0000055046 00000 n Washington - Blue Cross and Blue Shield's Federal Employee Program This means that you may see cards with ID numbers between six and 14 numbers/letters following the alpha prefix. We use cookies on this website to give you the best experience and measure website usage. ALR AR BC AR, PO Box 2181 , Little Rock , AR , 72203-2180 888-847-1400, AMU RI BCRI, 444 Westminister St , Providence , RI , 02903-3279 401-831-7300, AMZ KY BC KY, POB 37690 , Louisville , KY , 40233 800-925-0135, AON IL BC IL, POB 1364 , Chicago , IL , 60690 800-972-8088, APT DE BC DE, POB 8830 , Wilmington , DE , 19899-8830 800-342-2221 We can't process this claim until the incident questionnaire we sent the member is fully completed, signed and returned. Find Contact Information. AEP Carefirst BCBS Maryland 1-800-962-2731. Thank you for the care you provide to our members and people in our communities. AES BCBS of Alabama ** Do not add/delete characters or numbers within the member ID. Plan to submit test claims. ABD Blue Shield of California or sexual orientation.Premera Blue Cross HMO complies with applicablefederal and Washington state civil rights lawsand does not discriminate on the basis of race, If your request for mediation is timely, both parties must agree upon a mediator. AGX Anthem BCBS of Virginia ADF Healthnow of NY Buffalo Claims. ** PPOB in a suitcase logo, for PPO members with access to the BlueCard PPO Basic network 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. This prefix is the part of the distinctive identification number. Prefix Product Area Billing Address Phone #, AAX CA BC CA, POB 60007 , Los Angeles , CA , 90060 800-765-2588, ABW VA BC VA, Trigon POB 27401, Richmond , VA , 23279 800-445-7490, ACN PA BC PA, Highmark BC PO Box 1210 , Pittsburgh , PA , 15230 800-682-3386, ACT NY BCBS Empire, POB 11800 , Albany , NY , 12211-0800 800-992-2583 PDF Regence Provider Appeal Form 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. Regence Uniform Medical Plan Vision Claim Form All Rights Reserved to AMA. The provider appeals process does not apply to FEP, BlueCard Home Claims, Medicare Supplement plans, or Medicare Advantage plans. Claims Submission Map | FEP | Premera Blue Cross | We need the member to promptly complete and return this questionnaire to process claims in a timely manner. Learn how to contact your local Blue Cross and Blue Shield company, as well as other key areas. 598 0 obj <>stream 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. Thank you for choosing Regence as your health plan administrator. If the IQ states that there is no first-party coverage(s) available, but there is a third-party that is responsible for the incident, we will process all related claims based on the member's contract with us until all parties are ready to negotiate a settlement for possible reimbursement. However, there are some exceptions. 4. Identifying members Easily identify the kind of coverage our members have. . The Prefix tool determines where you should submit a medical claim, either Blue Cross of Idaho or Regence Blue Shield of Idaho, based on an prefix. This claim is a duplicate of a previously submitted claim for this member. Claims - SEBB - Regence Franais | (for both professional and facility claims) using claim frequency code 7. (For example, if your service was provided on March 5, 2022, you have until December 31, 2023 to submit your 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. 0000004941 00000 n The main identifier for out-of-area members is the alpha prefix. 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. 10/18) v2. Medical claims. Our electronic claims process electronically separates and routes only valid claims for processing. No pre-authorization for COVID-19 vaccinations, testing and treatment, No member cost shares for COVID-19 vaccinations, testing and treatment. national customer service numbers at fepblue.org, Espaol | Call 1 (855) 522-8894. ABU BCBS Minnesota ARH IN BCBS of Indiana, POB 68416, Accordia NW , Indianapolis , IN , 46268 317-488-6000, ARR OH BC OH Anthem, 4361 Irwin Simpson Rd , Mason , OH , 45040 513-872-8100, ASA Indemnity CNY PO Box 4809 , Syracuse , NY , 13221 315-448-3735, ASH WNY BCBS WNY, Auto Natl Accts, POB 757 , Buffalo , NY , 14240-0757 800-462-7237, AST TN BCBS Of Tennessee, 801 Pine St , Chattanooga , TN , 37402 423-755-5600, ATT Empire Empire BC, POB 5020 , Middletown , NY , 10940 800-772-2875, AWR PA PA BS Highmark, POB 535045 , Pittsburgh , PA , 15253-5045 800-294-2217, AZO IL BC IL, POB 1364 , Chicago , IL , 60690-1364 800-637-6917, BAN WV BC Washington DC/Carefirst, 550 12th St SW , Washington , DC , 20065 800-642-2411, BBH PPO GA BCBS GA, POB 9907 , Columbus , GA , 31908 800-628-3988, BDC MI BC MI, POB 1618 , Detroit , MI , 48231 800-462-7237 medical equipment supplier, ambulance services, applied behavior analysis services (ABA) or clinical social worker. ** When filing a claim, always enter the ID number, including the alpha prefix, exactly as it appears on the members card. Also its not a sequential order hence its hard to find unless we check with first 3 alpha prefix. . Practitioners who arent credentialed may have their claims returned until they submit a complete credentialing application. You