P | 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. | 2023 Regence BlueShield. Regence BlueShield of Idaho | Regence Para asistencia en espaol, por favor llame al telfono de Servicio al Cliente en la parte de atrs de su tarjeta de miembro. WELLMARK BCBS OF IOWA. Learn how to identify our members coverage, easily submit claims and receive payment for services and supplies. Please use the comment section for additional information. PDF Local Blue Cross and Blue Shield Mailing Addresses State/Alpha Prefix Regence BlueCross BlueShield of Oregon | OneHealthPort Learn about Regence Lewiston, ID office. If the decision was after the 60-day timeframe, please include the reason you delayed filing the appeal. 0. Asthma. For information on false claims, see False claims or statements in your certificate of coverage. You are about to leave regence.com and enter another website that is not affiliated with or licensed by the Blue Cross Blue Shield Association. If you have questions about submitting a claim for services outside the U.S., call UMP Customer Service.. Claims determinations The plan will notify you of action taken on a claim within 30 days of the plan receiving it. With a plan powered by the most trusted name in health insurance, youll have coverage tailored to your health. Coding toolkit View our clinical edits and model claims editing. REGENCE BS OF WASHINGTON. Regence BlueCross BlueShield of Utah is an independent licensee of the Blue Cross and Blue Shield Association. Blue Cross Blue shield claim submission address | Medical Billing and Products and networks Learn more about the products we offer and the provider networks that support them. Contact Us | Blue Cross Blue Shield You are about to leave regence.com and enter another website that is not affiliated with or licensed by the Blue Cross Blue Shield Association. We will accept verbal expedited appeals. Claims edits If you do not submit your claims through Availity Essentials, follow this process to submit your claims to us electronically. Find the correct address listed under the type of service received (see explanation). Learn how our innovative solutions can help your employees live healthier, while helping you manage your costs. PO Box 52080 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. Don't have a Regence account yet? REGENCE BS OF UTAH. 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. Box 30805 Salt Lake City, UT 84130- 0805 *Pennsylvania BCNEPA P.O. Learn about dental billing information to help ensure your dental claims are processed quickly and correctly. Espaol | If you wish to appoint someone to act on your behalf, you must complete an appointment of representative form (PDF) and send it to us with your grievance form (PDF). We respond to pharmacy requests within 72 hours for standard requests and 24 hours for expedited requests. You may send a complaint to us in writing or by calling Customer Service. Please contact the Medicare Appeals Team at 1 (866) 749-0355 or submit the appeal in writing and stating you need a fast, expedited, or hot" review, or a similar notation on the paperwork. As one of the state's largest health insurers, Regence BlueCross BlueShield of Oregon is committed to addressing current and emerging health needs for the nearly one million Oregonians we serve. Your trust is our top concern, so businesses can't pay to alter or remove their reviews. Join us! Box 999Appleton, WI 54912-0999Fax: 1 (855) 668-8550. MAXIMUS will review the file and ensure that our decision is accurate. For services outside this area, please contact customer service directly at 1 (800) 365-3155 as your claim will require special handling. Regence: The most trusted name in health insurance But there are some circumstances where you will need to submit a claim. Availity and Regence Your budget. Claims Submission Map | FEP | Premera Blue Cross 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. Attn: Appeal UnitPO Box 40168Portland, OR 97240-0168. Learn more. BCBS State by State | Blue Cross Blue Shield Note: If you submit your claim by mail, be sure to make copies of your documents for your records. You are about to leave regence.com and enter another website that is not affiliated with or licensed by the Blue Cross Blue Shield Association. Consult theFEP local plan directory to find addresses and telephone numbers for other plans.Note: If the laboratory work was sent to Washington for testing or analysis, refer to theWashington claims submission map to determine where to send your claim for processing. Learn more about informational, preventive services and functional modifiers. While it's a good idea to submit a complaint as soon as possible, there isn't a deadline to do so. 