QMC Retail OFF Exchange ), Tel:800-562-1011Fax: 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), Premera Blue Cross - FEPPO Box 33932Seattle, WA 98133, Retail Pharmacy Program Once the claim is found, you can click on original EOP view to pull up this information. Phoenix, AZ 85072, Retail Pharmacy Program P.O. AFZ Anthem Blue Cross of California hb``d``3g`c`P`eb@ !GCPI+""hr^eA ewJ?hx2-H IM:^7I,y ZPPTP J ! X,/ !q77p0P&{'LYr000 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. Uniform Medical Plan (UMP) offers you five different health plans through Washington state's Public Employees Benefits Board (PEBB). Remember to include the leading three-character prefix and enter it in the appropriate field on the claim form. Claims & payment - Regence Calypso, our affiliate, processes refunds and overpayment requests. Monday-Friday, 8-5 Pacific (800) 552-0635 www.CarpentersBenefits.org. If you are deaf, hard of hearing, or have a speech disability, dial 711 for TTY relay services. Coordination of Benefits (COB) is a provision included in both member and physician and provider contracts. Uprise Health General Access . Provider Claims Submission | Anthem.com Contact us for health care providers Contact us for healthcare providers. BCBS Prefix List XAA to XZZ - Alpha Lookup by State 2022 BCBS Prefix List QAA to QZZ - Alpha Lookup by State 2022 ** When filing a claim, always enter the ID number, including the alpha prefix, exactly as it appears on the members card. CVM Anthem BCBS of Ohio The ID cards also may have: Access fee schedules. (If no account number is assigned, the words No Patient Account # are noted. Related . 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. Federal Employee Program Overseas Claims P.O. AAN Anthem Blue Cross of California 0000055309 00000 n They can use such copies in different situations and get the complete support on time as awaited. For other language assistance or translation services, please call the customer service number for your local Blue Cross and Blue Shield company. Find helpful phone, fax and email information for assistance. Mental Health/Substance Use Disorder Precertification. Italiano | Availity is solely responsible for its products and services. Eastern WA and Alaska providers submit to Premera. ** The empty suitcase logo What you need to know about the disease and our commitment to ensuring you have access to the right care at the right time. We use an automated processing system to adjudicate claims. Members and Providers: 1-800-395-1616 Email Us. Sometimes an office returns a check to us that represents multiple claims because a portion (see Threshold below) of the payment may be incorrect. AHI BCBS of Rhode Island Facility Services are services received for the use of a facility such as a hospital, emergency room, freestanding ambulatory facility, attended sleep study at outpatient part of a hospital, alcohol treatment facility or residential Policy #s: Regular10017241-0001, Transit10017241-0004, Sheriff10017241-0016, Chinook Building Any suggestions. 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 Thank you for choosing Regence as your health plan administrator. Alaska contracted and non-contracted Caused by another party (e.g., slip and fall, medical malpractice, etc. ABC BCBS of Alabama Prompt Pay interest is currently calculated monthly for the previous month's paid claims. ABU BCBS Minnesota If you get the plan specific alpha prefix, then the first two characters in this prefix are used to identify your plan. This traditional, broad network includes a wide variety of doctors and specialists across the United States. Doing so may cause delays in the handling of your inquiries and claims. 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. See our FAQs for more claim information and contacts. 0000018886 00000 n AAY Wellmark BCBS Iowa/South Dakota trailer Professional Services are performed by a doctor or other healthcare professional. A fragmented or split professional billing is defined as professional services rendered by the same provider for the same date of service and submitted on multiple professional claim forms. To contact us without setting your ZIP code, call: Prescription questions?Call Customer Service and choose the Pharmacy option. Refund total overpayment amounts within 60 days of initial notice to avoid having outstanding refund amounts offset against future payments. To submit a Level I, Level II or Mediation Appeal (see above to submit a Complaint), send complete documentation to: Physician and Provider Appeals Physicians and providers may submit a proposal to modify a payment policy. AHW BCBS of MA Your account number can be included in box 26 (Patient's Account Number) of the CMS-1500 form whether you submit electronically or on paper. When the conversion factor is multiplied by the total RVUs, it will yield the reimbursement rate for the specific service (or code). Do not make up alpha prefixes or assume that the members ID number is the Social Security Number. AHC Anthem BCBS of Missouri View the instructions for verifying your information and notifying us of changes. Colorado. Email: Contact Regence. To obtain a UMP document in another format (such as Braille or audio), call UMP Customer Service. Contact Provider Relations | Blue Cross of Idaho - bcidaho.com 0000014956 00000 n When applicable, we will suspend payment until we determine which carrier is primary and which is secondary. 