<>>> Consult theFEP local plan directory to find addresses and telephone numbers The members full name (the name of the employee, retiree, or dependent covered by the plan), The member ID number (starting with a W on your UMP member ID card), The name(s) of any providers involved in the issue you are appealing, A statement describing the issue and your desired outcome, A copy of the Explanation of Benefits, if applicable, or a list of the claim numbers you are appealing. Sign in An appeal for services related to the Centers of Excellence Program must be submitted within 180 days after you receive notice of the denial to Premera.Submit appeals to: Mail:Premera Blue Cross Send your claim or correspondence to the Blue Cross Blue Shield plan in the state where the laboratory work was sent for testing.Example: The lab service you used is in Arizona but the sample was sent to Nevada for analysis. We must notify you of our decision about your grievance within 30 calendar days after receiving your grievance. View our clinical edits and model claims editing. Regence bluecross blueshield of oregon claims address Premera Blue Cross Blue Shield of Alaska - FEP PO Box 33932 Seattle, WA 98133-0932 Phone: 800-562-1011 6:00 AM - 5:00 PM AST Fax: 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) Email Members: Log in or register - MyBlue Customer eService | Step 3: Next, enter your Username/Password in the appropriate fields. Phoenix, AZ 85072, Retail Pharmacy Program endobj TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m EST., Monday through Friday. Blue Cross Blue shield claim submission address | Medical Billing and Make sure you submit your complaint to the right company (see below). For prescription drug coverage, show both plan cards to the pharmacy and make sure they know which plan to bill first. Learn more about our customized editing rules, including clinical edits, bundling edits, and outpatient code editor. When you use a network provider or network pharmacy, you dont need to submit a claimthe provider or pharmacy will do it for you. Claims & payment Claims & payment Learn how to identify our members' coverage, easily submit claims and receive payment for services and supplies. For member appeals that qualify for a faster decision, there is an expedited appeal process. You can also download the appeal form and submit your written appeal by email, fax, or mail:Email: UMPMemberAppeals@regence.comFax: 1 (877) 663-7526, Mail:UMP Appeals and GrievancesRegence BlueShieldPO Box 91015Seattle, WA 98111-9115. Step 2: Next, locate the "Login" button at the top-right corner. A list of reciprocal partners as well as membership benefits can be found at lifeflight.org. If you or your dependents have other insurance, you must let UMP Customer Service and Washington State Rx Services know so claims are paid correctly. Provider Representative Contact Form - Regence 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, or sexual orientation. In every state and every community, BCBS companies are making a difference not just for our members, but For the Health of America. Many issues may be resolved with a phone call. You receive services from an out-of-network provider. All features have been transitioned to the Availity Provider Portal. Regence BlueCross BlueShield of Oregon, headquartered in Portland, has been serving Oregonians since 1941 and now provides more than 974,000 people with comprehensive health insurance solutions. Professional Services are performed by a doctor or other healthcare professional. Your budget. Call the phone number on the back of your member ID card. With a plan powered by the most trusted name in health insurance, youll have coverage tailored to your health. An appeal is an oral or written request submitted by you or your authorized representative to Regence BlueShield or Washington State Rx Services to reconsider: You or someone you authorize to represent you may request an appeal. If additional information is needed, we will send you a request. UMP may cover some supplies through the medical benefit and other supplies under the prescription drug benefit. Be on the lookout for future communications with more information about this exciting enhancement for submitting claim appeals through Availity. FAQs & Resources See your certificate of coverage for more information on how to file a claim for specific services and supplies. Coordination of Benefits, Medicare crossover and other party liability or subrogation. If the decision was after the 60-day timeframe, please include the reason you delayed filing the appeal. You have the right to make a complaint if we ask you to leave our plan. You may send a complaint to us in writing or by calling Customer Service. Regence BlueShield - FEPPO Box 31207Salt Lake City, UT 84131, (Attended sleep study at outpatient part of a hospital, home hospice, organ/tissue transplants, clinical trials. Products and networks Learn more about the products we offer and the provider networks that support them. Claims Submission Map | FEP | Premera Blue Cross Please follow Your provider should supply clinically relevant information, such as medical records for services denied based on medical necessity or for other clinical reasons. For any appeals that are denied, we will forward the case file to MAXIMUS Federal Services for an automatic second review. You should wait until the primary plan has paid to submit a secondary claim to UMP, unless the primary plan's processing of the claim is delayed. Regence Lewiston, ID Office | Glassdoor If services were rendered in New York or Pennsylvania, then use the state-specific file address PDF. Learn more on the HCA website. PO Box 91102Seattle, WA 98111-9202. If your prescribing physician asks for a faster decision for you, or supports you in asking for one by stating (in writing or through a phone call to us) that he or she agrees that waiting 72 hours could seriously harm your life, health or ability to regain maximum function, we will give you a decision within 24 hours. . x][o%~`C?3=k7A I87ggglM"_Unx9d,*Wdx cwU74/_C&$jTD/ew|/_t_~suJo~/X7/fTjz=u?