BCBS Company. Uniform Medical Plan (UMP) offers you five different health plans through Washington state's Public Employees Benefits Board (PEBB). We regularly update (at least quarterly) our claims editors to keep pace with changes in medical technology, as well as CPT codes, HCPCS codes, and ICD-10-CM/PCS Diagnosis and Procedure code changes, standards, and complexities. Please review the terms of use and privacy policies of the new site you will be visiting. BCBS Provider Phone Number. | The total number of characters in the members ID ranges from six to fourteen. Be sure information lines up correctly within the respective fields (data that overlaps another field/box cannot be read accurately). All other related costs incurred by the parties shall be the responsibility of whoever incurred the cost. How to Submit a Claim - FEP Blue Complete the enrollment form on the following page to receive 835 ERA files from Regence payers . Regence Provider Appeal Form. How do I determine if a diagnosis or procedure code needs preauthorization? YDO Retail OFF Exchange Congestive Heart Failure. Church Street Station. Fax: 801-333-6523 (Mark claims: Attn New Claims) Email: Log in or register - MyBlue Customer eService. Before discussing member claim information, the Customer Service representative must verify the identity of the caller. 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. Web: Regence BlueShield. Send to Regence Blue Shield in accordance with the terms of your provider contract with Regence. Please review the terms of use and privacy policies of the new site you will be visiting. Correspondence. Uniform Medical Plan (UMP) | Washington State Health Care Authority 0000125980 00000 n DKC BCBS of Texas Email: Medicare/Medicaid: PRmedicaremedicaid@bcidaho.com. We'll process the claim after we receive that information. Kreyl Ayisyen | Boise, ID 83707. AES BCBS of Alabama 4. BET PA BC PA, 120 Fifth Ave , Pittsburgh , PA , 15222-3099 412-544-7000, BFM PA BC PA Highmark, POB 176 , Pittsburgh , PA , 15230-0176 866-316-6339, BGH AL BCBS of Alabama, POB 995 , Birmingham , AL , 35298 205-988-2213, BGP MI BC MI, POB 1618 , Detroit , MI , 48231 800-462-7237, BHP PA BC PA, POB 778988 , Harrisburg , PA , 17177-8988 800-222-3341, BIM MI BC MI, POB 1618 , Detroit , MI , 48231 800-462-7237, BMI IN BCBS of Indiana, 120 Monument Circle , Indianapolis , IN , 46204 317-488-6000, BOG MI BC MI, POB 1618 , Detroit , MI , 48231 800-462-7237 Regence BlueCross BlueShield of Oregon | OneHealthPort All the contents and articles are based on our search and taken from various resources and our knowledge in Medical billing. Appeals rights will be exhausted if not received within the required timeframe. Does not determine the reimbursement dollar amount for any particular service (reimbursement is specific to the provider applicable fee schedule). 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 You may request to have a customer service representative call you at a scheduled time during normal business hours for plan help. Tagalog | To make tracking patient reimbursement easier, we can include these account numbers on our payment vouchers. ABL BCBS of IL 0000013357 00000 n Designed by Elegant Themes | Powered by WordPress. To help you move from paper to electronic claims, follow these steps: Electronic claims can be sent when we are the secondary insurance payer. Box 22999 Rochester, NY 14692 *New York *The Buffalo office handles the receipt of claims and correspondence for BS The three characters preceding the subscriber identification number on BCBS member ID cards. hb``d``3g`c`P`eb@ !GCPI+""hr^eA ewJ?hx2-H IM:^7I,y ZPPTP J ! X,/ !q77p0P&{'LYr000 If you are unsure how to submit secondary claims electronically, contact your practice management system vendor or contact an EDI representative at 800-435-2715. Policy #s: Regular10017241-0001, Transit10017241-0004, Sheriff10017241-0016, Chinook Building When we process a claim, we coordinate benefits if the member has other primary coverage from another carrier, our health plan, service plan, or government third-party payer. 1-800-962-2731. Benefits are not available through us until the first-party carrier has exhausted, denied, or stopped paying due to its policy limits. 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. 