DHB Empire BCBS 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 1fcZi=s6Z@n7;W^ugC:CGLi@0^pQY4#o0 y>_ ADT BCBS Minnesota 0000087176 00000 n Precertification remains the responsibility of the provider for all Empire HMO network members. . Calypso, our affiliate, processes refunds and overpayment requests. They are identified by Guest Member on their health plan ID card. Prefix State/Area Plan Type Plan Name Provider and member service CMS contract, VOF NY MA HMO MediBlue HMO 1-800-499-9554 H3370 These claim editors evaluate billing information and coding accuracy on submitted claims and assists in achieving consistent, accurate, and timely processing of physician and provider payments. | 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. Deutsch | ADA Anthem Blue Cross of California Costco Mail-Order PharmacyOnline: Sign in to your Costco accountPhone: 1 (800) 607-6861TRS: 711Fax: 1 (800) 633-0334Business 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. Mailing address: Blue Cross of Idaho. To help your office complete year-end accounting, each December we'll issue you a check for the accrued interest we owe you, even if the amount is below the 553 0 obj <> endobj Does not determine the reimbursement dollar amount for any particular service (reimbursement is specific to the provider applicable fee schedule). 0000125980 00000 n Use search function and put your comment any alpha prefix not found here. CWQ Anthem BCBS of Ohio %PDF-1.4 % ADW Carefirst BCBS Maryland 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. All Rights Reserved to AMA. . 0000006371 00000 n DJS Blue Cross of Idaho (Boise) ABY Carefirst BCBS Maryland The alpha prefix identifies the Blue Plan or National Account to which the member belongs. Professional Services are performed by a doctor or other healthcare professional. CZP Anthem BCBS of Ohio We are unable to quote a benefit by a diagnosis or procedurecode. Please follow ADL Anthem BCBS Kentucky Email: Prproviderrelations@bcidaho.com. In these cases, please don't return the check to us. ** PPO in a suitcase logo, for eligible PPO members Call the National Information Center at 1-800-411-BLUE (2583) weekdays from 8 a.m. to 8 p.m. Eastern time. You can also use the Office of Financial Management MyPortal to update your address. BlueCard/FEP Lookup | Blue Cross of Idaho - bcidaho.com January 19, 2022 by tamble. Tricare Phone Number and Claim Address; Molina Healthcare Phone Number claims address of Medicare and Medicaid. KingCare - King County Portugus | AHK Anthem Blue Cross of California To submit a Level I, Level II or Mediation Appeal (see above to submit a Complaint), send complete documentation to: Physician and Provider Appeals Call Customer Service and choose the Pharmacy option. Blue Cross and Blue Shield of Illinois P.O. P.O. BCBS Prefix List 2021 - Alpha. 2023 Regence BlueShield. How do I identify international members? DJM BCBS of Texas 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 Portugus | AGX Anthem BCBS of Virginia You have 365 calendar days to submit a complaint following the action that prompted the complaint. You have five UMP medical plan options: UMP Classic. Uniform Medical Plan (UMP) | Washington State Health Care Authority CVT Anthem Blue Cross of California When processing claims, the system: Actual payment is subject to our fee schedule and payment policies; to a members eligibility, coverage, and benefit limits at the time of service; and to claims adjudication edits common to the industry. CUQ Blue Shield of California Tagalog | You will need special software to send insurance claims electronically. DJE BCBS of Alabama There is no charge to healthcare providers who submit electronic claims directly to us. As members renew or enroll their individual or group contracts for health care coverage in 2016, they will be presented with a new Highmark branded ID card. Pay clean claims within 30 days of receipt; and, Pay unclean claims within 15 days after receipt of information, Pay unclean claims within 30 days after receipt of information. The ID cards also may have: If you have questions about COB, contact Customer Service by calling the phone number on the back of the member's ID card. H\@F. PDF Electronic Remittance Advice Enrollment - Availity ACH Wellmark BCBS Iowa/South Dakota Blue Cross Blue Shield Federal Phone Number. It is only after we determine a members eligibility or coverage that payment policies and edits are applied. Washington Help Center: Important contact information for Premera Blue Cross, and Regence BlueShield. . Subrogation permits the plan to recover payments when the negligence or wrongdoing of another causes a member personal illness or injury. Contact us - BridgeSpan Health Do not make up alpha prefixes or assume that the members ID number is the Social Security Number. TINs are still a required element for claims. 