|1w_k;vZ]!w??!~pw!cw DG6JOw{v?M.>~h9{/|0 _&CrOL%be_/WWc9U~;?#*bX Fz-w~7`e_ :5ZmLme'UFSgs\\@=~!r)Q;ZDf}Z1^W8qw`v0]wcEo5tLBn-4%x\I[s$8eBM:)$2dY9s>E;& 3. Regence BlueCross BlueShield of Oregon offers health and dental coverage to 750,000 members throughout the state. Learn about electronic funds transfer, remittance advice and claim attachments. Portugus | If you have questions about submitting a claim for services outside the U.S., call UMP Customer Service. You can submit a marketing complaint to us by calling the phone number on the back of your member ID card or by calling 1-800-MEDICARE (1-800-633-4227). You can also get information and assistance on how to submit a written appeal by calling the Customer Service number on the back of your member ID card. Oregon - Blue Cross and Blue Shield's Federal Employee Program Make sure you have your Member ID card handy when you call us. 2023 Regence health plans are Independent Licensees of the Blue Cross and Blue Shield Association serving members in Idaho, Oregon, Utah and select counties of Washington. Recommended Reviews. Please reference your agents name if applicable. Were proud to stand with you during this challenging time. See "Appeals related to eligibility" section of your plan's. Instructions: 1. We offer the option to subscribe to receive the following communications via email: Subscribe to receive an email when new editions of the provider newsletters are available. Din kehji k'eyeedgo, t' shdi k anidaalwoi bi bsh bee hane ninaaltsoos bee atah nilinigii bined bik. Out-of-network providers may submit a claim on your behalf. Step 4: After you have completed the login details correctly . UMP medical plans are administered by Regence BlueShield. 4 0 obj The following information must appear on the provider's itemized bill for the plan to consider the claim for payment: a. claim was denied or 30 months for claims subject to coordination of benefits. (Note: Claims received with an ICD-9 code will be rejected with a notice to re-bill using ICD-10.) We will accept verbal expedited appeals. Regence BlueCross BlueShield of Utah is an independent licensee of the Blue Cross and Blue Shield Association. Though it is not required, you may want to include the UMP Appeals and Grievance form (for medical services) or the Washington State Rx Services Complaint and Appeal Form (for prescription drugs) with your appeal. Premera Blue Cross Blue Shield of Alaska - FEP PO Box 33932 Seattle, WA 98133-0932 Phone: 800-562-1011 6:00 AM - 5:00 PM AST Fax: 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) Email Members: Log in or register - MyBlue Customer eService Regence BlueCross BlueShield of Utah Box 999Appleton, WI 54912-0999Fax: 1 (855) 668-8550. Appropriate staff members who were not involved in the earlier decision will review the appeal. Open 24 hours a day, 7 days a week. %PDF-1.5 If you have any questions about specific aspects of this information or need clarifications, please email press@bcbsa.com . Learn more about global periods, modifiers, virtual care, unlisted codes and NCCI bypass modifiers. Please use the comment section for additional information. REGENCE BS OF WASHINGTON. the instructions to determine where to send claims or correspondence. Regence BlueCross BlueShield of Oregon MAXIMUS Federal Services is a contracted provider hired by the Center for Medicare and Medicaid Services (also known as CMS) and has no affiliation with us. If you are a member of another air ambulance's membership program that is a reciprocal partner of Life Flight Network, please make sure you report this to our billing office at (866) 883-9998. See how our affordable Regence plans offer coverage, access and convenienceso you can live your best. Complete the Prescription Drug Claim Form and send it with your pharmacy receipts to: Pharmacy Manual ClaimsP.O. For information on false claims, see False claims or statements in your certificate of coverage. Step 1: Start your internet browser, and then go to the official regence bluecross blueshield of oregon address website. PDF State Mail to Mailing Address City, State Zip If we must request additional information, the processing of your claim may be delayed. Lastupdated01/23/2023Y0062_2023_M_MEDICARE. Box 890179 Camp Hill, PA 17089 2023 Regence health plans are Independent Licensees of the Blue Cross and Blue Shield Association serving members in Idaho, Oregon, Utah and select counties of Washington. Customer Service will help you with the process. If your primary plan uses a different mail-order pharmacy, you will have to use your primary plans mail order pharmacy and then submit a claim to Washington State Rx Services. Read the "Guidelines for prescription drugs UMP covers" section of your certificate of coverage for details. When the plan is the primary payer (pays first), UMP pays its normal benefit as described in the certificate of coverage. Is this your business? Regence bluecross blueshield of oregon address BCBS State by State | Blue Cross Blue Shield Coordination of Benefits or Other Party Liability . If you have any questions about your member appeal process, call our Customer Service department at the number on the back of your member ID card. Follow the prompts to submit your claim online. 