0000004829 00000 n CVQ BCBS of Georgia BCBS Provider Phone Number. P | CUP CBA BLUE (BCBS VT) Karen Lyons, APR Sr. Director, Public Relations 612.777.5742 klyons@primetherapeutics.com. Contact us - Regence All Rights Reserved to AMA. DKB Highmark BCBS Payment of this claim depended on our review of information from the provider. AHC Anthem BCBS of Missouri Email: Contact Regence. ADG Anthem BCBS of Ohio Applicable to facility claims only - reflects the APG code, DRG code, or room type that may relate to the reimbursement amounts. Blue cross Blue Shield association cannot accept Guest Membership claims electronically. DAC BCBS of Tennessee CVK BCBS of Florida 0000056226 00000 n DJF Anthem BCBS of Virginia Claims submission Learn more about billing and how to submit claims to use for payment. Generally, if the court decrees financial responsibility for the child's healthcare to one parent, that parent's health plan always pays first. Review our pricing disputes and appeals information to ensure you are following the correct process. BCBS Provider Phone Number. In these cases, please don't return the check to us. For more information, view our privacy policy. Tricare Phone Number and Claim Address; Molina Healthcare Phone Number claims address of Medicare and Medicaid. 0000012556 00000 n . Mail this claim to: Regence BlueShieldPO Box 1106Lewiston, Idaho 83501 Or Fax claim to: (888) 606-6582 FORM PD020-WA Page 2 of 3 (Eff. ACS BCBS of IL Federal Employee Program Overseas Claims P.O. Premera Blue Cross complies with applicable federal and Washington state civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, gender identity, Regence BlueShield of Idaho P. O. DJK Empire BCBS You can also use the Office of Financial Management MyPortal to update your address. Note: When submitting an email inquiry, please include your tax identification number (TIN) and/or Organizational NPI number. Disclosure Notice Patient Protection Surprise Billing, 270/271 Eligibility inquiry and response, 278 Referral certification and authorization, 837 Claims and encounters (P, D, and I). APT DE BC DE, POB 8830 , Wilmington , DE , 19899-8830 800-342-2221 On the other hand, the third character in the prefix is used to find out the product type you have enrolled in. Washington Help Center: Important contact information for Premera Blue Cross, and Regence BlueShield. The claim(s) will suspend and a processor will review to determine whether to send an Incident Questionnaire (IQ) to the member. Refer to your contract for further claims submission information. Deutsch | Washington contracted providers: We process your claims as soon as we receive them. However we have some guide to follow, using prefixes we could find the state of the BCBS and contact phone number to proceed further. AGH Anthem Blue Cross of California DJQ Anthem Blue Cross of California 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. 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. The NPI replaces all proprietary (payer-issued) provider identifiers, including Medicare ID numbers (UPINs). We recommend that you make copies of everything that is submitted for your personal records. DJY Anthem BCBS of Ohio national customer service numbers at fepblue.org, Espaol | CZY BCBS of North Carolina If you feel some of our contents are misused please mail us at medicalbilling4u at gmail dot com. ACL Anthem Blue Cross of California Access fee schedules. BCBS Prefix List 2021 - Alpha. Check out the changes and updates to our plan in 2023. Unclean claims will begin to accrue interest on the 16th day 0000000016 00000 n Bill all original lines-not including all of the original lines will cause the claim to be rejected. The provider needs to submit itemized charges to us. complies with applicable Federal and Washington state civil rights laws, Determine the county where the service was performed* (see exceptions below). QAA. When the member completes and returns the IQ form to Calypso Subrogation department, a representative will screen the document to determine if another party is responsible for processing claims prior to the health carrier stepping in. ACA BCBS of Alabama BCBS Prefix List QAA to QZZ - Alpha Lookup by State 2022 Ideally, we'd like you to submit claims within 60 calendar days of the covered services, but no later than 365 calendar days from the date of submission. Regence BlueCross BlueShield of Utah is an independent licensee of the Blue Cross and Blue Shield Association. Learn more about global periods, modifiers, virtual care, unlisted codes and NCCI bypass modifiers. Some