will need special software to send insurance claims electronically. CVQ BCBS of Georgia We are now processing credentialing applications submitted on or before March 14, 2023. DJM BCBS of Texas AFS Blue Shield of California CYP BCBS of IL Only a member can request a Level I or Level II Appeal for a non-billing issue, unless the member has completed a release to allow the provider to act as their Representative. the claims for which interest payments have been applied during that period. AEK Independence Blue Cross P | ** A local network identifier, (for example, BlueMark) CZW BCBS of North Carolina Claims submission Learn more about billing and how to submit claims to use for payment. To ensure that OCR reads your paper claims accurately: Submitting a corrected claim may be necessary when the original claim was submitted with incomplete information (e.g., procedure code, date of service, diagnosis code). If Workers' Compensation denies payment of such claims, Premera will pay according to the subscriber's contract benefits after receiving a copy of a valid denial. Tricare Phone Number and Claim Address; Molina Healthcare Phone Number claims address of Medicare and Medicaid. All people who have BCBS health insurance policy have to make copies of their ID front and back and keep such records on hand. Provider: please send us your office notes for this claim. The ID cards also may have: 0000015026 00000 n This is worthwhile to avoid selecting the alpha prefix randomly. Email: Prproviderrelations@bcidaho.com. CZM Highmark BCBS to 6:00 PM PT or log in to your RGA account and submit an electronic request. | xref CZU Anthem Blue Cross of California For complete plan details, seeBenefits Summaries. Related . CVM Anthem BCBS of Ohio PDF Electronic Remittance Advice Enrollment - Availity Oromoo | | If you need more information about the NPI mandate, Medicare timelines, and/or the enumeration process, visit the CMS website. 0000004829 00000 n AHC Anthem BCBS of Missouri View your credentialing status in Payer Spaces on Availity Essentials. Use only red CMS-1500 forms (no photocopied forms). CYK BCBS of Georgia Michigan. 0 Join us! Many offices assign their own account numbers to patients. CWF BCBS of Georgia ADY BCBS of South Carolina 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. (BlueCard will request refunds regardless of the dollar amount.) This standard is called the "Birthday Rule.". Ting Vit | Find helpful phone, fax and email information for assistance. We abide by the following COB standards to determine which insurance plan pays first (primary carrier) and which pays second (secondary carrier). The plan doesn't cover cosmetic services. Please refer to your electronic billing manual for specific formatting for electronic claims. You can make a complaint verbally to Customer Service or in writing to Customer Service Correspondence. ** The alpha prefix is critical for the electronic routing of specific HIPAA transactions to the appropriate Blue Plan. In this health insurance plan, alpha prefix is assigned to national accounts. LAA. Is there any way that I can download the contact# with prefix. Portugus | Receiving payment Phone: 1-800-628-3481. Lack of credentialing can be grounds for termination from Premeras network. After these steps are completed, you can choose one of the following options to resolve the overpayment: Calypso will apply the refund to the claim as soon as they receive the refund. Contact Us | Blue Cross and Blue Shield of Illinois - BCBSIL DKB Highmark BCBS We send the member a questionnaire requesting information to determine if benefits are available. The IQ is available in the Provider Library under Forms. We accept electronic claims through Availity using payer ID RGA01. Use the following codes: In the Original.Ref.Co segment of box 22 enter the original claim number. View your credentialing status in Payer Spaces on Availity Essentials. It identifies the members Blue Cross Blue Shield company or national account in order to properly route the claim. Before implement anything please do your own research. CZQ Anthem BCBS of Ohio CVS Caremark. trailer Every user of BCBS health insurance is assigned an alpha prefix that contains three letters. They include a request of medical records for review. CWN Carefirst BCBS Washington DC Our Provider Integrity Oversight Committee reviews proposals for new payment policies and updates to our policies. View remittance advices. If you are not registered, please click on the Not Registered link to set up your account. Check out the changes and updates to our plan in 2023. If you find anything not as per policy. Regence BlueShield of Idaho | Regence Primary submission: Show all insurance information on the claim, and then submit the claim to the primary plan first. When dependent children are double-covered by divorced parents, coverage depends on any court decrees. Box 805107 Chicago, IL 60680-4112 Iowa . If you are unable to submit claims electronically, you can submit paper claims on CMS-1500 or UB-04 forms. Provider: please send us your operative notes for this claim. Regence BlueShield serves select counties in the state of Washington and is an independent licensee of the Blue Cross and Blue Shield Association. Box 805107 Chicago, IL 60680-4112. 