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 Retail pharmacy services Claims Member identification prefixes were updated as part of that transition. AAY Wellmark BCBS Iowa/South Dakota AII BCBS of Louisiana Service not a benefit of subscriber's contract, Investigational or experimental procedure. Fax: 801-333-6523 (Mark claims: Attn New Claims) Email: Log in or register - MyBlue Customer eService. If you require a written refund request before mailing the overpayment, contact Calypso directly at 800-364-2991. How do I determine if a diagnosis or procedure code needs preauthorization? 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. Physicians and providers may submit a proposal to modify a payment policy. Mail the overpayment amount to our finance department (address on check) along with a completed Refund Request form, or. Provider Contacts | Provider | Premera Blue Cross For more specific contact information, choose from the following: Individuals and families Medicare Employers Producers Providers Fraud or abuse You can remain anonymous. AEF BCBS of IL In general, this prefix is mainly used to confirm the eligibility of the member and coverage information. If we need additional information for subrogation determine to pay or deny, the IQ will either be sent back to the member requesting the information, or subrogation will make two calls within five days of receiving the IQ. Learn how to contact your local Blue Cross and Blue Shield company, as well as other key areas. Interest less than Other specialized services (home hospice, organ/tissue transplants, and clinical trials). We'll notify you in writing or by telephone when you have successfully completed the test phase. Payment of this claim depended on our review of information from the provider. ** Do not change the sequence of the characters following the alpha prefix. ACL Anthem Blue Cross of California Contact Us | FEP | Premera Blue Cross The ID cards may also have: ** PPO in a suitcase logo, for eligible PPO members Karen Lyons, APR Sr. Director, Public Relations 612.777.5742 klyons@primetherapeutics.com. 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. We do not request refunds for overpayments less than $25, but you may submit these voluntarily. | Caused by another party (e.g., slip and fall, medical malpractice, etc. treatment center. Regence BlueShield serves select counties in the state of Washington and is an Independent Licensee of the Blue Cross and Blue Shield Association. Use only red CMS-1500 forms (no photocopied forms). Box 105557. 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. Download the bcbs pdf document which has been at the bottom of the post and you could find prefix for OHIO too. Join us! We may send a questionnaire to the member regarding possible duplicate coverage. BCBS Provider Phone Number. Below you will find a list of the 2015 BCNEPA plans with the corresponding Highmark Blue Cross Blue Shield plans for 2016. Discover all the ways members can earn wellness incentives and rewards for taking an active role in their health. Uniform Medical Plan - Benefits Note: Some members will remain in Blue Cross of Northeastern Pennsylvania health plans until their coverage renews to Highmark health plans later this year. There are three separate components that affect the value of each medical service or procedure: RVUs are assigned to each of these components. For more information, please visit regence.com, Regence BlueCross BlueShield of Oregon | Regence PO Box 3876. Asthma. If you bill your claims using the ANSI 837 electronic format, then you must include the Coordination of Benefits (COB) information from the primary coverage payer in your claim. 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. Enter a ZIP code in that box. Italiano | Blue cross Blue Shield association cannot accept Guest Membership claims electronically. We are unable to quote a benefit by a code. CVQ BCBS of Georgia to 6:00 PM PT or log in to your RGA account and submit an electronic request. Box 3004 Naperville, IL 60566-9747. Federal Employee Program Overseas Claims P.O. 0 Once the IQ is returned, all claims are reviewed and processed based on the information supplied. DHP Excellus BCBS All Blue Plans replaced Social Security numbers on member ID cards with an alternate, unique identifier. Coronary Artery Disease. 