You may request to have a customer service representative call you at a scheduled time during normal business hours for plan help. H\@F. Coordination of Benefits (COB) is a provision included in both member and physician and provider contracts. A Level I Appeal is used for both billing and non-billing issues. Regence BlueShield. Paper Claim Form . DCY BCBS of Florida endstream endobj 597 0 obj <>/Filter/FlateDecode/Index[30 523]/Length 41/Size 553/Type/XRef/W[1 1 1]>>stream 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). CUW Anthem Blue Cross of California Payment policy: You can find our payment policies on our website in the Library, under Reference Info. That way, we can verify your account and start helping you as quickly as possible. CWR Anthem Blue Cross of California Always refer to the online branded versions of our payment policies to ensure the most current and accurate information. Get help when you need it. The IQ is available in the Provider Library under Forms. 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. AAC BCBS of IL 0000087176 00000 n Seattle, WA 98111-9202, Back to Medical Reference Manuals overview, Espaol | Regence Group Administrators offers a complete suite of health risk management services in addition to benefit administration. 553 0 obj <> endobj 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 View your credentialing status in Payer Spaces on Availity Essentials. DJQ Anthem Blue Cross of California Instead, deposit the check, circle the claim in question on the Explanation of Payment (EOP) and include a short explanation as to why there was an overpayment. YDW Retail OFF Exchange Use search function and put your comment any alpha prefix not found here. For most plans, we'll deny claims received more than 12 months after the date of service with no member responsibility. 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. Use our onboarding resource to quickly get started. Note: Some members will remain in Blue Cross of Northeastern Pennsylvania health plans until their coverage renews to Highmark health plans later this year. Regence BlueShield Attn: UMP ClaimsP.O. Appeals rights will be exhausted if not received within the required timeframe. You can reach Customer Service by calling 877-342-5258, option 2. Please provide a detailed description of the service being provided and the code to a member of our Customer Care Team at 1-866-738-3924 and they will provide you with an accurate benefit quote. Please review the terms of use and privacy policies of the new site you will be visiting. 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 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. You can submit claims daily, weekly, or monthly. AFC BCBS of IL 0000018886 00000 n Tricare Phone Number and Claim Address; Molina Healthcare Phone Number claims address of Medicare and Medicaid. Policy #s: Regular 10017241-0001, Transit 10017241-0004, Sheriff 10017241-0016 . BCBS Provider Phone Number. Any suggestions. Blue Advantage Administrators of However we have some guide to follow, using prefixes we could find the state of the BCBS and contact phone number to proceed further. 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. HMO products include BlueChoice HMO, Direct Connection HMO, Child Health Plus, BlueChoice HMO/POS and Direct POS. 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. If you have questions about COB, contact Customer Service by calling the phone number on the back of the member's ID card. The earlier you submit claims, the earlier we process them. 0000004716 00000 n A subrogation provision is included in both member and physician/provider contracts. EMPIRE BCBS Decides the pre certification requirements based on the prefix id. 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. Claims AAU Blue Shield of California Box 91102 DJD BCBS of Nebraska Polski | Discover all the ways members can earn wellness incentives and rewards for taking an active role in their health. DKA Wellmark BCBS Iowa/South Dakota national customer service numbers at fepblue.org, Espaol | To do so, please submit the proposal in writing to your assigned Provider Network Executive (PNE) or Provider Network Associate (PNA). This service is considered a standard exclusion. to 6:00 PM PT or log in to your RGA account and submit an electronic request. All services rendered by the same provider for the same patient for the same date of service must be submitted on one claim form. We do not request refunds for overpayments less than $25, but you may submit these voluntarily. You can submit a complaint about one of our actions (verbally or in writing) to one of our employees. CZG Premera Blue Cross of Washington For other language assistance or translation services, please call the customer service number for your local Blue Cross and Blue Shield company. National Correct Coding Initiative (NCCI) editing is followed when applicable. The Identification cards will include: ** The three-character alpha prefix at the beginning of the members ID number AAB BCBS of Michigan Washington Help Center: Important contact information for Premera Blue Cross, and Regence BlueShield. Retirees and PEBB Continuation Coverage members:Phone: 1 (800) 200-1004TRS: 711Business hours: Monday through Friday 8 a.m. to 4:30 p.m. (Pacific). Who do I contact for EDI questions? 0000008616 00000 n QMF Retail ON Exchange BCBS Prefix List 2021 - Alpha. (If no account number is assigned, the words No Patient Account # are noted. BCBS Provider Phone Number. We can't process this claim because we haven't received the necessary information we requested from your provider. Premera Blue Cross 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, AAN Anthem Blue Cross of California All people who have BCBS health insurance policy have to make copies of their ID front and back and keep such records on hand. 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. CYS BCBS of IL Electronic claims without a TIN are rejected as incomplete. 0000018383 00000 n Carpenters Retirement Plan Individual Account Pension Plan Pre-Retirement Planning Your Balances & Accruals. We also provide information regarding mediation should you disagree with the decision. You can find a claim by the members ID number or by the claim number. PO Box 52057 You have to avoid this idea when you have geared up for successfully using the health insurance plan. CVB BCBS of Florida We will notify you once your application has been approved or if additional information is needed. YDO Retail OFF Exchange Its often confused that BCBS have lot of prefixes and where to contact. Premera Blue Cross Blue Shield of Alaska FEP PO Box 33932 Seattle, WA 98133-0932, Phone:800-562-1011 Claim edits in place will identify those services previously billed and bundle ALL services on to a single ADL Anthem BCBS Kentucky AAS Anthem Blue Cross of California 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. ** A local network identifier, (for example, BlueMark) AGG Anthem BCBS of Ohio Regence BlueShield - FEP PO Box 857 Lewiston, ID 83501. Correspondence. ADW Carefirst BCBS Maryland CVA Anthem BCBS of Ohio The claim(s) will suspend and a processor will review to determine whether to send an Incident Questionnaire (IQ) to the member. CZV BCBS of Alabama Regence BlueShield serves select counties in the state of Washington and is an independent licensee of the Blue Cross and Blue Shield Association. Regence health plans operate in Oregon, Idaho, Utah and select counties in Washington, each an independent licensee of the Blue Cross and Blue Shield Association dedicated to making health care better, simpler and more affordable. When members from Blue Plans arrive at your office or facility, be sure to ask them for their current Blue Plan membership identification card. Tricare Phone Number and Claim Address; Molina Healthcare Phone Number claims address of Medicare and Medicaid. Here are common reasons why claims suspend or reject: Contact Customer Service with questions regarding claims processing or send a copy of the voucher highlighting the claim in question and the inquiry reason. Heres everything you need to know about it. Congestive Heart Failure. 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) 401 Fifth Ave. They have Coordination of Benefits when we are the secondary carrier on the claim. Uprise Health General Access . AFA Anthem BCBS of Virginia Here are examples: A Level I Appeal must be submitted with complete supporting documentation that includes all of the following: Incomplete appeal submissions are returned to the sender with a letter requesting information for review. All Rights Reserved to AMA. 24/7 anonymous hotline: 1 (800) 323-1693 KingCareSMuses a preferred provider organization (PPO) for its network. They require completion and mailing of an Incident Questionnaire for possible accident investigation or a Workers Compensation injury (claims in subrogation). Tagalog | Examples: medical doctor, osteopath, optometrist, chiropractor, physical therapist, audiologist, independent laboratory, nurse practitioner, durable AFP Anthem BCBS of Ohio Please refer to your electronic billing manual for specific formatting for electronic claims.
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