2023 Regence health plans are Independent Licensees of the Blue Cross and Blue Shield Association serving members in Idaho, Oregon, Utah and select counties of Washington. Regency Blue Cross Blue Shield Of Oregon (541) 772-8906 Visit Website Map & Directions 2057 Commerce Dr Medford, OR 97504 Write a Review. <> Learn about Regence Lewiston, ID office. An appeal is a request from a member, or an authorized representative, to change a decision we have made about: Other matters included in your plan's contract with us or as required by state or federal law, Someone who has insurance through an employer, and any dependents they choose to enroll. Coverage decisionsA coverage decision is a decision we make about what well cover or the amount well pay for your medical services or prescription drugs. For questions about appeals, call the SEBB Appeals Unit at 1 (800) 351-6827. To obtain information on the aggregate number of grievances, appeals and exceptions filed with the plan contact Customer Service. Regence BlueCross BlueShield of Oregon hiring Trainer I in Medford If you have questions, contact Premera at 1 (855) 784-4563 (TRS: 711) Monday through Friday 7 a.m. to 5 p.m. (Pacific). Use the link below to find your local BCBS company's website. Regence BlueCross BlueShield of Oregon. 1-800-962-2731. stream Coding toolkit View our clinical edits and model claims editing. Please note: This form is to be used by physicians, other professional providers or medical facilities to contact their assigned provider relations representatives. P | Box 1106Lewiston, ID 83501-1106 Fax: 1 (877) 357-3418 If you have questions about submitting a claim for services outside the U.S., call UMP Customer Service. 2003 Western Ave # 600, Regence BlueCross BlueShield Medicare Advantage Plans in Oregon Blue Cross Blue Shield Association (BCBS, BCBSA) is a federation, or supraorganization, of, in 2022, 34 independent and locally operated BCBSA companies that provide health insurance in the United States to more than 115 million people. Find forms that will aid you in the coverage decision, grievance or appeal process. Join us! complies with applicable Federal and Washington state civil rights laws, Determine the county where the service was performed* (see exceptions below). The plan will decide on your expedited appeal within 72 hours of the request. Learn more about billing and how to submit claims to us for payment, including claims for BlueCross and BlueShield Federal Employee Program (BCBS FEP) members. Follow the steps below to submit your claim online. Were empathetic, reliable and tenacious, too. PDF Member Reimbursement Form Waiting too long on the phone, waiting room, in the exam room or when getting a prescription, The length of time required to fill a prescription or the accuracy of filling a prescription, Access to health care benefits, including a pre-authorization request denial, Claims payment, handling or reimbursement for health care services, A person who has bought insurance for themselves (also called a contract holder) and any dependents they choose to enroll. Dissatisfaction with service provided by the health plan. Care Management Programs. Make sure Costco Mail Order Pharmacy or PPS has the information for both plans and knows which plan is primary. Rocketreach finds email, phone & social media for 450M+ professionals. Contact informationMedicare Advantage/Medicare Part D Appeals and GrievancesPO Box 1827, MS B32AGMedford, OR 97501, FAX_Medicare_Appeals_and_Grievances@regence.com, Oral coverage decision requests1 (855) 522-8896, To request or check the status of a redetermination (appeal): 1 (866) 749-0355, Fax numbersAppeals and grievances: 1 (888) 309-8784Prescription coverage decisions: 1 (888) 335-3016. Premera Blue Cross Blue Shield of Alaska FEP PO Box 33932 Seattle, WA 98133-0932, Phone:800-562-1011 Completion of the credentialing process takes 30-60 days. You may need to submit your own claim if you buy drugs at a non-network pharmacy, dont show your ID card, or have other prescription coverage that pays first and UMP is secondary. Send your claim or correspondence to the Blue Cross Blue Shield plan in the state where the ambulance picked up the patient.Example: An ambulance picks up the patient in Oregon and transports her to a care facility in Washington. They are also available outside these hours with limited services. Franais | Appeal form (PDF): Use this form to make your written appeal. Be sure to include any other information you want considered in the appeal. Ting Vit | Blue Cross and Blue Shield of Nevada will process the claim. Get 5 free searches. Choose the right company to process your complaints and appeals: To appeal online, sign in to your Regence account, select Programs & Resources, and select Appeals. Regence BlueShield of Idaho. Select a State. Para asistencia en espaol, por favor llame al telfono de Servicio al Cliente en la parte de atrs de su tarjeta de miembro. Excluded pharmacies are pharmacies that have been excluded due to fraud, waste, or abuse.
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