?} AN Prior authorization requirements are specific to each patients policy type and the procedure(s) being rendered. Do not create one or use the BCBS prefix from another member ID card. Final Instructions about BCBS Prefix Lookup, United Healthcare Claims Address Information. The three-character prefix at the beginning of the member's identification number is the key element used to identify and correctly route out-of-state claims to the appropriate BCBS Plan. AIM Specialty Health (AIM) is an independent company that has contracted with BCBSIL to provide utilization management services for members with coverage through BCBSIL. BCBS prefix is a three character prefixes followed by the id number except for the following products and programs. Hi, Im Kim Keck! There are three variants; a typed, drawn or uploaded signature. I have completed my Bachelor of Business Administration in Healthcare Management from University of Texas. BCBS is one of the largest medical insurance company by total members of more than 45 million. We offer a wide choice of individual plans to fit your health needs and budget. Independence Blue Cross (BC) of Philadelphia (Phi) and the Southeastern Pennsylvania (PA) PAI. Infusion Site of Care Prior Authorization Drug List: New Codes Will Be Added, Effective Jan. 1, 2021 This notice was posted Dec. 28, 2020, to advise you of 14 new codes being added to our specialty pharmacy prior authorization drug list. Secondly, it ensures that you have the most up-to-date information about each and every BCBS prefix home plan because we update the BCBS prefix list on daily basis. In the District of Columbia and . hbbd```b``A$ This new site may be offered by a vendor or an independent third party. 741 0 obj <> endobj There are several benefits of using our BCBS Prefix Lookup tool. $=0j]xkM#[f4YgI|in Z(0zF1-9gk!D @WeUUn/R%$'c|J6:z}\}8ZNd+SL5-h"\wE$w{3\zO>,Vta$a`D7rHmr$bwZm7yYO)&^E<2@9#&UDOz The notice also refers to a medical policy for more information to help clarify when and how prior authorization requirements may apply. BCBS Prefix List AAA to AZZ - Alpha Lookup by State 2022 Does BCBS policy number same as BCBS member ID number? %%EOF 0|kEMi_a*-Yfj#uqEcA/6 .M.6YNw4cyo>lESMC\)H~L 1B> O}BAXv:OP)Qt9>PN,RG4uZu~?raYW+Q`|w[OD klW1Kg|'6'8=rRW00+,oD~`Ox(4DLMm,$Uy69r!$w0.<5>gJd'0?wf\2t| :\xQ cwh)}Ycb8I5vg~TQNnx^Y$M'JL+0?\:3Y(+Sb1:_%^uur(h>mS Amerihealth Caritas Directory Healthcare, Health Insurance in United States of America, Place of Service Codes List Medical Billing. To identify correct department, they use 3 characters Prefix in the BCBS members plan ID. 1 of 7. Born in Texas, USA. PDF CSS-E121 Blue Cross Select Silver 01012021 - bcbsal.org 'MNiXG]dRBC; 0'Va~9&c}Ag$Pge;\UY,$MtN 2021, for some of our commercial non-HMO members, such as those listed below: - PPO - Blue Choice Preferred PPO(SM) - Blue Choice PPO(SM) - Blue Options(SM)/Blue Choice Options(SM) - Blue High Performance Network(SM) [Blue HPN(SM)] This is not an exhaustive listing of all codes. Prior Authorization List for Blue Shield Effective April 1, 2023 (This list is updated monthly) blueshieldca.com 601 12th Street | Oakland, CA 94607 Blue Shield of California is an independent member of the Blue Shield Association April 1, 2023 Page 1 of 8 Policy Name/Program Procedure Code (To search, press Ctrl + F) . PDF Updated November 2021 - BCBSIL PDF 2021 Commercial Prior Authorization Requirements Summary Final Remarks about BCBS Prefix Lookup Directory. Normally, account specific prefix associates to the employer group name. For example: A2A12345678 Here " A2A" is BCBS alpha numeric prefix. Although we regularly update the BCBS Prefix information but in case youre unable to get information about correct BCBS plan from our BCBS Prefix lookup, feel free to contact us OR call BCBS directory phone number at 800-676-2583. Added to list, with AIM effective 04/01/2021 22802 Joint, Spine Surgery Post Fusion 7-12 Vert Seg SUR712.036 AIM Guidelines Lumbar Spinal Fusion Retire from BCBS PA effective 1/1/22; continue to request PA through AIM if applicable; Added to list, with AIM effective 04/01/2021 22804 Joint, Spine Surgery Post Fusion 13/> Vert Seg SUR712.036 AIM . 