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. CVG BCBS of Florida Regence Blue-Cross Blue-Shield: YAM-Unallocated/Not Assigned: YAN-Unallocated/Not Assigned: YAO-Unallocated/Not Assigned: YAP: Minnesota: Generally, if the court decrees financial responsibility for the child's healthcare to one parent, that parent's health plan always pays first. A comprehensive list is posted in the Library under Reference Info. The preferred process for submitting corrected claims is to use the 837 transaction There is other activity on your account during the payment cycle. No pre-authorization for COVID-19 vaccinations, testing and treatment, No member cost shares for COVID-19 vaccinations, testing and treatment. If you are deaf, hard of hearing, or have a speech disability, dial 711 for TTY relay services. We can't process this claim until the incident questionnaire we sent the member is fully completed, signed and returned. Thank you for choosing Regence as your health plan administrator. 0000010231 00000 n DCY BCBS of Florida CZU Anthem Blue Cross of California Find Contact Information. FEP claims - Provider - REG - Regence 0000001240 00000 n (Note: Claims received with an ICD-9 code will be rejected with a notice to re-bill using ICD-10. | Featured In: May 2020 Empire Provider News. The most commonly occurring codes and messages are listed below. Mental Health/Substance Use Disorder Precertification. The member or provider can submit the completed IQ using one of the following methods: The member may contact Customer Service (the number is on the back of the ID card) to update IQ information over the phone. 0000005570 00000 n We follow industry standard coding recommendations and guidelines from sources such as the CMS, CPT, and AMA, and other professional organizations and medical societies and colleges. AFB BCBS of South Carolina There is a minimum threshold of $25 for monthly interest payments on delayed clean claims. ** Always include the members ID number, including the alpha prefix, on any documents pertaining to services to ensure accurate handling by the BCBS Plan. PDF Regence Provider Appeal Form You can find a claim by the members ID number or by the claim number. A Level I Appeal is used to dispute one of our actions. 0000009519 00000 n 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 Also its not a sequential order hence its hard to find unless we check with first 3 alpha prefix. See our FAQs for more claim information and contacts. ACN BCBS of IL QMF Retail ON Exchange Prefix Tool. Electronic Transactions and Claim Payer ID, Resource-based relative value scale (RBRVS), Claims from Non-credentialed contracted providers, federal and Washington state civil rights laws, Subscriber's number and patient suffix number (including plan prefix) assigned by plan as shown on the member's identification card, Number assigned by the clinic for patient. Box 22999 Rochester, NY 14692 *New York *The Buffalo office handles the receipt of claims and correspondence for BS AHI BCBS of Rhode Island ACK Anthem Blue Cross of California 0000008643 00000 n Prefixes with * include all characters for the 3rd position unless otherwise . ABD Blue Shield of California You can submit a complaint about one of our actions (verbally or in writing) to one of our employees. Email: Medicare/Medicaid: PRmedicaremedicaid@bcidaho.com. endstream endobj 554 0 obj <>/Metadata 28 0 R/Pages 27 0 R/StructTreeRoot 30 0 R/Type/Catalog/ViewerPreferences<>>> endobj 555 0 obj >/PageTransformationMatrixList<0[1.0 0.0 0.0 1.0 -306.0 -396.0]>>/PageUIDList<0 203>>/PageWidthList<0 612.0>>>>>>/Resources<>/Font<>/ProcSet[/PDF/Text/ImageB]/XObject<>>>/Rotate 0/StructParents 0/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>> endobj 556 0 obj <> endobj 557 0 obj <> endobj 558 0 obj <> endobj 559 0 obj <> endobj 560 0 obj <> endobj 561 0 obj <> endobj 562 0 obj [591 0 R] endobj 563 0 obj <>stream DAC BCBS of Tennessee 0000004829 00000 n 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). Regence and other health insurers share responsibility for Blue Cross and Blue Shield Federal Employee Program (BCBS FEP) claims information, claims processing and customer service based on the location of where the services were performed and the type Find a doctorContact us Sign in 0000056226 00000 n Its often confused that BCBS have lot of prefixes and where to contact. BCBS Company. ALN PA BC PA, Highmark, POB 1210 , Pittsburgh , PA , 15230 800-433-9906 Italiano | The provider needs to submit itemized charges to us. 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. The IQ is available in the Provider Library under Forms. ** PPOB in a suitcase logo, for PPO members with access to the BlueCard PPO Basic network 1-800-676-BLUE (2583) (toll free) Blueline voice response unit. Tricare Phone Number and Claim Address; Molina Healthcare Phone Number claims address of Medicare and Medicaid. 