members may carry outdated identification cards that may not have an alpha prefix. CUW Anthem Blue Cross of California We will notify you once your application has been approved or if additional information is needed. Call Customer Service and choose the Pharmacy option. January 19, 2022 by tamble. Subrogation permits the plan to recover payments when the negligence or wrongdoing of another causes a member personal illness or injury. BCBS Prefix List PAA to PZZ - Alpha Lookup by State 2022 The main identifier for out-of-area members is the alpha prefix. ADM BCBS of IL Claims determinationsThe plan will notify you of action taken on a claim within 30 days of the plan receiving it. Prescriptions. Claims and clinical appeals address: PO Box 21702 Eagan, MN 55121 Care management Phone: 844-996-0329 Fax: 888-302-9325 2023 holiday closures January 2 May 29 July 4 September 4 November 23 November 24 December 25 We will response ASAP. Claims & payment Claims and payment Learn how to identify our members' coverage, easily submit claims and receive payment for services and supplies. Electronic claims without a TIN are rejected as incomplete. Saturday and Sunday 6 a.m. to 2 p.m. (Pacific), HealthEquityOnline: HealthEquityPhone: 1 (844) 351-6853TRS: 711Business hours: 24 hours, 7 days a week, Vision Service PlanOnline: Your vision accountPhone: 1 (844) 299-3041Deaf, DeafBlind, Late Deafened and Hard of Hearing members call: 1-800-428-4833Business hours: Monday through Friday 5 a.m. to 8 p.m. (Pacific). An EDI representative will review the test claims with you or your vendor. AFK Empire BCBS Regence Blue-Cross Blue-Shield: PDS: Maryland/District of Columbia/Northern Virginia: Carefirst Blue-Cross Blue-Shield: PDT: Pennsylvania: AAX Anthem Blue Cross of California Enter a ZIP code in that box. To send an electronic claim, use the Availity clearinghouse with payer ID RGA01. Contact us - Regence For Example: XYZ123456789. 0000001240 00000 n ADC BCBS of IL Regence BlueCross BlueShield of Oregon | Regence | The 2015 member identification prefixes for individual Medicare Advantage plans are listed below. *Follow instructions on these ID cards to verify eligibility, submit claims and obtain health plan contact information. Special Message: Coming soon, you will be able to dispute (appeal) a claim on Availity from the claim status result page. However, there are some exceptions. We can process the claim after we receive that information. AFS Blue Shield of California 0000018383 00000 n You have to bear in mind that the alpha prefix has three letters usually followed by the identification of member of BCBS. 10700 Northup Way, Suite 100 Use search function and put your comment any alpha prefix not found here. This is a duplicate of a previously denied claim. It is important to file a claim with all insurance companies to which the member subscribes. We can't process this claim until the incident questionnaire we sent the member is fully completed, signed and returned. Tricare Phone Number and Claim Address; Molina Healthcare Phone Number claims address of Medicare and Medicaid. The earlier you submit claims, the earlier we process them. Box 105557. See our FAQs for more claim information and contacts. DJM BCBS of Texas CZU Anthem Blue Cross of California Open 24 hours a day, 7 days a week. Correct Mailing Address for Federal Employee Program Paper Claims and In third-party cases, this provision permits the plan to recover the medical bill costs on behalf of the member. CUR Healthnow of NY Buffalo If you are outside the U.S. and need to find a local provider, make an appointment or be hospitalized, call Blue Cross Blue Shield Global Core at 1-800-810-2583 or call collect at 1-804-673-1177, 24 hours a day, 7 days a week. We can process the claim after we receive that information. <<1CC62891B116FE488EB50D904D0BD9AE>]/Prev 176800/XRefStm 1570>> Prefix Tool. If we cannot resolve the matter through non-binding mediation, either one of us may institute an action in any Superior Court of competent jurisdiction. BlueCard/FEP Lookup | Blue Cross of Idaho - bcidaho.com CWR Anthem Blue Cross of California Before implement anything please do your own research. Provider: please send us the member's lab results for this claim. ABQ Blue Cross of Idaho (Boise) UMP medical plans are administered by Regence BlueShield. Be on . YDZ SG OFF Exchange AEG Anthem BCBS of Ohio If you are aware about the bcbs alpha prefix of your health