The charges for this service have been combined into the primary procedure based on the provider's contract. Once you have signed in, simply click on the Authorizations on the top menu and you will be able to submit your preauthorization request. 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. Contact Us - Uprise Health A member is primary on the plan in which he/she is the subscriber versus the plan in which he/she is a dependent. CYP BCBS of IL Polski | 02/16/2023 Retirement Workshop in Lacey on Feb. 18. . You may like to substitute any prefix of BCBS with an existing BCBS. For Providers | Regence Group Administrators | Healthcare Benefits Availity. RBRVS is a method of reimbursement that determines allowable fee amounts based on established unit values as set norms for various medical and surgical procedures, and further based on weights assigned to each procedure code. AGT Blue Shield of California You can get the standardized coverage from this health insurance plan all through the nation. BCBS Provider Phone Number. We require that you verify the information about your practice and the networks you participate in at least every 90 days. Box 7408. LAA. ), claims will be processed accordingly and under the terms of our subscriber's contract. If it is, call the BlueCard Eligibility line 800-676-BLUE (2583) to verify the ID number. Below is a list of the old and new alpha prefix codes. We also apply the following prompt pay standards set by Washington's Office of the Insurance Commission to our claims adjudication process in order to: If the above standards are met, the regulation does not require interest for those individual claims paid outside of the 95 percent threshold. Regence There is no charge to healthcare providers who submit electronic claims directly to us. Lewiston, ID 83501 . The maximum limit has been met for this benefit. The Identification cards will include: ** The three-character alpha prefix at the beginning of the members ID number CUZ Anthem BCBS of Ohio ABU BCBS Minnesota AEC BCBS of IL Benefits are not available through us until the first-party carrier has exhausted, denied, or stopped paying due to its policy limits. 0000018650 00000 n Access eContracting to view and sign agreement documents. CUW Anthem Blue Cross of California View your credentialing status in Payer Spaces on Availity Essentials. Care Management Programs. 0000006620 00000 n CZW BCBS of North Carolina 0000014956 00000 n You could download the full BCBS prefixes list is here. Type forms in black ink (handwritten forms cannot be read by OCR equipment). AFI BCBS of Rhode Island Need help with a claim? Members and Providers: 1-800-395-1616 Email Us. CZV BCBS of Alabama If your request for mediation is timely, both parties must agree upon a mediator. The protection of your privacy will be governed by the privacy policy of that site. We will continue to update this section of our website to make sure you have the latest COVID-19-related information and helpful resources. This member wasn't eligible for services on the date of service. They have Coordination of Benefits when we are the secondary carrier on the claim. | 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 Tricare Phone Number and Claim Address; Molina Healthcare Phone Number claims address of Medicare and Medicaid. Media Contact: Lou Riepl Regence BlueCross BlueShield of Utah Regence BlueShield of . Mail the overpayment amount to our finance department (address on check) along with a completed Refund Request form, or. AEQ BCBS of Michigan There are three separate components that affect the value of each medical service or procedure: RVUs are assigned to each of these components. . AAS Anthem Blue Cross of California 0000015111 00000 n You can learn more about credentialing by visiting the provider section of our website. This is worthwhile to avoid selecting the alpha prefix randomly. 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). 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). (If no account number is assigned, the words No Patient Account # are noted. 