404 0 obj <>stream Coverage For: Individual + Family. for medical policies and prior authorization requests. Identifying BlueCard members - Regence ). There are two types of BCBS prefixes which are mentioned below: Plan Specific prefix are assigned by BCBS to each plan. This indicates that the claims are excluded from the BlueCard Program. What is Medical Billing and Medical Billing process steps in USA? 2021 Commercial Outpatient Behavioral Health Prior Authorization Code List This list is a new addition on our website for 2021. Commercial Prior Authorization Summary and Code Lists Services that require precertification As of January 1, 2022, this list applies to all Independence Blue Cross HMO, PPO, and POS products, including Flex products. Also, these BCBS prefixes helps providers and medical billers to reach the correct claims department for claims and benefits inquiry. B}hJu`n+Z9>)2B~feo,TV [ZI^ylRr8DGo;ckrA;X2SjUlW]$4_vN(Tvh6#moc0!pbJ;oW)A'oR&bH=`1K}P(u3gD9:#1!m2saW1SD5/p2 'Su &x@`N.e#U(Fne]4;$"o*k;$~gn-Sd"mjdTY2R*I:w8w3;fpCfQH& The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. We always make sure to keep BCBS prefix list and BCBS provider phone numbers directory up to date. Most PDF readers are a free download. This article offers an overview of 2021 prior authorization support materials and related communications that may apply for some of our non-HMO commercial and government programs members, effective Jan. 1, 2021. BCBS alpha prefix only contains alphabets and each alpha prefix represents different BCBS home plan. Check any internal documents you may have and update any references of "alpha prefix" to "prefix". Here Letter R indicates BCBS FEP prefix. hbbd```b``"`r9LLN`DR,>6l30&U$60D2HO rH+H f`bdV8J View Medicare information Radiology utilization for Arkansas Blue Cross FEP Wheelchairs - Mobility Assistive Equipment (Manual & Power) & Scooters - Wheelchair Purchase only -Motorized) Wheelchair: E1050, E1060, E1070, E1083, E1084, E1085 . 1268 0 obj <>stream q8-_?UT"X e+1?#7DMKHY]?R,-e;PE\mL Save my name, email, and website in this browser for the next time I comment. Codes may chan ge, and this list may be updated throughout the year. PDF Traditional Coverage - BCBSIL Always make sure to submit claims to insurance company on time to avoid timely filing denial. First Care, Inc. are independent licensees of the Blue Cross and Blue Shield Association. It clarifies a utilization management vendor change for specific members. You can also contact us for specialty medical billing services. NBT . So, all BCBS plans, including Anthem prefix and Non-Anthem plans announced that member IDs will also be Alpha Numeric from 2018 onwards. The first two characters of such BCBS prefix spots member plan and the third character is to identify the type of product in which the BCBS member is enrolled. Correct BCBS home plan can easily be identified using our BCBS prefix lookup directory. On the other hand, the BCBS member ID number is a unique identifier assigned to each individual member covered under a BCBS health insurance policy. Xceed Billing Solutions motive is to create ease for providers, medical billers, patients and everyone who is involved in revenue cycle process. First Character P is symbolizing that member plan/product type is BCBS PPO. Yes, Policy number same as member ID number and also known as subscriber ID number. Have a look at our BCBS alpha prefix and BCBS alpha numeric prefix directory below. Contact us to learn how we can improve your revenue cycle. Box 7930 Philadelphia, PA 19101-7930 Our Health Choice plans are available to Arizonans who qualify for Medicaid. The three-character prefix identifies the Blue Cross and Blue Shield Plan to which the member belongs. Does policy number same as member ID number? Carefirst BCBS of Maryland the (MD), District of Columbia (DC) and the Northern Virginia (VA) Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. It means that BCBS members IDs prefix will must have alphabets and they may or may not have numbers. PDF 2022 Commercial PA Code Lists December Updates - BCBSIL BCBS Alpha Numeric Prefix Its a three letter Alpha numeric prefix followed by id number. Plan Type: PPO . Lets dig into it! TT$%b"Dg!h^`]-ce?i8xRiu1IrD-%oR#yt;JBOJ#"TXwD0L Fw,]xS_CU3zf]06_T} PNGCqWV^UET6X~`U If you have any questions, call the number on the members ID card. Also, pre-authorization information and medical policy for out of state plans may be found on the Blue Cross Blue Shield of Texas provider website section under Standards and Requirements, and then select "Medical Policy and Precertification/Preauthorization for Out of Area Members. %%EOF This new site may be offered by a vendor or an independent third party. The