correct process. What you need to know about the disease and our commitment to ensuring you have access to the right care at the right time. Regence Uniform Medical Plan Vision Claim Form - An ERISA Section 502 (a) prepare can be reported in many different methods. QAB. | CPT Codes, Descriptors, and other data only are copyright 1999 American Medical Association (or such other date of publication of CPT). note: Exclusions to paying interest may apply based on line of business. An EDI representative will review the test claims with you or your vendor. Seattle, WA 98111-9202, Back to Medical Reference Manuals overview, Espaol | ABD Blue Shield of California If you require a written refund request before mailing the overpayment, contact Calypso directly at 800-364-2991. If you bill your claims using the ANSI 837 electronic format, then you must include the Coordination of Benefits (COB) information from the primary coverage payer in your claim. Note : We have added some more prefixes in the list. All of our contracts exclude coverage for care covered under the Workers' Compensation Act. For complete plan details, seeBenefits Summaries. Regence Blue Shield in accordance with the terms of your provider contract with Regence. AAC BCBS of IL 0000009222 00000 n 10700 Northup Way, Suite 100 Be sure to submit a paper CMS-1500 claim form or electronic 837P claim form that is complete and accurately filled out. QME Retail OFF Exchange ABF Healthnow of NY Buffalo Example: 001-916-635-7373. We will continue to update this section of our website to make sure you have the latest COVID-19-related information and helpful resources. AHD BCBS of South Carolina In Washington, Premera Blue Cross and Regence BlueShield share responsibility for claims processing, customer service, and prior authorization requests based on where the patient receives the service and what kind of service was received. If there are no court decrees, the plan of the parent with custody is primary. 6:00 AM - 5:00 PM ASTFax: 877-239-3390 (Claims and Customer Service)Fax: 877-202-3149 (Member Appeals only)Fax: 866-948-8823 (FEP Care A free form note with an explanation for the corrected/replacement claim, in loop 2300 claim note as: For professional and dental claims: segment NTE01 must contain ADD and segment NET02 must contain the note, for example: NTE*ADD*CORRECTED PROCEDURE CODE (or whatever data element was corrected/changed on the claim), For facility/institutional claims: segment NTE01 must contain UPI and segment NTE02 must contain the note, for example: NTE*UPI*CORRECTED LAB CHARGES (or whatever data element was corrected/changed on the claim), Premera Blue Cross Blue Shield of Alaska Participating (Traditional/Indemnity) and Preferred/BestCare (PPO), Dimensions (HeritagePlus, HeritageSelect, or Global), Validation to ensure that they are HIPAA-compliant, Detailed claim acceptance and rejection reporting. 0000009519 00000 n Your member ID card is your key to using your medical plan benefits. Send us other carrier's explanation of benefits. 0000018992 00000 n The IQ is available in the Provider Library under Forms. Phone:800-562-1011Fax: 877-239-3390 (Claims and Customer Service)Fax: 877-202-3149 (Member Appeals)Fax: 866-948-8823 (FEP Care Management - prior auth/pre-service requests), Email: If you know which division you would like to contact, you can also reach out directly using the following phone numbers and email addresses. As a beginner to alpha prefix of BCBS at this time, you like to know about the role of the alpha prefix and how to use this alpha prefix properly. $25 will continue to accrue until it reaches that threshold or until December of each year. Provider Contact Center. These ID cards also will contain three-character alpha prefixes. Please Need help with a claim? The alpha prefix is critical for inquiries regarding the member, including eligibility and benefits, and is necessary for proper claim filing. Open 24 hours a day, 7 days a week. ), Email all EDI questions to: EDIRequests@accesstpa.com. How do I identify BlueCard Managed Care/POS members? Payments are issued under a separate voucher and mailed to the address on the original claim. All services rendered by the same provider for the same patient for the same date of service must be submitted on one claim form. DJR Anthem BCBS of Ohio If you are deaf, hard of hearing, or have a speech disability, dial 711 for TTY relay services. CVB BCBS of Florida ADJ Anthem BCBS of Missouri BCBS Provider Phone Number. Access eContracting to view and sign agreement documents. | They include a request of medical records for review. Karen Lyons, APR Sr. Director, Public Relations 612.777.5742 klyons@primetherapeutics.com. AFI BCBS of Rhode Island In these cases, please don't return the check to us. That's why Anthem uses Availity, a secure, full-service web portal that offers a claims clearinghouse and real-time transactions at no charge to healthcare professionals. Appeals rights will be exhausted if not received within the required timeframe. Calypso, our affiliate, processes refunds and overpayment requests. Deutsch | Physicians and providers may submit a proposal to modify a payment policy. 0000055776 00000 n For services not listed in the RBRVS published annually in the Federal Register, we use Optum's Essential RBRVS (previously known as Ingenix Essential RBRVS and St. Anthony's Complete RBRVS). A non-billing issue is classified as a member appeal because the financial liability is that of the member, not the provider (please refer to Chapter 6). Oregon Providers (non-contracted and contracted): If we fail to satisfy any of the above standards, commencing on the 31st day, well pay interest at a 12 percent annual rate on the unpaid or un-denied clean claim. You can also call using Skype. Eastern WA and Alaska providers submit to Premera. Availity. Washington Help Center: Important contact information for Premera Blue Cross, and Regence BlueShield. 0000006620 00000 n Use find (Ctrl + F) and enter the prefix to find the BCBS state. DJJ Horizon BCBS of New Jersey | ), Covered under the provisions of motor vehicle medical policy, personal injury protection (PIP), medical payments (Medpay), Uninsured (UIM) and/or underinsured (UM) motorist or other similar coverage (e.g., homeowners, commercial medical premises), Checks for eligibility of the member listed on the claim, Compares the services provided on the claim to the benefits in the subscribers contract, Applies industry standard claim edits and applicable payment policy criteria, Applies to professional and facility claims.
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