1fcZi=s6Z@n7;W^ugC:CGLi@0^pQY4#o0 y>_ All Rights Reserved to AMA. . from receipt of the information. We use cookies on this website to give you the best experience and measure website usage. DJQ Anthem Blue Cross of California AGL Premera Blue Cross of Washington The following are examples of ID numbers with the alpha prefix highlighted: Note : Guest members do not have an alpha prefix. CZF BCBS of Rhode Island Find Contact Information. Make sure you have your Member ID card handy when you call us. PDF State Mail to Mailing Address City, State Zip - Pnnl Use 8 to void a claim billed in error, The initial claim number (in loop 2300, REF01 must contain F8 and REF02 must contain the claim number). APT DE BC DE, POB 8830 , Wilmington , DE , 19899-8830 800-342-2221 You can find a claim by the members ID number or by the claim number. Before implement anything please do your own research. AGB Excellus BCBS AFS Blue Shield of California If the card presented has no alpha prefix, follow the instructions on the back of the ID card for inquiries and claim handling. AFM BCBS Minnesota If you need more information about the NPI mandate, Medicare timelines, and/or the enumeration process, visit the CMS website. Mailing address: Blue Cross of Idaho. ), Email all EDI questions to: EDIRequests@accesstpa.com. DJK Empire BCBS 24/7 anonymous hotline: 1 (800) 323-1693 0000008298 00000 n Claims & payment Claims and payment Learn how to identify our members' coverage, easily submit claims and receive payment for services and supplies. DJR Anthem BCBS of Ohio Paid to refers to the payee code (where the check was sent/issued) and is listed only in the claim total or subtotal line (e.g., G = Provider Group). Discover all the ways members can earn wellness incentives and rewards for taking an active role in their health. When a Medicare patient received services that Medicare specifically requires to be submitted on separate claim forms, this one claim requirement will not apply. Contact Provider Relations | Blue Cross of Idaho - bcidaho.com . (Field not populated for CMS-1500 claims. endstream endobj 597 0 obj <>/Filter/FlateDecode/Index[30 523]/Length 41/Size 553/Type/XRef/W[1 1 1]>>stream UMP Customer ServicePhone: 1 (888) 849-3681 TRS: 711 Business hours: Monday through Friday 5 a.m. to 8 p.m. and Saturday 8 a.m. to 4:30 p.m. (Pacific)Chat Live: Sign in to your Regence account Monday through Friday 7 a.m. to 5 p.m. (Pacific) to access chat live. CVZ Horizon BCBS of New Jersey The plan mailing addresses are available on our website under Contact Us. The Prefix tool determines where you should submit a medical claim, either Blue Cross of Idaho or Regence Blue Shield of Idaho, based on an prefix. DAC BCBS of Tennessee AGS Anthem Blue Cross of California The ID cards also may have: Eastern WA and Alaska providers submit to Premera. DJN BCBS Minnesota We can process the claim after we receive that information. Pension & Retirement. CVP Anthem BCBS of Ohio Your member ID card is your key to using your medical plan benefits. Claims All services rendered by the same provider for the same patient for the same date of service must be submitted on one claim form. You have five UMP medical plan options: UMP Classic. | 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). Thank you for choosing Regence as your health plan administrator. For most plans, we'll deny claims received more than 12 months after the date of service with no member responsibility. ALR AR BC AR, PO Box 2181 , Little Rock , AR , 72203-2180 888-847-1400, AMU RI BCRI, 444 Westminister St , Providence , RI , 02903-3279 401-831-7300, AMZ KY BC KY, POB 37690 , Louisville , KY , 40233 800-925-0135, AON IL BC IL, POB 1364 , Chicago , IL , 60690 800-972-8088, APT DE BC DE, POB 8830 , Wilmington , DE , 19899-8830 800-342-2221 ), 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 Calypso, our affiliate, processes refunds and overpayment requests. 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. BRH TX BCBS of TX, POB 655730 , Dallas , TX , 75265-5730, BRI MA BC MA, PO Box 9198 , N Quincy , MA , 02171-9198 800-451-8123, BRV MI BC MI, PO Box 166 , Detroit , MI , 48231-0166 800-249-5103, BUR Indemnity CNY PO Box 4809 , Syracuse , NY , 13221 315-448-3735, We cant decide Blue cross Blue shield members state just by looking first alpha prefix. You can reach Customer Service by calling 877-342-5258, option 2. Send us other carrier's explanation of benefits. Identifying members Easily identify the kind of coverage our members have. State Lookup. the instructions to determine where to send claims or correspondence. The preferred process for submitting corrected claims is to use the 837 transaction 0000004968 00000 n All people who have BCBS health insurance policy have to make copies of their ID front and back and keep such records on hand. We're here to help (651) 662-5200 1-800-262-0820 . 