purpose of this list is to assist WA and AK providers to determine plan [PDF] CareFirst Third Party Administrator (TPA)/Network Lease Accounts Prefix. Medical providers - Arkansas Blue Cross and Blue Shield K8Z : Page 2 . Blue KC Commercial Prior Authorization and Notification List Have a look at our BCBS alpha prefix and BCBS alpha numeric prefix directory below. CareFirst IDs have plan codes 080/580 and 190/690. To view this file, you may need to install a PDF reader program. Enter a location and search by doctor or hospital name, health condition, or specialty. We recently received a query from a provider that how I can identify that patient is BCBS health insurance member. For Federal Employee Program (FEP) precertification requirements, please see the separate FEP precertification list. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. Narrow Network: Provider participation is by invitation. How To Identify Blue Cross Blue Shield Member? See the Medical oncology prior authorization list for Blue Cross and BCN commercial members for a supportive care drugs (other than CAR -T comprehensivelist of managed by AIM, and groupsincluded in the program. In case, you need any additional information related to BCBS prefix then feel free to reach out to us. a'm `xn_F-y(MQ&O!y1?-uZ=t'=E$r2$IA)gYWp&g` 777 0 obj <>stream BCBS prefix lookup directory is a valuable resource for anyone who is looking for right Blue Cross Blue Shield home plan. 2021 Commercial Prior Authorization Requirements Summary (Updated December 2020) This document provides an overview of services/care categories for which prior authorization may be required for some commercial, non-HMO Blue Cross and Blue Shield of Illinois (BCBSIL) members. %PDF-1.6 % We update BCBS prefix list data on daily basis to provide latest BCBS prefix home plan information. Baltimore, MD 21237 . So, to accomplish our goal, we have listed down the complete BCBS alpha prefix list so that you can easily identify correct BCBS plan. The site may also contain non-Medicare related information. Most Blue Cross Blue Shield (BCBS) member IDs begin with a three-character prefix. Third, it can help you make more informed decisions to choose right insurance plan and benefits. Blue Shield (BS) of California. Amerihealth Caritas Directory Healthcare, Health Insurance in United States of America, Place of Service Codes List Medical Billing, Empire Blue-Cross Blue-Shield of New York, Anthem Blue-Cross Blue-Shield of Kentucky, Maryland/District of Columbia/Northern Virginia, Highmark Blue-Cross Blue-Shield of Pennsylvania, Anthem Blue-Cross Blue-Shield of Connecticut, Anthem Blue-Cross Blue-Shield of Colorado, Anthem Blue-Cross Blue-Shield of New Hampshire, Anthem Blue-Cross Blue-Shield of Missouri, Blue-Cross Blue-Shield of Western New York, Independence Blue-Cross of Philadelphia and Southeastern Pennsylvania, Anthem Blue-Cross Blue-Shield of Virginia, Excellus Blue-Cross Blue-Shield of New York, Anthem Blue-Cross Blue-Shield of Wisconsin, Highmark Blue-Cross Blue-Shield of West Virginia, Horizon Blue-Cross Blue-Shield of New Jersey, Highmark Blue-Cross Blue-Shield of Delaware. Suppose assume claims filed with an incorrect member ID number or BCBS prefix by Provider or Billing companies, then BCBS insurance will deny the claim stating Incorrect member ID, please submit with an correct member ID number. PDF 2021 Three Character Prefix External link You are leaving this website/app (site). No, the BCBS policy number is not typically the same as the BCBS member ID number. (Note: For changes to come later this year, refer to this notice, posted Dec. 28, 2020: Commercial Prior Authorization Code Changes, Effective April 1, 2021. BCBS Alpha Prefix List BCBS member ID have maximum 17 characters but most of the member IDs have 12 characters. Not assigned prefix. BCBS Prefix will not only have numbers and the . By doing it may cause delay in processing or handling the claim. For example: ABC12345678 Here " ABC" is BCBS alpha prefix. Follow the step-by-step instructions below to design your premiere blue cross amp the regency group three character prefixes: Select the document you want to sign and click Upload. BCBS Railroad refers to Blue Cross Blue Shield health insurance plans that are specifically designed for members who are affiliated with railroad organizations in the United States. The three-character prefix at the beginning of the members identification number is