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. Attn: Member Appeals Blue cross blue shield address Medicaid Address and phone number - List 1 Medicaid claim submission address - List 2 Medicare . You receive services from an out-of-network provider. If you have questions about eligibility and enrollment:Employees:Contact your payroll or benefits office.SEBB Continuation Coverage members:Call the SEBB ProgramPhone: 1 (800) 200-1004 2. 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. Regence BlueCross BlueShield of Oregon offers health and dental coverage to 750,000 members throughout the state. In the left-hand column, locate the state where services were rendered. A complaint or grievance is an oral statement or written document submitted by or on behalf of a member regarding: Note: If your issue is regarding a denial, reduction, or termination of payment or non-provision of medical services, it is an appeal. You must submit first-level and second-level appeals no more than 180 days after receiving the previous decision. Regence Direct Member Reimbursement Form You must appeal within 60 days of getting our written decision. Medical records from your provider, if applicable. Coordination of benefits (COB) happens when you have health coverage through two or more groups (such as your employer and your spouses employer), and these two group health plans both pay a portion of your health care claims. medical equipment supplier, ambulance services, applied behavior analysis services (ABA) or clinical social worker. 4 0 obj Manage your claimsGet your prescription claims history, view your benefits and claims information, and more by logging in to your Washington State Rx Services Account. You have the right to make a complaint if we ask you to leave our plan. Make sure you submit your complaint to the right company (see below). Claims submission - Regence TTY users should call, 1-800-325-0778; or your Medicaid Office. If additional information is needed, we will send you a request. You get a vaccine or flu shot from an out-of-network provider. Information current and approximate as of December 31, 2018. Quickly identify members and the type of coverage they have. If you do not submit your claims through Availity Essentials, follow this process to submit your claims to us electronically. Claims not submitted to UMP within 12 months of the date of service will not be paid. 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. You can appeal a decision online; in writing using email, mail or fax; or verbally. Use the appeal form below. 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. (Note: Claims received with an ICD-9 code will be rejected with a notice to re-bill using ICD-10.) Out-of-network providers may submit a claim on your behalf. 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. Portugus | If you have questions about submitting a claim for services outside the U.S., call UMP Customer Service. If you wish to appoint someone to act on your behalf, you must complete an appointment of representative form and send it to us with your prescription coverage determination form. This 30-day period may be extended by 15 days when action cannot be taken on the claim due to: Manage your claimsSee the status of your claims, see how much you owe, find a specific claim, and more by logging in to your Regence account. Follow the steps below to submit your claim online. Is this your business? The plan will notify you within the 30-day period that an extension is necessary, with a description of the information needed and why it is needed. Examples: medical doctor, osteopath, optometrist, chiropractor, physical therapist, audiologist, independent laboratory, nurse practitioner, durable Please include the following information when requesting an appeal: The plan will send confirmation when it receives your appeal. When we make a decision about what services we will cover or how well pay for them, we let you know. You can send your appeal online today through DocuSign. To request or check the status of a redetermination (appeal). You can submit a claim online through your Regence account, or you can fax or mail your claim to Regence. Mail or fax both the claim form and the provider's claim document (or bill) to: Regence BlueShield Attn: UMP Claims P.O. A list of reciprocal partners as well as membership benefits can be found at lifeflight.org. If MAXIMUS disagrees with our decision, we authorize or pay for the requested services within the timeframe outlined by MAXIMUS. Step 1: Start your internet browser, and then go to the official regence bluecross blueshield of oregon address website. Ask your provider. People with a hearing or speech disability can contact us using TTY: 711. Premera Blue Cross Learn more on the HCA website. Step 2: Next, locate the "Login" button at the top-right corner. PDF Amendment to Regence Bluecross Blueshield of Oregon Medical Group Agreement 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. Learn about dental billing information to help ensure your dental claims are processed quickly and correctly. Instructions are included on how to complete and submit the form. the instructions to determine where to send claims or correspondence. Grievances must be filed within 60 days of the event or incident. Get help when you need it. **If you, or your prescribing physician, believe that waiting for a standard decision (which will be provided within 72 hours) could seriously harm your life, health or ability to regain maximum function, you can ask for an expedited decision. 