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). . You can print and assist the member in completing the form, but it's important to review the instructions included with the form because the patient must complete the form and then sign it. Some members may carry outdated identification cards that may not have an alpha prefix. Final Instructions about BCBS Prefix Lookup. Availity is an independent provider of health information network services that does not provide Blue Cross Blue Shield products or services. CVX BCBS of IL Applicable to facility claims only - reflects the APG code, DRG code, or room type that may relate to the reimbursement amounts. CVY BCBS of Louisiana Call 1 (855) 522-8894. Coordination of Benefits (COB) is a provision included in both member and physician and provider contracts. Coronary Artery Disease. Workers' Compensation will pay when the member's employer is liable to pay medical bills resulting from illness or injury arising out of, or in, the scope of employment. To pay this claim, we needed to review information from the provider. ADG Anthem BCBS of Ohio Regence Uniform Medical Plan Vision Claim Form - An ERISA Section 502 (a) prepare can be reported in many different methods. Claims filing information and provider service phone numbers are available in the December, January and February Provider Bulletins. Management - prior auth/pre-service requests), Email: Members: Log in/register at MyBlue Customer eService, Regence BlueShield - FEPPO Box 21709Seattle, WA 98111. you will need to contact Regence to update your account to ensure your claim processes correctly and timely. Membership Address. We're here to help (651) 662-5200 1-800-262-0820 . 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. BCBS Company. Contact us - Asuris Invalid claims are reported back to the provider with rejection details. AEV Keystone Health Plan East (IBC) ** The alpha prefix is critical for the electronic routing of specific HIPAA transactions to the appropriate Blue Plan. | 398-0520-PN-NY. Examples: medical doctor, osteopath, optometrist, chiropractor, physical therapist, audiologist, independent laboratory, nurse practitioner, durable ABB BCBS of IL We need the member to promptly complete and return this questionnaire to process claims in a timely manner. 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. Once we have received a payment ledger from the first-party carrier(s) showing where they paid out their limits (with dates of services, provider names, total charges, total paid, etc. AFA Anthem BCBS of Virginia YDW Retail OFF Exchange The main identifier for out-of-area members is the alpha prefix. Always use the alpha prefix on the members current ID card. We use cookies on this website to give you the best experience and measure website usage. Many residents in our time do not aware about how they can decide on the alpha prefix and reap more than a few benefits from the best suitable health insurance plan. They must be sent hard copy. When Calypso identifies an overpayment, they mail an Overpayment Notification letter with a request for the overpaid amount. Please make copies of the front and back of the ID card, and pass this key information to your billing staff. https://drive.google.com/file/d/0Bzbk78qiF4H_ZU9NTmxSenJwb0U/view?usp=sharing, Nice to know, this should be useful as a reference, I'm just looking for the alpha prefix reference list for OHIO but all I keep getting is other states. The charges for this service have been combined into the primary procedure based on the provider's contract. AGY BCBS of South Carolina To speed claims processing, we use document imaging and optical character recognition (OCR) equipment to read your claims. CYP BCBS of IL AGR Anthem BCBS of Colorado 10700 Northup Way, Suite 100 The Federal Employee Program (FEP) NO LONGER uses the address below, and mail will discontinue to be forwarded to the correct address above. Occasionally, you may see identification cards from members residing abroad or foreign Blue Plan members. We abide by the following COB standards to determine which insurance plan pays first (primary carrier) and which pays second (secondary carrier). See our FAQs for more claim information and contacts. 0000001570 00000 n 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). . When members of Blue Plans arrive at your office or facility, be sure to ask them for their current Blue Plan membership identification card. News. What type of EDI transactions does RGA accept? DAD Anthem BCBS of Ohio AAP BCBS of Tennessee CZM Highmark BCBS Click on the View Explanation of Payment link. DBT BCBS of Michigan Regence BlueShield of Idaho P. O. Washington Regence Blue Shield (800) 552-0733 (Member) (877) 668-4651 (Provider) (800) 344-2227 (866) 873-9743: Wisconsin (800) 242-9635 (800) 860-2156 (800) 424-4011 (800) 711-2225: View your credentialing status in Payer Spaces on Availity Essentials. We'll coordinate the benefits of the members plan with those of other plans to make certain that the total payments from all plans aren't more than the total allowable expenses. Dont write or stamp extra information on the form. account number and claim number handy when you call. 1/2022) v1 INSTRUCTIONS FOR FILING A CLAIMIMPORTANT: If your organization is contracted with Premera, most practitioners must be credentialed, with the exception of hospital-based practitioners. Box 1106Lewiston, ID 83501-1106Fax: 1 (877) 357-3418 If you have questions about submitting a claim for services outside the U.S., call UMP Customer Service. Email: Contact Regence. ADM BCBS of IL CVB BCBS of Florida | Before discussing member claim information, the Customer Service representative must verify the identity of the caller. Mail a completed Overpayment Notification form (found in our online library under Forms) and mark the box requesting a voucher deduction to recover the overpayment on future claim payments. P.O. 