You can submit claims daily, weekly, or monthly. These charges are included in the main anesthesia service. 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. DJG Anthem BCBS of Ohio BCBS Company. Tricare Phone Number and Claim Address; Molina Healthcare Phone Number claims address of Medicare and Medicaid. Verify eligibility via Highmarks NaviNet. 0000055046 00000 n People who include both alpha prefix as well as alpha numeric characters precede the alpha prefix in every claim and correspondence submitted to BCBS can get the desired assistance almost immediately. Claim Submission and Payments | Provider | Premera Blue Cross QMC Retail OFF Exchange ACN BCBS of IL Mail the overpayment amount to our finance department (address on check) along with a completed Refund Request form, or. 1-877-764-8724 Email Us. AAC BCBS of IL Media Contact: Lou Riepl Regence BlueCross BlueShield of Utah Regence BlueShield of . Phone: 1-800-628-3481. To do so, please submit the proposal in writing to your assigned Provider Network Executive (PNE) or Provider Network Associate (PNA). What is an 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. complies with applicable Federal and Washington state civil rights laws, Determine the county where the service was performed* (see exceptions below). Oromoo | Unclean claims will begin to DKD Wellmark BCBS Iowa/South Dakota, HPS Gordmans Inc. (formerly 1/2 Price Stores), How to Identify Members 3.1.1 Member ID Cards. https://www.bcnepa.com/Providers/providerrelations/ReferenceGuides/AlphaPrefixList.pdf. They must be sent hard copy. 0000011774 00000 n 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. ABA BCBS of IL CMS also uses RVUs to allocate dollar values to each CPT or HCPCS code. Regence BlueCross BlueShield of Oregon | OneHealthPort P.O. Premera Blue Cross & The Regence Group Common Alpha Plan Prefixes Last updated: 09/01/2016 Premera Blue Cross & Premera Blue Cross/NASCO Prefixes Western WA providers submit claims to Regence Blue Shield. ), claims will be processed accordingly and under the terms of our subscriber's contract. If you have questions about COB, contact Customer Service by calling the phone number on the back of the member's ID card. DJR Anthem BCBS of Ohio Use search function and put your comment any alpha prefix not found here. 0000004829 00000 n When this notification has occurred, change the indicator on your claims from (. AAT Anthem Blue Cross of California 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. This claim is a duplicate of a previously submitted claim for this member. Management - prior auth/pre-service requests), Members: Log in or register - MyBlue Customer eService, Retail Pharmacy Program PO Box 52057 Phoenix, AZ 85072, Retail Pharmacy Program PO Box 52080 Phoenix, AZ 85072, Phone:800-552-0733Fax: 801-333-6523 (Mark claims: Attn New Claims)Email: Log in or register - MyBlue Customer eService, Regence BlueShield - FEPPO Box 857Lewiston, ID 83501, Regence BlueShield - FEPPO Box 1388Lewiston, ID 83501Customer Service. For Example: XYZ123456789. Final Instructions about BCBS Prefix Lookup. The protection of your privacy will be governed by the privacy policy of that site. We recommend that you make copies of everything that is submitted for your personal records. AFA Anthem BCBS of Virginia Your account number can be included in box 26 (Patient's Account Number) of the CMS-1500 form whether you submit electronically or on paper. You will be going to a new website, operated on behalf of the Blue Cross and Blue Shield Service Benefit Plan by a third party. Provider: please send us the radiology reports for this claim. P | Once you have signed in, simply click on the Authorizations on the top menu and you will be able to submit your preauthorization request. Box 3004 Naperville, IL 60566-9747. Your Claims & Eligibility. DJW Wellmark BCBS Iowa/South Dakota ** Do not add/delete characters or numbers within the member ID. CUW Anthem Blue Cross of California ACH Wellmark BCBS Iowa/South Dakota This standard is called the "Birthday Rule.". Provider: send us medical records relating to prescription drug charges. CYP BCBS of IL 0000001570 00000 n Payments are issued under a separate voucher and mailed to the address on the original claim. They will be satisfied when they properly use this insurance plan and fulfil overall requirements on the prompt assistance for claiming the insurance. Use the following codes: In the Original.Ref.Co segment of box 22 enter the original claim number. After these steps are completed, you can choose one of the following options to resolve the overpayment: Calypso will apply the refund to the claim as soon as they receive the refund. 