insurance, then you can get the desired support on time for claiming the insurance. ABK Carefirst BCBS Maryland Attach a completed Corrected Claim - Standard Cover Sheet.. ADI Anthem Blue Cross of California AAS Anthem Blue Cross of California Franais | Contact us - Regence 0000004716 00000 n We are unable to quote a benefit by a diagnosis or procedurecode. A comprehensive list is posted in the Library under Reference Info. Below you will find a list of the 2015 BCNEPA plans with the corresponding Highmark Blue Cross Blue Shield plans for 2016. Italiano | We haven't received the information. Pay or deny 95 percent of a provider's monthly clean claims within 30 days of receipt; and. CZJ Premera Blue Cross of Washington DJC Anthem BCBS of Ohio The plan mailing addresses are available on our website under Contact Us. Regence Blue Shield of Idaho - FEPPO Box 30270Salt Lake City, UT 84131-0207. AAK Anthem Blue Cross of California View the toolkit Claims submission AFG BCBS of Nebraska Visit the Regence provider website, regence.com to learn more about: Claims and payment: Appeals. Claims & payment - Regence 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: We can process the claim after we receive that information. Regence Uniform Medical Plan Vision Claim Form - An ERISA Section 502 (a) prepare can be reported in many different methods. Do not make up alpha prefixes or assume that the members ID number is the Social Security Number. Sometimes an office returns a check to us that represents multiple claims because a portion (see Threshold below) of the payment may be incorrect. DJE BCBS of Alabama Media Contact: Lou Riepl Regence BlueCross BlueShield of Utah Regence BlueShield of . 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. contracted): If we fail to satisfy any of the above standards, commencing on the 31st day, well pay interest at a 15 percent annual rate on the unpaid or un-denied clean claim. Box 31 Enter the physician or providers name that performed the service. Only a member can request a Level I or Level II Appeal for a non-billing issue, unless the member has completed a release to allow the provider to act as their Representative. Please provide a detailed description of the service being provided and the code to a member of our Customer Care Team at 1-866-738-3924 and they will provide you with an accurate benefit quote. DAD Anthem BCBS of Ohio ), Charges billed by physician/provider at a line item level, Amount allowed for service at a line item level, Adjudication explanation code(s) at a line item level and claim level (if applicable), Printed at the end of each claim, the line items are summed and an asterisk indicates the claim total line, Less Paid to Codes Listed as S or C, The sum of the claim total Payable Amounts which have a PD TO code of S or C, The sum of any amount withheld and applied to a prior refund or recovery. The National Uniform Claim Committee (NUCC) has developed a 1500 Reference Instruction Manual detailing how to complete the claim form to help nationally standardize how the form is completed. Once we accept your level II appeal, we will respond within 15 days in writing or a revised Explanation of Payment. 0000018816 00000 n CZB Wellmark BCBS Iowa/South Dakota CVG BCBS of Florida It is critical for confirming a patients membership and coverage. You can use Availity to submit and check the status of all your claims and much more. AEF BCBS of IL Contact Us | BCBSMN - Blue Cross MN Regence Blue Shield in accordance with the terms of your provider contract with Regence. Regence Health Plans, Prime Therapeutics study shows significant Precertification remains the responsibility of the provider for all Empire HMO network members. When two or more health plans cover a member, COB protects against double or over-payment. 10/18) v2. Members and Providers: 1-800-395-1616 Email Us. 0000018650 00000 n 0000015026 00000 n BCBS Prefix List HAA to HZZ - Alpha Lookup by State 2022 1-800-423-1973. CMS also uses RVUs to allocate dollar values to each CPT or HCPCS code. 