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) AAS Anthem Blue Cross of California In these cases, please don't return the check to us. Tricare Phone Number and Claim Address; Molina Healthcare Phone Number claims address of Medicare and Medicaid. Download the bcbs pdf document which has been at the bottom of the post and you could find prefix for OHIO too. BCBS Provider Phone Number. How to Submit a Claim - FEP Blue PDF State Mail to Mailing Address City, State Zip - Pnnl ABY Carefirst BCBS Maryland There is a balance due to us at the end of the payment cycle. 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. Your health care provider will require that you full and distribute these declare paperwork to UnitedHealthcare. Management - prior auth/pre-service requests), Email: Members: Log in/register at MyBlue Customer eService, Regence BlueShield - FEPPO Box 21709Seattle, WA 98111. For Example: XYZ123456789. 0000003471 00000 n Blue Cross Blue Shield Federal Phone Number. The revenue codes and UB-04 codes are the IP of the American Hospital Association. 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. That way, we can verify your account and start helping you as quickly as possible. (Note: Claims received with an ICD-9 code will be rejected with a notice to re-bill using ICD-10.) AHO BCBS of Tennessee 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 We haven't received the information. For Providers | Regence Group Administrators | Healthcare Benefits . The Level I Appeal must be submitted within 365-days following the action that prompted the dispute. 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). AIH Anthem Blue Cross of California Policy #s: Regular 10017241-0001, Transit 10017241-0004, Sheriff 10017241-0016 . Your office staff can then post this remittance manually or electronically (if your software has electronic posting capability). Blue Cross and Blue Shield of Illinois (BCBSIL) members ID cards in the BlueCare Direct and Blue Choice Preferred PPO plans have been updated. We abide by the following COB standards to determine which insurance plan pays first (primary carrier) and which pays second (secondary carrier). Who do I contact for EDI questions? the instructions to determine where to send claims or correspondence. 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. AEA BCBS of Texas Verify eligibility via Highmarks NaviNet. AEO MI BC MI, POB 1618 , Detroit , MI , 48231 800-462-7237, AFM PA BC PA, 5th Ave Pl Ste 2012L , Pittsburgh , PA , 15222 800-489-4484 We notify you in writing if the request for mediation is not timely. ABJ BCBS Minnesota We also apply the following prompt pay standards set by Washington's Office of the Insurance Commission to our claims adjudication process in order to: If the above standards are met, the regulation does not require interest for those individual claims paid outside of the 95 percent threshold. AGG Anthem BCBS of Ohio The conversion factor represents the dollar value of each relative value unit (RVU). 1-866-977-7378. CWF BCBS of Georgia Box 33 Enter the contract name of physician or provider who performed the service. (For example, if your service was provided on March 5, 2022, you have until December 31, 2023 to submit your claim). | national customer service numbers at fepblue.org, Espaol | Our medical staff reviewed this claim and determined that this admission doesn't meet the criteria for medical necessity. We will notify you once your application has been approved or if additional information is needed. LAB. Use only red CMS-1500 forms (no photocopied forms). 1-800-962-2731. Download and complete the appropriate form below, then submit it by December 31 of the year following the year that you received service. Featured In: May 2020 Empire Provider News. QME Retail OFF Exchange ** Always include the members ID number, including the alpha prefix, on any documents pertaining to services to ensure accurate handling by the BCBS Plan. Washington contracted providers: We process your claims as soon as we receive them. AGF Anthem BCBS of Ohio UMP PEBB | Contact us - Regence CWI Blue Shield of California BCBS Provider Phone Number. When this notification has occurred, change the indicator on your claims from (. https://www.bcnepa.com/Providers/providerrelations/ReferenceGuides/AlphaPrefixList.pdf. 0000004829 00000 n Box 