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: 10/18) v2 INSTRUCTIONS FOR FILING A CLAIM IMPORTANT: Use this form for all medical, pharmacy, dental, and vision services covered by Regence. Dental billing - Regence Sign in If you have questions, contact Washington State Rx Services Customer Service at 1 (888) 361-1611 (TRS: 711) Monday through Friday 7:30 a.m. to 5:30 p.m. (Pacific). 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 Note: If the pick-up location is in Washington, refer to theWashington claims submission map to determine where to send your claim for processing. We stay on top of issues until theyre resolved. 2 0 obj We must notify you of our decision about your grievance within 30 calendar days after receiving your grievance. 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. To obtain information on the aggregate number of grievances, appeals and exceptions filed with the plan contact Customer Service. Were empathetic, reliable and tenacious, too. Address: 200 SW Market St Portland, OR, 97201-5715 United States See other locations Phone: Website: www.regence.com Employees (this site): Actual Employees (all sites): Actual Revenue: Modelled Year Started: Incorporated: ESG ranking: ESG industry average: What is D&B's ESG Ranking? Completion of the credentialing process takes 30-60 days. We will notify you once your application has been approved or if additional information is needed. PDF Provider Dispute Resolution Process Dental billing. Care Management Programs. First, you'll need to gather these documents: An itemized bill from your provider that describes the services and charges. Learn more about when, and how, to submit claim attachments. Coverage decision requests can be submitted by you or your prescribing physician by calling us or faxing your request. Learn more about our customized editing rules, including clinical edits, bundling edits, and outpatient code editor. Blue Cross and Blue Shield of Nevada will process the claim. 636 GRAND AVE DES MOINES, IA 50309 800-245-6105. Step 2: Next, locate the "Login" button at the top-right corner. PDF Regence Provider Appeal Form *If you are asking for a formulary or tiering exception, your prescribing physician must provide a statement to support your request. If your coverage changes, call UMP Customer Service and Washington State Rx Services. In every state and every community, BCBS companies are making a difference not just for our members, but For the Health of America. CLAIM.MD | Payer Information | OR BCBS (Regence) Payer Information OR BCBS (Regence) Payer ID: 00851 This insurance is also known as: Regence Blue Cross of Oregon Blue Cross Blue Shield of OR REGENCE BLUECROSS BLUESHIELD OF OREGON REGENCE BCBS OF OREGON FEP G00851 Other ID's: 12B41, SB850 Need to submit transactions to this insurance carrier? treatment center. Notice will include explanation why an extension is needed and when the plan expects to act on the claim. Other specialized services (home hospice, organ/tissue transplants, and clinical trials). Chronic Obstructive Pulmonary Disease. Para humingi ng tulong sa Tagalog, pakitawagan ang numero ng telepono ng Serbisyo sa Kostumer (Customer Service) na nakasulat sa likod ng inyong kard bilang miyembro. 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. TTY/TDD users can call 1-877-486-2048, 24 hours a day/7 days a week. Congestive Heart Failure. Please reference your agents name if applicable. Box 1106 Lewiston, ID 83501-1106 Fax: 1 (877) 357-3418 . If you want a written response, you must request one. Complete and send your appeal entirely online. If we must request additional information, the processing of your claim may be delayed. | Franais | Identify BlueCard members, verify eligibility and submit claims for out-of-area patients. For member appeals that qualify for a faster decision, there is an expedited appeal process. Complete and mail or fax a Multiple Coverage Inquiry Form to Regence: Regence BlueShieldAttn: UMP ClaimsPO Box 91015MS BU386Seattle, WA 98111-9115. Professional Services are performed by a doctor or other healthcare professional. No enrollment needed, submitters will receive this transaction automatically, Web portal only: Referral request, referral inquiry and pre-authorization request, Implementation Acknowledgement for Health Care Insurance.
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