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. YUV SG ON Exchange CWA Carefirst BCBS Washington DC Physicians and other healthcare providers receive an Explanation of Payment (EOP), which describes our determination of the payment for services. Appeals rights will be exhausted if not received within the required timeframe. However, there are some exceptions. 0000008616 00000 n Contact Us | FEP | Premera Blue Cross 0000128769 00000 n the lookout for future communications with more information about this exciting enhancement for submitting claim appeals through . 0000001762 00000 n Click on the Submit a Preauthorization Request link. For more information, view our privacy policy. CYW Anthem BCBS of Ohio AGV BCBS of MA 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. Friday 6:00 AM. 4. AFY BCBS of IL Regence BlueShield serves select counties in the state of Washington and is an independent licensee of the Blue Cross and Blue Shield Association. Availity is an independent provider of health information network services that does not provide Blue Cross Blue Shield products or services. Ting Vit | A members ID number includes the alpha prefix in the first three positions and all subsequent characters between 6 and 14 numbers or letters up to 17 characters total. 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 Box 33 Enter the contract name of physician or provider who performed the service. Boise, ID 83707. FEP claims - Provider - REG - Regence ABZ Carefirst BCBS Maryland If you have questions, please contact your local Blue Cross and Blue Shield company. BCBS Prefix List 2021 - Alpha. Claim edits in place will identify those services previously billed and bundle ALL services on to a single We need the member to promptly complete and return this questionnaire to process claims in a timely manner. You have 365 calendar days to submit a complaint following the action that prompted the complaint. If the card presented has no alpha prefix, follow the instructions on the back of the ID card for inquiries and claim handling. Washington Contracted Providers: If we fail to satisfy either of the above standards, well pay interest on each claim that took longer than 60 days to process at a 12 percent annual rate (unclean days are not applied toward the 60 day calculation). Benefits are not available through us until the first-party carrier has exhausted, denied, or stopped paying due to its policy limits. Check out the changes and updates to our plan in 2023. If you know which division you would like to contact, you can also reach out directly using the following phone numbers and email addresses. They require completion and mailing of an Incident Questionnaire for possible accident investigation or a Workers Compensation injury (claims in subrogation). 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. information. AFS Blue Shield of California Contact us - Regence Tricare Phone Number and Claim Address; Molina Healthcare Phone Number claims address of Medicare and Medicaid. Diabetes. ABQ Blue Cross of Idaho (Boise) You can learn more about credentialing by visiting the provider section of our website. Blue Cross Blue Shield Federal Phone Number. AEX BCBS of IL ADY BCBS of South Carolina We'll process the claim after we receive that information. Provider home - Regence When members from Blue Plans arrive at your office or facility, be sure to ask them for their current Blue Plan membership identification card. 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. TINs are still a required element for claims. Do not add or omit any characters from the member ID numbers. If you are deaf, hard of hearing, or have a speech disability, dial 711 for TTY relay services. Access fee schedules. 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). Please treat these members the same as domestic Blue Plan members. This member wasn't eligible for services on the date of service. A fragmented or split professional billing is defined as professional services rendered by the same provider for the same date of service and submitted on multiple professional claim forms. Claims - SEBB - Regence Eastern WA and Alaska providers submit to Premera. From there, you will be directed to a new site; at this site, enter in your login information. AHB Anthem BCBS of Ohio RGA observes theholiday schedule below. This means that you may see cards with ID numbers between six and 14 numbers/letters following the alpha prefix. We are now processing credentialing applications submitted on or before March 6, 2023. If we receive the complaint before the 365-day deadline, we review and issue a decision within 30 calendar days via letter or revised Explanation of Payment. BCBS Provider Phone Number. If you are