BlueCard/FEP Lookup | Blue Cross of Idaho - bcidaho.com Regence BlueShield - FEP PO Box 857 Lewiston, ID 83501. QMF Retail ON Exchange Subrogation permits the plan to recover payments when the negligence or wrongdoing of another causes a member personal illness or injury. Tricare Phone Number and Claim Address; Molina Healthcare Phone Number claims address of Medicare and Medicaid. The NPI replaces all proprietary (payer-issued) provider identifiers, including Medicare ID numbers (UPINs). CVP Anthem BCBS of Ohio Our provider complaints and appeals process ensure we address a complaint or an appeal in a fair and timely manner. | If we processed the original claim incorrectly, you do not need to rebill. Visit the Regence provider website, regence.com to learn more about: Claims and payment: Appeals. Verify eligibility via Highmarks NaviNet. 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. Claims - PEBB - Regence Prompt Pay interest is currently calculated monthly for the previous month's paid claims. 0000010898 00000 n Heres everything you need to know about it. This is a duplicate of a previously denied claim. Make sure you have your Member ID card handy when you call us. Call customer service and web support at 800-607-0546 between 8 a.m. and 6 p.m., Monday through Friday, Pacific Time. YDW Retail OFF Exchange 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. ** Make copies of the front and back of the members ID card and pass this key information on to your billing staff. Pension & Retirement. Mail the overpayment amount to our finance department (address on check) along with a completed Refund Request form, or. Do not add or omit any characters from the member ID numbers. Get immediate member information by phone or fax . The ID cards also may have: . We can process the claim after we receive that information. This claim is a duplicate of a previously submitted claim for this member. KingCareSMuses a preferred provider organization (PPO) for its network. Pay or deny 95 percent of a provider's monthly clean claims within 30 days of receipt; and. CWI Blue Shield of California 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. 0000008643 00000 n QAB. We also apply the following Prompt Pay standards set by the State of Alaska to our claims adjudication process in order to: Oregon contracted and non-contracted AGH Anthem Blue Cross of California CUR Healthnow of NY Buffalo AFY BCBS of IL We can't process this claim because we haven't received the necessary information we requested from your provider. BCBS Prefix List YAA to YZZ - Alpha Lookup by State 2022 We haven't received the information. We send the member a questionnaire requesting information to determine if benefits are available. Included with the interest voucher is a summary report detailing 10/18) v2. We can't process this claim because we haven't received your response to our request for information. Provider who rendered the service. 02/16/2023 Retirement Workshop in Lacey on Feb. 18. . We accept electronic claims through Availity using payer ID RGA01. AAX Anthem Blue Cross of California the claims for which interest payments have been applied during that period. PDF Electronic Remittance Advice Enrollment - Availity We haven't received the information. Interest less than Please provide a detailed description of the service for preauthorization to a member of our Customer Care Team at 1-866-738-3924 and they will let you know if the service requires preauthorization. You can recognize Managed Care/POS members who are enrolled in out-of-area networks through the member identification card as you do for all other BlueCard members. Please refer to your electronic billing manual for specific formatting for electronic claims. BCBS Provider Phone Number. When we process a claim, we coordinate benefits if the member has other primary coverage from another carrier, our health plan, service plan, or government third-party payer. 1-800-423-1973. To cancel or waive your coverage, visit the PEBB Program website using these links: Uniform Medical Plan (UMP) is a self-insured Preferred Provider Organization (PPO) medical plan offered through the Washington State Health Care Authority. BCBS Prefix List ZAA to ZZZ - Alpha Lookup by State 2022 Contact us - BridgeSpan Health 553 0 obj <> endobj (Note: Claims received with an ICD-9 code will be rejected with a notice to re-bill using ICD-10.) AGW BCBS of MA 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. 