the key element used to identify and correctly route out-of-state claims to the appropriate BCBS Plan. BCBS alpha numeric prefix contains alphabets as well as digits ranging from 1 to 9. ;MTK Customer Service: 1-800-409-9462 HCSC-PORT. bcbs prefix list PDF,Doc ,Images - pdfprof.com New BCBS Alpha Numeric Prefixes | My Payer Directory Denials with solutions in Medical Billing, Denials Management Causes of denials and solution in medical billing, CO 4 Denial Code The procedure code is inconsistent with the modifier used or a required modifier is missing, CO 5 Denial Code The Procedure code/Bill Type is inconsistent with the Place of Service, CO 6 Denial Code The Procedure/revenue code is inconsistent with the patients age, CO 7 Denial Code The Procedure/revenue code is inconsistent with the patients gender, CO 15 Denial Code The authorization number is missing, invalid, or does not apply to the billed services or provider, CO 17 Denial Code Requested information was not provided or was insufficient/incomplete, CO 19 Denial Code This is a work-related injury/illness and thus the liability of the Workers Compensation Carrier, CO 23 Denial Code The impact of prior payer(s) adjudication including payments and/or adjustments, CO 31 Denial Code- Patient cannot be identified as our insured, CO 119 Denial Code Benefit maximum for this time period or occurrence has been reached or exhausted, Molina Healthcare Phone Number claims address of Medicare and Medicaid, Healthfirst Customer Service-Health First Provider Phone Number-Address and Timely Filing Limit, Kaiser Permanente Phone Number Claims address and Timely Filing Limit, Amerihealth Caritas Phone Number, Payer ID and Claim address, ICD 10 Code for Sepsis Severe Sepsis and Septic shock with examples, Anthem Blue Cross Blue Shield Timely filing limit BCBS TFL List, Workers Compensation Insurances List of United States, Workers Compensation time limit for filing Claim and reporting in United States. %%EOF So the next time you need to identify accurate BCBS prefix home plan, remember to use the BCBS prefix list lookup finder. Its important to remember that benefit plans differ in their benefits, and details such as prior authorization requirements are subject to change. BlueCard Program Alpha Prefixes | Blue Cross and Blue Shield - BCBSTX Choose My Signature. Additionally, the following services require Prior Authorization regardless of place of service or level of care: To submit a prior authorization request you may also fax or mail your request. PREFIXES . BCBS prefix List plays a vital role in filing the health care claims properly to the correct BCBS address and also to verify members eligibility, health insurance coverage information and to reach the correct BCBS department to check the claim status or disputes of the claim. We update BCBS prefix list data on daily basis to provide latest BCBS prefix home plan information. Prefix Group Address Group Name TPA Name & Address Claims Filing Claims & Benefit Contact Name Phone . Below in our BCBS prefix lookup directory, you can lookup all the BCBS prefix appropriate home plans and their contact information. Let's start with you. To identify correct blue cross blue shield department, they use three characters BCBS prefix in the start of each BCBS member plan ID. PPO 837P Prefixes are also applicable, . To accommodate our increasing lines of business, Blue Cross and Blue Shield of Montana (BCBSMT) has adopted several new three character prefixes as part of the member identification numbers. AZBlue - Blue Cross Blue Shield of Arizona - Health Insurance Plans A healthier Arizona is what we're all about. In some case provider or billing company may file the claim to an incorrect address without checking the correct BCBS address. (Note: For changes to come later this year, refer to this notice, posted Dec. 31, 2020: New Prior Authorization Requirements for Advocate Aurora Health Members Will Take Effect April 1, 2021.). endstream endobj 366 0 obj <>>>/Filter/Standard/Length 128/O(`iYJhD[>R`Xq)/P -1324/R 4/StmF/StdCF/StrF/StdCF/U(ETWBQcf )/V 4>> endobj 367 0 obj <>/Metadata 16 0 R/PageLayout/OneColumn/Pages 363 0 R/StructTreeRoot 28 0 R/Type/Catalog>> endobj 368 0 obj <>/Font<>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 369 0 obj <>stream External link You are leaving this website/app (site). endstream endobj startxref ", Blue Cross and Blue Shield of Texas, aDivision of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association, PDF File is in portable document format (PDF). Box 805107, Chicago, Illinois 60680-4112. BCBS Prefix should be included along with ID number, exactly as it appears on the member ID card when filing the claims to insurance company. Decide on what kind of signature to create. For Example: ABC, AQT, TXX, TEA, A2B, 2AB, 2A2, PAS, ZGP, XXU etc. BCBS FEP Prefix BCBS Federal Employee Program is identified by the letter R followed by the number. Three-Character Prefixes. b(f{YH^tn}u62\}TgT>ENWJB=J #=a$oXIq(n,tU+D'j}L(t#,w?!