deaf, hard of hearing, or have a speech disability, dial 711 for TTY relay services. We use cookies on this website to give you the best experience and measure website usage. Prefixes with * include all characters for the 3rd position unless otherwise listed, https://www.premera.com/documents/020469.pdf. ** Do not change the sequence of the characters following the alpha prefix. Remember to include the leading three-character prefix and enter it in the appropriate field on the claim form. to 6:00 PM PT or log in to your RGA account and submit an electronic request. Any exceptions are documented as Payment Policies. How do I identify BlueCard Managed Care/POS members? Our medical staff reviewed this claim and determined that this continued stay doesn't meet the criteria for medical necessity. ARH IN BCBS of Indiana, POB 68416, Accordia NW , Indianapolis , IN , 46268 317-488-6000, ARR OH BC OH Anthem, 4361 Irwin Simpson Rd , Mason , OH , 45040 513-872-8100, ASA Indemnity CNY PO Box 4809 , Syracuse , NY , 13221 315-448-3735, ASH WNY BCBS WNY, Auto Natl Accts, POB 757 , Buffalo , NY , 14240-0757 800-462-7237, AST TN BCBS Of Tennessee, 801 Pine St , Chattanooga , TN , 37402 423-755-5600, ATT Empire Empire BC, POB 5020 , Middletown , NY , 10940 800-772-2875, AWR PA PA BS Highmark, POB 535045 , Pittsburgh , PA , 15253-5045 800-294-2217, AZO IL BC IL, POB 1364 , Chicago , IL , 60690-1364 800-637-6917, BAN WV BC Washington DC/Carefirst, 550 12th St SW , Washington , DC , 20065 800-642-2411, BBH PPO GA BCBS GA, POB 9907 , Columbus , GA , 31908 800-628-3988, BDC MI BC MI, POB 1618 , Detroit , MI , 48231 800-462-7237 You can also use the Office of Financial Management MyPortal to update your address. Provider: send us the member's medical records for this claim. ABT Carefirst BCBS Maryland medical equipment supplier, ambulance services, applied behavior analysis services (ABA) or clinical social worker. 398-0520-PN-NY. If there are no court decrees, the plan of the parent with custody is primary. 3. Regence BlueShield of Idaho P. O. Franais | Insurance Denial Claim Appeal Guidelines. Uniform Medical Plan - Benefits 24/7 anonymous hotline: 1 (800) 323-1693 Regence Provider Appeal Form. Our medical staff reviewed this claim and determined that this service isn't covered by the plan. An EDI representative will review the test claims with you or your vendor. When dependent children are double-covered by divorced parents, coverage depends on any court decrees. The maximum limit has been met for this benefit. Level II appeals must be submitted in writing within 30 calendar days of the Level I appeal decision and can only pertain to a billing issue. If we do not receive the EOB and are unable to obtain the primary payment information by phone, the claim will be denied with a request for a copy of the primary EOB before processing can be completed. Regence BlueShield - FEP PO Box 1388 Lewiston, ID 83501 Customer Service. ** Remember: Member ID numbers must be reported exactly as shown on the ID card and must not be changed or altered. QME Retail OFF Exchange While you pay for coverage through UW, the state designs the plans and contracts with Regence BlueShield and Washington State Rx Services to administer the plan. endstream endobj 597 0 obj <>/Filter/FlateDecode/Index[30 523]/Length 41/Size 553/Type/XRef/W[1 1 1]>>stream 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. Once you have signed in, simply click on the Claim Search link. Below you will find a list of the 2015 BCNEPA plans with the corresponding Highmark Blue Cross Blue Shield plans for 2016. Box 105557. Learn more about which practitioners need to be credentialed by viewing our credentialing matrix, located in our credentialing manual, available by request from Credentialing.Updates@premera.com. ABN Anthem BCBS of Virginia <<1CC62891B116FE488EB50D904D0BD9AE>]/Prev 176800/XRefStm 1570>> In general, this prefix is mainly used to confirm the eligibility of the member and coverage information. We can't process this claim because we haven't received the necessary information we requested from your provider. DHB Empire BCBS 0000001921 00000 n . CVY BCBS of Louisiana 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. ABY Carefirst BCBS Maryland providers: We process your claim as soon as we receive them. CZP Anthem BCBS of Ohio We are unable to quote a benefit by a diagnosis or procedurecode. Precertification remains the responsibility of the provider for all Empire HMO network members. PO Box 3876. 