1fcZi=s6Z@n7;W^ugC:CGLi@0^pQY4#o0 y>_ Physicians and other healthcare providers receive an Explanation of Payment (EOP), which describes our determination of the payment for services. | If the Level II appeal is timely and complete, the appeal will be reviewed. There is a minimum threshold of $25 for monthly interest payments on delayed clean claims. 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. Diabetes. 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). See our FAQs for more claim information and contacts. We use an automated processing system to adjudicate claims. AGC MO BCBS MO, POB 419169 , Kansas City , MO , 64141-6169 888-989-8842, AHP Empire Empire BC, POB 5020 , Middletown , NY , 10940 800-772-2875, AHU PPO MD BC MD, 10455 Mill Run Circle , Owings Mills , MD , 21117 877-228-7268, AHW PA BCBS NE PA, 70 N Main St , Wilkes-Barre , PA , 18711 717-829-8500, AIU PA Independence BC, 1901 Market St , Philadelphia , PA , 19103 215-564-2100, AKM MI BC MI, POB 1618 , Detroit , MI , 48231 800-462-7237 If submitting a corrected claim on paper, remember to: Obtain Corrected Claim - Standard Cover Sheets at onehealthport.com in the administration simplification claims processing section, or under Forms on our provider website. As a nonprofit independent licensee of the Blue Cross and Blue Shield Association, Regence is part of a family of companies dedicated to transforming health care by delivering innovative products and services that change the way consumers nationwide experience health care. | . QMB SG ON Exchange 2. This member wasn't eligible for services on the date of service. AFG BCBS of Nebraska Please review the terms of use and privacy policies of the new site you will be visiting. Filing your claims should be simple. 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. If all pertinent information is obtained, the claim(s) will then be processed according to the member's contract benefits. Prompt Pay interest is currently calculated monthly for the previous month's paid claims. ABV Anthem BCBS of Ohio UMP medical plans are administered by Regence BlueShield. Open 24 hours a day, 7 days a week. Log in to Availity Don't have an Availity account? Your member ID card is your key to using your medical plan benefits. Regence BlueShield - FEPPO Box 31207Salt Lake City, UT 84131, (Attended sleep study at outpatient part of a hospital, home hospice, organ/tissue transplants, clinical trials. For Providers | Regence Group Administrators | Healthcare Benefits 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. It is critical for confirming a patients membership and coverage. ABY Carefirst BCBS Maryland Asthma. Learn more about which practitioners need to be credentialed by viewing our credentialing matrix, located in our credentialing manual, available by request from Credentialing.Updates@premera.com. The 2015 member identification prefixes for individual Medicare Advantage plans are listed below. ABN Anthem BCBS of Virginia DAC BCBS of Tennessee Phoenix, AZ 85072, Retail Pharmacy Program Kreyl Ayisyen | YDW Retail OFF Exchange AHQ Anthem BCBS of Ohio If you are unsure how to submit secondary claims electronically, contact your practice management system vendor or contact an EDI representative at 800-435-2715. If you already have a computer system, notify your software vendor of your desire to convert to electronic claims. Postal Prescription Services Online: Your PPS account Phone: 1 (800) 552-6694 TRS: 711 Fax (for providers only): 1 (800) 723-9023 BET PA BC PA, 120 Fifth Ave , Pittsburgh , PA , 15222-3099 412-544-7000, BFM PA BC PA Highmark, POB 176 , Pittsburgh , PA , 15230-0176 866-316-6339, BGH AL BCBS of Alabama, POB 995 , Birmingham , AL , 35298 205-988-2213, BGP MI BC MI, POB 1618 , Detroit , MI , 48231 800-462-7237, BHP PA BC PA, POB 778988 , Harrisburg , PA , 17177-8988 800-222-3341, BIM MI BC MI, POB 1618 , Detroit , MI , 48231 800-462-7237, BMI IN BCBS of Indiana, 120 Monument Circle , Indianapolis , IN , 46204 317-488-6000, BOG MI BC MI, POB 1618 , Detroit , MI , 48231 800-462-7237 AFI BCBS of Rhode Island AHA BCBS of IL AHB Anthem BCBS of Ohio 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. You can reach Customer Service by calling 877-342-5258, option 2, or by calling the Customer Service phone number on the back of the member's ID card. CWR Anthem Blue Cross of California 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. 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. ACX BCBS of IL We are unable to quote a benefit by a code. 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: We can process the claim after we receive that information. Prefix Plan Name, AAA BCBS of Alabama Box 22999 Rochester, NY 14692 *New York *The Buffalo office handles the receipt of claims and correspondence for BS AFM BCBS Minnesota Eligibility, enrollment, and address/name changes. 1-800-423-1973. For more information about RBRVS methodology visit the CMS website. Refer to your contract for further claims submission information. Box 91102 ** Members who are part of the FEP will have the letter R in front of their member ID number. Our process meets or exceeds the requirements set by the Office of the Insurance Commissioner.