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. Mail this claim to: Regence BlueShieldPO Box 1106Lewiston, Idaho 83501 Or Fax claim to: (888) 606-6582 FORM PD020-WA Page 2 of 3 (Eff. Provider: send us medical records relating to prescription drug charges. YDM SG Off Exchange Postal Prescription ServicesOnline: Your PPS accountPhone: 1 (800) 552-6694TRS: 711Fax (for providers only): 1 (800) 723-9023Business hours: Monday through Friday 6 a.m. to 6 p.m. and Saturday 9 a.m. to 2 p.m. (Pacific), Ardon HealthPhone: 1 (855) 425-4085TRS: 711Fax (for providers only): 1 (855) 425-4096Business hours: Monday through Friday 8 a.m. to 7 p.m. and Saturday 8 a.m. to 12 p.m. (Pacific), Online: Medicare or MyMedicarePhone: 1 (800) MEDICARE (1-800-633-4227)TTY: 1 (877) 486-2048. ABV Anthem BCBS of Ohio CZK Anthem BCBS of Virginia ADG Anthem BCBS of Ohio Claim Submission and Payments | Provider | Premera Blue Cross 3. News. Regence Blue Cross Blue Shield of Oregon - Yelp We may send a questionnaire to the member regarding possible duplicate coverage. Where do I submit a preauthorization request? Regence Group Administrators offers a complete suite of health risk management services in addition to benefit administration. Ting Vit | 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. 4. Lewiston, ID 83501 . 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. Tricare Phone Number and Claim Address; Molina Healthcare Phone Number claims address of Medicare and Medicaid. The employer group name is usually associated with the alpha prefix of the account specific health insurance type. You can submit claims daily, weekly, or monthly. CYJ Horizon BCBS of New Jersey Note: When submitting an email inquiry, please include your tax identification number (TIN) and/or Organizational NPI number. A detailed description of the disputed issue, All evidence offered by you in support of your position including medical records, A description of the resolution you are requesting. 1-877-764-8724 Email Us. Professional Services are performed by a doctor or other healthcare professional. Boise, ID 83707. Your member ID card is your key to using your medical plan benefits. Featured In: May 2020 Empire Provider News. | 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. Box 260070 Pembroke Pines, FL 33026 . 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. Call the National Information Center at 1-800-411-BLUE (2583) weekdays from 8 a.m. to 8 p.m. Eastern time. Regence Blue Shield in accordance with the terms of your provider contract with Regence. We use cookies on this website to give you the best experience and measure website usage. Completion of the credentialing process takes 30-60 days. Claims - SEBB - Regence ALN PA BC PA, Highmark, POB 1210 , Pittsburgh , PA , 15230 800-433-9906 Use find (Ctrl + F) and enter the prefix to find the BCBS state. AAU Blue Shield of California 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. ** PPOB in a suitcase logo, for PPO members with access to the BlueCard PPO Basic network By continuing to use this website, you consent to these cookies. ACD BCBS of Michigan No pre-authorization for COVID-19 vaccinations, testing and treatment, No member cost shares for COVID-19 vaccinations, testing and treatment. CUQ Blue Shield of California CMS also uses RVUs to allocate dollar values to each CPT or HCPCS code. To obtain a UMP document in another format (such as Braille or audio), call UMP Customer Service. ABD Blue Shield of California This includes Management - prior auth/pre-service requests), Email: Members: Log in/register at MyBlue Customer eService, Regence BlueShield - FEPPO Box 21709Seattle, WA 98111. 24/7 anonymous hotline: 1 (800) 323-1693 Tennessee. trailer AFZ Anthem Blue Cross of California The alpha prefix identifies the Blue Plan or National Account to which the member belongs. Uniform Medical Plan (UMP) offers you five different health plans through Washington state's Public Employees Benefits Board (PEBB). ** When filing a claim, always enter the ID number, including the alpha prefix, exactly as it appears on the members card. The total number of characters in the members ID ranges from six to fourteen. TINs are still a required element for claims. If submitting a corrected claim electronically, remember to: For additional instructions on electronic corrected, replacement or voided claims, visit the online section Electronic Transactions and Claim Payer ID, for additional If you feel some of our contents are misused please mail us at medicalbilling4u at gmail dot com. 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) color, national origin, age, disability, sex, gender identity, or sexual orientation. 