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 They include a request of medical records for review. CWN Carefirst BCBS Washington DC 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: For Providers | Regence Group Administrators | Healthcare Benefits ABW Anthem BCBS of Virginia This prefix is the part of the distinctive identification number. Call customer service and web support at 800-607-0546 between 8 a.m. and 6 p.m., Monday through Friday, Pacific Time. Many offices assign their own account numbers to patients. Box 22999 Rochester, NY 14692 *New York *The Buffalo office handles the receipt of claims and correspondence for BS CZO Anthem BCBS of Ohio 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. Insurance Denial Claim Appeal Guidelines. UMP medical plans are administered by Regence BlueShield. Uniform Medical Plan - Benefits The dates-of-service (to and from - also referred to as beginning and ending dates) at a, The code/modifier shown in box 24D of the CMS-1500. 0000055776 00000 n Remember to include the leading three-character prefix and enter it in the appropriate field on the claim form. Tennessee. CWI Blue Shield of California CYV Anthem BCBS of Missouri CYY Premera Blue Cross of Washington Regence BlueCross BlueShield of Utah is an independent licensee of the Blue Cross and Blue Shield Association. CVV Anthem Blue Cross of California AAB BCBS of Michigan TRS: 711 Fax: 1 (800) 633-0334 Business hours: Monday through Friday: 5 a.m. to 7 p.m. (Pacific) Saturday: 9:30 a.m. to 2 p.m. (Pacific) Note: UMP members do not need to be Costco members to use their mail-order service. As a KingCare member, your care is covered at a higher level inside the network, but the plan also pays a smaller amount toward your bill if you see a doctor outside of the KingCare PPO network. 1 (888) 675-6570 Prescription questions? Phone: 1-800-628-3481. 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 Sign the completed form where indicated at the bottom of this page and submit the completed claim form to: Regence BlueShield Attn: UMP Claims PO Box 1106 Lewiston, ID 83501-1106 or by fax to: 1 (877) 357-3418 Payments will be mailed to the address on file for the subscriber. Email: Prproviderrelations@bcidaho.com. On the Availity Web Portal, you can: Run transactions to obtain member benefit, eligibility and claims information. Box 260070 Pembroke Pines, FL 33026 . | Friday 6:00 AM. Our provider complaints and appeals process ensure we address a complaint or an appeal in a fair and timely manner. In general, this prefix is mainly used to confirm the eligibility of the member and coverage information. We forwarded this claim to the member's home plan for processing. We use cookies on this website to give you the best experience and measure website usage. Prefix Product Area Billing Address Phone #, AAX CA BC CA, POB 60007 , Los Angeles , CA , 90060 800-765-2588, ABW VA BC VA, Trigon POB 27401, Richmond , VA , 23279 800-445-7490, ACN PA BC PA, Highmark BC PO Box 1210 , Pittsburgh , PA , 15230 800-682-3386, ACT NY BCBS Empire, POB 11800 , Albany , NY , 12211-0800 800-992-2583 Regence BlueCross BlueShield of Utah. Alpha Prefix, The three-character alpha prefix at the beginning of the members identification number is the key element used to identify and correctly route claims. CVT Anthem Blue Cross of California If member returns the call and the information is obtained, claims will be processed. Our Provider Integrity Oversight Committee reviews proposals for new payment policies and updates to our policies. Email: Medicare/Medicaid: PRmedicaremedicaid@bcidaho.com. BCBS Provider Phone Number. Empire BCBS Phone Number and Claim Address (2023) BCBS Alpha Prefix IAA-IZZ (2023) BCBS Alpha Prefix HAA-HZZ (2023) BCBS Alpha Prefix List GAA-GZZ (2023) If the Level II appeal is timely and complete, the appeal will be reviewed. They can take note of bcbs alpha prefix online in detail and gain knowledge of how to choose the right alpha prefix. Since new ID cards may be issued to members throughout the year, this will ensure that you have the most up-to-date information in your patients file. Provider: send us the NDC #, quantity and date span for this claim. Regence Blue Shield in accordance with the terms of your provider contract with Regence. Box 105557. Oromoo | 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. AHI BCBS of Rhode Island All our content are education purpose only. Once the submission is complete and if the issue is billing related, we review the request and issue a decision within 30 days, along with your right to submit a Level II Appeal if you are not satisfied with the