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. providers: We process your claim as soon as we receive them. Claims & payment - Asuris How to Submit a Claim - FEP Blue Briefly, these rules are as follows: Some group contracts are not subject to state regulations may have unique COB rules that could change the order of liability. CVS Caremark. View your credentialing status in Payer Spaces on Availity Essentials. the lookout for future communications with more information about this exciting enhancement for submitting claim appeals through . Regence Blue Shield in accordance with the terms of your provider contract with Regence. Type forms in black ink (handwritten forms cannot be read by OCR equipment). 0000008433 00000 n This procedure is considered cosmetic. Doing so may cause delays in the handling of your inquiries and claims. DJG Anthem BCBS of Ohio A required waiting period must pass before we can provide benefits for this service. The main identifier for out-of-area members is the alpha prefix. Regence BlueCross BlueShield of Utah. ABL BCBS of IL This includes If you are interested in purchasing a new computer system, ask us for a list of vendors that submit claims to us in the HIPAA standard ANSI 837 format. CVJ BCBS of Florida AFP Anthem BCBS of Ohio The employer group name is usually associated with the alpha prefix of the account specific health insurance type. Unclean claims will begin to accrue interest on the 16th day AFK Empire BCBS 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. AET Anthem Blue Cross of California (Note: Claims received with an ICD-9 code will be rejected with a notice to re-bill using ICD-10.) Franais | CNK-HR-0230 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. This is worthwhile to avoid selecting the alpha prefix randomly. DJQ Anthem Blue Cross of California Box 260070 Pembroke Pines, FL 33026 . A subsidiary of Cambia Health Solutions (formerly Regence Group) and one of Oregon's largest health plan provider, the company offers both group and individual health policies, including PPO plans and . BCBS Contact Info - Providers, Overseas, and More - FEP Blue ABK Carefirst BCBS Maryland State Lookup. 1 (877) 878-2273 To ensure accurate claim processing, it is critical to capture all ID card data. Contact us - Regence Kreyl Ayisyen | This prefix is the part of the distinctive identification number. The member's benefit program contains special provisions for benefits when an injury or condition is: An onset date should be recorded on all accident-related claims. AAB BCBS of Michigan AAS Anthem Blue Cross of California We haven't received the information. The conversion factor represents the dollar value of each relative value unit (RVU). Completion of the credentialing process takes 30-60 days. We are now processing credentialing applications submitted on or before March 14, 2023. Provider: please send us your office notes for this claim. 1-800-423-1973. Tel: 877-668-4651. If your request for mediation is timely, both parties must agree upon a mediator. Contact Us | Blue Cross and Blue Shield of Illinois - BCBSIL We send the member a questionnaire requesting information to determine if benefits are available. AGL Premera Blue Cross of Washington 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. Pay or deny 95 percent of a provider's monthly volume of all claims within 60 days of receipt. A non-billing issue is classified as a member appeal because the financial liability is that of the member, not the provider (please refer to Chapter 6). complies with applicable Federal and Washington state civil rights laws, Determine the county where the service was performed* (see exceptions below). Many offices assign their own account numbers to patients. Attach a completed Corrected Claim - Standard Cover Sheet.. CZX Anthem BCBS of Ohio PO Box 1106. The alpha prefix is critical for inquiries regarding the member, including eligibility and benefits, and is necessary for proper claim filing. AEA BCBS of Texas In this health insurance plan, alpha prefix is assigned to national accounts. 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.
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