^oZUQR, 7a. Regence Prefix List Form - Fill Out and Sign Printable PDF Template All prefixes are unique. PDF Provider Quick Reference Guide - CareFirst BCBS prefix are easy to identify using our BCBS prefix lookup because they're part of every BCBS member ID and we included all of them here in the BCBS prefix list. Unraveling the Truth, United Healthcare Claims Address, Payer ID, Fax and Phone Number, BCBS Prefix List 2023 Alpha Prefix and Alpha Number Prefix Lookup, BCBS Alpha Numeric Prefix from L2A to L9Z (Updated 2023), BCBS Provider Phone Number for Claims and Eligibility Verification, Benefits and Eligibility Verification Services. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Xceed Billing Solutions is amedical billing company for outsourcing medical billing services. For more information, contact your Network Provider Consultant or call 406-437-6100. If you have any questions or need help submitting a prior authorization, please call 816-395-3989 for assistance. For 2021, there were no changes to overall care categories, but some of the codes within certain categories may have been updated. Blue Cross and Blue Shield of Illinois, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue . PAJ. You may also want to know: United Healthcare Claims Address Information. Use this guide to see prior approval information for members with ID card prefixes: AEE, AXC, EXX, XCB, XCQ, XCR View guides [pdf] Medicare plans Learn more about providing care for Medicare members. hbbd```b``@$Df/i #D2lE``vd@ "@,iZ R R2H{v# k This can be especially helpful if youre in a rush or need to access your BCBS prefix home plan information quickly. BCBS National accounts are employer groups that have outlets/offices in multiple states but they offer limited coverage to their employees. BCBS Alpha Prefix Its a three letter alpha prefix followed by id number. BCBS is one of the biggest insurance companies in USA and serving more than 106 million people. It allows you to quickly and easily identify your insurance home plan, saving you time and hassle. The following summaries and related prior authorization lists were posted on the Support Materials (Government Programs) page as of Jan. 1, 2021: Important Reminder: Check Eligibility and Benefits First Member ID cards with no prefix Some member ID cards may not have a prefix. A2Z, G2A, J4K etc. These prefixes may include alpha and numerical characters. You may see cards with four-character prefixes, e.g., HMSA Blue Cross Blue Shield of Hawaii uses four-character prefixes. Checking eligibility and/or benefit information and/or the fact that a service has been prior authorized is not a guarantee of payment. BCBS Railroad member IDs are assigned to members who served in railroad organizations. Medicare Working or retired, we'll help you every step of the way to find the right plan. BCBS Prefix List 2023 - Alpha Prefix and Alpha Number Prefix Lookup What is the difference between BCBS alpha prefix and BCBS alpha numeric prefix? Please look for claim filing instructions on the back of the ID card. PDF Blue Cross and BCN utilization management medical drug list - BCBSM Independence Blue Cross* Quick Reference Guide . Summaries and code lists are posted as a reference to help you determine when prior authorization may be required for non-HMO government programs members. eO\v; tU9kN@]fh:~q:Fye{Q)ihJ HP/VD/_oy\ H ~fa4L?!ekF(\0>o Blue Cross Select Silver. Due to the exceeding number of BCBS insurance members, Alpha-Only Prefix member IDs exhausted. The three-character prefixes listed do not represent an exhaustive listing of prefixes. 1229 0 obj <> endobj Blue Cross and Blue Shield of Illinois, aDivision of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association, PDF File is in portable document format (PDF). PDF Member account and prefix updates: Provider FAQs
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