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. We will notify you once your application has been approved or if additional information is needed. We abide by the following COB standards to determine which insurance plan pays first (primary carrier) and which pays second (secondary carrier). CYP BCBS of IL Postal Prescription ServicesOnline: Your PPS accountPhone: 1 (800) 552-6694TRS: 711Fax (for providers only): 1 (800) 723-9023Business hours: Monday through Friday 6 a.m. to 6 p.m. and Saturday 9 a.m. to 2 p.m. (Pacific), Ardon HealthPhone: 1 (855) 425-4085TRS: 711Fax (for providers only): 1 (855) 425-4096Business hours: Monday through Friday 8 a.m. to 7 p.m. and Saturday 8 a.m. to 12 p.m. (Pacific), Online: Medicare or MyMedicarePhone: 1 (800) MEDICARE (1-800-633-4227)TTY: 1 (877) 486-2048. To send an electronic claim, use the Availity clearinghouse with payer ID RGA01. xref Phoenix, AZ 85072, Retail Pharmacy Program 0000009222 00000 n AHB Anthem BCBS of Ohio All people who have BCBS health insurance policy have to make copies of their ID front and back and keep such records on hand. 0000004073 00000 n 0000055046 00000 n ALN PA BC PA, Highmark, POB 1210 , Pittsburgh , PA , 15230 800-433-9906 Tricare Phone Number and Claim Address; Molina Healthcare Phone Number claims address of Medicare and Medicaid. You can make a complaint verbally to Customer Service or in writing to Customer Service Correspondence. To do so, please submit the proposal in writing to your assigned Provider Network Executive (PNE) or Provider Network Associate (PNA). Box 7408. Here are common reasons why claims suspend or reject: Contact Customer Service with questions regarding claims processing or send a copy of the voucher highlighting the claim in question and the inquiry reason. CPT Codes, Descriptors, and other data only are copyright 1999 American Medical Association (or such other date of publication of CPT). Please reach out and we would do the investigation and remove the article. Practitioners who arent credentialed may have their claims returned until they submit a complete credentialing application. If Workers' Compensation denies payment of such claims, Premera will pay according to the subscriber's contract benefits after receiving a copy of a valid denial. Regence Blue-Cross Blue-Shield: YAM-Unallocated/Not Assigned: YAN-Unallocated/Not Assigned: YAO-Unallocated/Not Assigned: YAP: Minnesota: $25 will continue to accrue until it reaches that threshold or until December of each year. Doing so may cause delays in the handling of your inquiries and claims. 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. We also apply the following Prompt Pay standards set by the Oregon Insurance Division to our claims adjudication process in order to: A clean claim is one that has no defect or impropriety, including any lack of any required substantiating documentation, or particular circumstances requiring special treatment that prevents timely payments from being made on the claim. CVJ BCBS of Florida ** Remember: Member ID numbers must be reported exactly as shown on the ID card and must not be changed or altered. Verify benefits or eligibility for BlueCard members. 7:00 AM - 6:00 PM PSTFax: 877-239-3390 (Claims and Customer Service)Fax: 877-202-3149 (Member Appeals only)Fax: 866-948-8823 (FEP Care If we processed the original claim incorrectly, you do not need to rebill. 0 Eastern WA and Alaska providers submit to Premera. P.O. Our Customer Care lines will re-open at 6 AM PT the following business day. ABC BCBS of Alabama Blue Cross and Blue Shield of Illinois P.O. To speed claims processing, we use document imaging and optical character recognition (OCR) equipment to read your claims. 0000008616 00000 n CVS Caremark. Box 260070 Pembroke Pines, FL 33026 . Contact us for health care providers Contact us for healthcare providers. When completing the CMS-1500 form, note the following: HIPAA's Administration Simplification provision requires a standard unique identifier for each covered healthcare provider (those that transmit healthcare information in an electronic form in connection with HIPAA-standard claim transactions). When dependent children are double-covered by divorced parents, coverage depends on any court decrees. View your credentialing status in Payer Spaces on Availity Essentials. In box 22 on the CMS-1500 Claim form, enter the appropriate bill frequency code, left justified in the left hand side of the field. 553 46 DJJ Horizon BCBS of New Jersey DJW Wellmark BCBS Iowa/South Dakota Franais | 1-800-962-2731. Idaho Regence BlueShield of Idaho PO Box 31603 Salt Lake City, UT 84131 Illinois BlueCross BlueShield of Illinois PO Box 1364 Chicago, IL 60690 Find the correct address listed under the type of service received (see explanation). Heres everything you need to know about it.