0000004829 00000 n AFM BCBS Minnesota 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. ABQ Blue Cross of Idaho (Boise) Provider home - Regence AFG BCBS of Nebraska PDF Local Blue Cross and Blue Shield Mailing Addresses State/Alpha Prefix Prefix State/Area Plan Type Plan Name Provider and member service CMS contract, VOF NY MA HMO MediBlue HMO 1-800-499-9554 H3370 CWA Carefirst BCBS Washington DC DJG Anthem BCBS of Ohio It is only after we determine a members eligibility or coverage that payment policies and edits are applied. 0000004941 00000 n Once you have signed in, simply click on the Claim Search link. Get help when you need it. Modifiers. Claims submission Learn more about billing and how to submit claims to use for payment. When Calypso identifies an overpayment, they mail an Overpayment Notification letter with a request for the overpaid amount. You can learn more about credentialing by visiting the provider section of our website. AGU Carefirst BCBS Maryland Regence Blue-Cross Blue-Shield: HCT BCBS Prefix: Pennsylvania: Highmark Blue-Cross Blue-Shield of Pennsylvania: HCU: Tennessee: Blue-Cross Blue-Shield of Tennessee: HCV: Mental Health/Substance Use Disorder Precertification. LAB. We are unable to quote a benefit by a code. 1 (888) 675-6570 Prescription questions? ABY Carefirst BCBS Maryland Claims submitted that indicate possible Workers' Compensation illness or injuries are investigated. 2. AGY BCBS of South Carolina When a Medicare patient received services that Medicare specifically requires to be submitted on separate claim forms, this one claim requirement will not apply. PO Box 3876. This service is considered a standard exclusion. View your credentialing status in Payer Spaces on Availity Essentials. (BlueCard will request refunds regardless of the dollar amount.) Were ready. Note : We have added some more prefixes in the list. What you need to know about the disease and our commitment to ensuring you have access to the right care at the right time. 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. To send an electronic claim, use the Availity clearinghouse with payer ID RGA01. Premera Blue Cross Before implement anything please do your own research. Use our onboarding resource to quickly get started. All Excellus plans use this mailing address: Excellus BCBS Attn: Claims P.O. CUP CBA BLUE (BCBS VT) Claims & payment - Asuris If you require a written refund request before mailing the overpayment, contact Calypso directly at 800-364-2991. This standard is called the "Birthday Rule.". LAA. These weights are then multiplied by the dollar conversion factor we publish. Complaints received beyond the 365-day timeframe will not be reviewed and the appeals rights pertaining to the issue will be exhausted. CVG BCBS of Florida When you go to this page, you should see a dialog box that asks for your ZIP code. Electronic claims without a TIN are rejected as incomplete. AAP BCBS of Tennessee DJW Wellmark BCBS Iowa/South Dakota Provider home - Asuris Washington - Blue Cross and Blue Shield's Federal Employee Program Uprise Health General Access . Coordination of Benefits (COB) is a provision included in both member and physician and provider contracts. Note: Some members will remain in Blue Cross of Northeastern Pennsylvania health plans until their coverage renews to Highmark health plans later this year. Secondary submission: When submitting secondary claims to us, submit the primary processing information with the submission of the secondary claim. P.O. If there are no court decrees, the plan of the parent with custody is primary. To make tracking patient reimbursement easier, we can include these account numbers on our payment vouchers. 0000010231 00000 n Regence Provider Appeal Form. In this health insurance plan, alpha prefix is assigned to national accounts. The claim(s) will suspend and a processor will review to determine whether to send an Incident Questionnaire (IQ) to the member. 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. Box 805107 Chicago, IL 60680-4112. You have five UMP medical plan options: UMP Classic. Claims Submission Map | FEP | Premera Blue Cross 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. CZU Anthem Blue Cross of California Some members may carry outdated identification cards that may not have an alpha prefix. Tricare Phone Number and Claim Address; Molina Healthcare Phone Number claims address of Medicare and Medicaid. This is a claim adjustment of a previously processed claim. Empire BlueCross moved Individual (non-group) Medicare Advantage members to a single claims processing system Jan. 1, 2015. ABA BCBS of IL Eastern WA and Alaska providers submit to Premera. Web: Regence BlueShield. treatment center.
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