outcome. Contact Us. Monday-Friday, 8-5 Pacific (800) 552-0635 www.CarpentersBenefits.org. Premera Blue Cross Please refer to the members ID card to determine if he/she has one of these products. Your software vendor can help you set up your computer to accommodate Premera's billing requirements. For more information, please visit regence.com, Select the area of the map that matches the color of the county where the service was performed. ABE BCBS Minnesota | Here are examples: A Level I Appeal must be submitted with complete supporting documentation that includes all of the following: Incomplete appeal submissions are returned to the sender with a letter requesting information for review. Both for dental and medical professional services, promises forms can be found. 0000004829 00000 n ACV BCBS of Georgia AHB Anthem BCBS of Ohio DJC Anthem BCBS of Ohio From there, you will be directed to a new site; at this site, enter in your login information, if you are not registered, please click on the Not Registered link to set up your account information. We abide by the following COB standards to determine which insurance plan pays first (primary carrier) and which pays second (secondary carrier). P.O. ALN PA BC PA, Highmark, POB 1210 , Pittsburgh , PA , 15230 800-433-9906 Policy #s: Regular 10017241-0001, Transit 10017241-0004, Sheriff 10017241-0016 . Examples of ID numbers: As a provider servicing out-of-area members, you may find the following tips helpful: ** Ask the member for the most current ID card at every visit. BCBS Contact Info - Providers, Overseas, and More - FEP Blue January 19, 2022 by tamble. ACU Anthem Blue Cross of California UMP members: If you are outside the U.S. and you have questions about your benefits and coverage, you can contact UMP Customer Service by signing into your Regence account and selecting chat live or email through the Message Center. For general inquiries and questions about the Service Benefit Plan, our overseas and pharmacy coverage or fraud assistance, you can call us toll-free nationwide. AGU Carefirst BCBS Maryland accrue interest on the 31st day from receipt of the information. Michigan. any missing required substantiating documentation or particular circumstances requiring special treatment. Tagalog | Physicians and providers may submit a proposal to modify a payment policy. DJD BCBS of Nebraska ** A local network identifier, (for example, BlueMark) Claims determinationsThe plan will notify you of action taken on a claim within 30 days of the plan receiving it. The SORA is generated when one of the following occurs during a payment cycle: Physicians and providers have the right to appeal certain actions of ours. We'll process the claim after we receive that information. 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 AEA BCBS of Texas The main identifier for out-of-area members is the alpha prefix. A billing issue is classified as a provider appeal because the issue directly impacts your write-off or payment amount. Stay up to date on what's happening from Bonners Ferry to Boise. color, national origin, age, disability, sex, gender identity, or sexual orientation. Asthma. Primary submission: Show all insurance information on the claim, and then submit the claim to the primary plan first. Karen Lyons, APR Sr. Director, Public Relations 612.777.5742 klyons@primetherapeutics.com. 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. Our medical staff reviewed this claim and determined that this service isn't covered by the plan. ABJ BCBS Minnesota | We can't process this claim because we haven't received the necessary information we requested from your provider. How do I identify international members? Blue Cross Blue Shield Federal Phone Number. Medical claims. We can process the claim after we receive that information. YDW Retail OFF Exchange CYQ BCBS of IL 10700 Northup Way, Suite 100 Retirees and PEBB Continuation Coverage members:Phone: 1 (800) 200-1004TRS: 711Business hours: Monday through Friday 8 a.m. to 4:30 p.m. (Pacific). ** When filing a claim, always enter the ID number, including the alpha prefix, exactly as it appears on the members card. Service not a benefit of subscriber's contract, Investigational or experimental procedure. It is critical for confirming a patients membership and coverage. 0000001762 00000 n You can reach Customer Service by calling 877-342-5258, option 2, or by calling the Customer Service phone number on the back of the member's ID card. DJT BCBS Minnesota
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