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. UMP PEBB | Contact us - Regence You can submit a complaint about one of our actions (verbally or in writing) to one of our employees. To send an electronic claim, use the Availity clearinghouse with payer ID RGA01. startxref treatment center. Before implement anything please do your own research. They are suspended due to the group or individual's non-payment of premium or dues. Who do I contact for EDI questions? ADE BCBS of IL 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. AAX Anthem Blue Cross of California BCBS Provider Phone Number. Premera Blue Cross Blue Shield of Alaska FEP PO Box 33932 Seattle, WA 98133-0932, Phone:800-562-1011 We use an automated processing system to adjudicate claims. To contact Corporate, please call 1-425-462-1000 Monday - Friday 8:00 AM to 5:00 PM PT. AEM Highmark BCBS ACQ BCBS of Georgia BCBS Alpha Prefix YAA-YZZ(2023) | Medical Billing RCM | If that dialog box did not appear, click the "(change)" link next to the "ZIP code" label. 1-800-962-2731. Claims & payment Claims and payment Learn how to identify our members' coverage, easily submit claims and receive payment for services and supplies. You can use Availity to submit and check the status of all your claims and much more. Franais | AHA BCBS of IL 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 . We may send a questionnaire to the member regarding possible duplicate coverage. 10/18) v2. Italiano | PDF State Mail to Mailing Address City, State Zip - Pnnl 0 When Calypso identifies an overpayment, they mail an Overpayment Notification letter with a request for the overpaid amount. Open 24 hours a day, 7 days a week. YDM SG Off Exchange AGE Independence Blue Cross This review is necessary to determine whether the claim(s) should be covered by a first-party carrier (e.g., PIP, Med Pay or similar coverage - homeowners or a commercial medical premise policy). It doesn't replace your tax ID number (TIN) or Drug Enforcement Administration (DEA) number. They are identified by Guest Member on their health plan ID card. Box 260070 Pembroke Pines, FL 33026 . YDO Retail OFF Exchange CVB BCBS of Florida CZV BCBS of Alabama | Electronic claims without a TIN are rejected as incomplete. xref Correct Mailing Address for Federal Employee Program Paper Claims and A Level I Appeal is used to dispute one of our actions. Members: Log in/register at MyBlue Customer eService, Regence Blue Cross Blue Shield of Oregon - FEPPO Box 31105Salt Lake City, UT 84131, Regence Blue Cross Blue Shield of Oregon - FEPPO Box 1269Portland, OR 97207, Find Select the area of the map that matches the color of the county where the service was performed. CNK-HR-0230 | Our process meets or exceeds the requirements set by the Office of the Insurance Commissioner. ADC BCBS of IL Claims & payment - Regence Identifying members Easily identify the kind of coverage our members have. Completion of the credentialing process takes 30-60 days. (BlueCard will request refunds regardless of the dollar amount.) Provider home - Asuris threshold. AEG Anthem BCBS of Ohio All Blue Plans replaced Social Security numbers on member ID cards with an alternate, unique identifier. 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. Call the National Information Center at 1-800-411-BLUE (2583) weekdays from 8 a.m. to 8 p.m. Eastern time. 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. Box 91102 Get help when you need it. ACA BCBS of Alabama ALN PA BC PA, Highmark, POB 1210 , Pittsburgh , PA , 15230 800-433-9906 Payment of this claim depended on our review of information from the provider. BCBS alpha prefixes list and claim submission address - Updated list Illinois. Regence BlueShield. Our medical staff reviewed this claim and determined that this admission doesn't meet the criteria for medical necessity. AEC BCBS of IL DJE BCBS of Alabama All other related costs incurred by the parties shall be the responsibility of whoever incurred the cost. Box 25 Enter the applicable tax ID number. These weights are then multiplied by the dollar conversion factor we publish. Physicians and providers may submit a proposal to modify a payment policy. Management - prior auth/pre-service requests), Email: Members: Log in/register at MyBlue Customer eService, Regence BlueShield - FEPPO Box 21709Seattle, WA 98111. CZB Wellmark BCBS Iowa/South Dakota Regence BlueCross BlueShield of Utah is an independent licensee of the Blue Cross and Blue Shield Association. Atlanta, GA 30348-5557. Box 7408. 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 PO Box 52057 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. | The claim will be reprocessed and reflected on the payment voucher. Employees:Contact your payroll or benefits office. This includes Do not make up alpha prefixes or assume that the members ID number is the Social Security Number.

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