1106Lewiston, ID 83501-1106 Fax: 1 (877) 357-3418 If you have questions about submitting a claim for services outside the U.S., call UMP Customer Service. Where do I determine if a code is covered? Tricare Phone Number and Claim Address; Molina Healthcare Phone Number claims address of Medicare and Medicaid. DJG Anthem BCBS of Ohio Your member ID card is your key to using your medical plan benefits. CYJ Horizon BCBS of New Jersey ABQ Blue Cross of Idaho (Boise) DKC BCBS of Texas Select the area of the map that matches the color of the county where the service was performed. You can also use the Office of Financial Management MyPortal to update your address. CZO Anthem BCBS of Ohio We can't process this claim because we haven't received the necessary information we requested from your provider. In third-party cases, this provision permits the plan to recover the medical bill costs on behalf of the member. ** The alpha prefix is critical for the electronic routing of specific HIPAA transactions to the appropriate Blue Plan. Michigan. You can learn more about credentialing by visiting the provider section of our website. If you are a clinic or hospital-based physician or other qualified healthcare provider, use a CMS-1500 (02-12) form for claims for professional services and supplies related to: This includes claims for outpatient services and services performed by a hospital-based physician or other qualified healthcare provider. 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). They can take note of bcbs alpha prefix online in detail and gain knowledge of how to choose the right alpha prefix. CZZ Highmark BCBS VOG NY MA PPO MediBlue PPO Plus 1-866-395-5175 H3342, Premera Blue Cross & The Regence Group Common Alpha Plan Prefixes Last updated: 09/01/2016, Premera Blue Cross & Premera Blue Cross/NASCO Prefixes. AEX BCBS of IL ** PPOB in a suitcase logo, for PPO members with access to the BlueCard PPO Basic network 0 AFY BCBS of IL 0000007198 00000 n 0000013357 00000 n the lookout for future communications with more information about this exciting enhancement for submitting claim appeals through . Oregon Providers (non-contracted and contracted): If we fail to satisfy any of the above standards, commencing on the 31st day, well pay interest at a 12 percent annual rate on the unpaid or un-denied clean claim. Blue-Cross Blue-Shield of Illinois. 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. 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. The main identifier for out-of-area members is the alpha prefix. We're here to help (651) 662-5200 1-800-262-0820 . CWB BCBS of Georgia We use cookies on this website to give you the best experience and measure website usage. 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. 1/2022) v1 INSTRUCTIONS FOR FILING A CLAIMIMPORTANT: ADE BCBS of IL ABI BCBS Minnesota Regence Blue Shield in accordance with the terms of your provider contract with Regence. The claim will be reprocessed and reflected on the payment voucher. 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. Be on . threshold. Complete the enrollment form on the following page to receive 835 ERA files from Regence payers . hbbe`b``3 1x0@ t I ABA BCBS of IL Our Provider Integrity Oversight Committee reviews proposals for new payment policies and updates to our policies. Correct Mailing Address for Federal Employee Program Paper Claims and 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 1 (888) 675-6570 Prescription questions? Eligibility, enrollment, and address/name changes. Claim Forms; Get to know your member ID card. ACK Anthem Blue Cross of California Call customer service and web support at 800-607-0546 between 8 a.m. and 6 p.m., Monday through Friday, Pacific Time. This plan allows you to self-refer. any missing required substantiating documentation or particular circumstances requiring special treatment. It is important to file a claim with all insurance companies to which the member subscribes. Blue Advantage Administrators of It is critical for confirming a patients membership and coverage. Be sure to submit a paper CMS-1500 claim form or electronic 837P claim form that is complete and accurately filled out. BCBS Company. These ID cards also will contain three-character alpha prefixes. See the following pages for an explanation of the EOP fields and a description of codes and messages. Box 105557. Our medical staff reviewed this claim and determined that this service isn't covered by the plan. H\@F. AAX Anthem Blue Cross of California Portugus | ABF Healthnow of NY Buffalo CPT Codes, Descriptors, and other data only are copyright 1999 American Medical Association (or such other date of publication of CPT). Online Claim Submission. Practitioners who arent credentialed may have their claims returned until they submit a complete credentialing application. (BlueCard will request refunds regardless of the dollar amount.) All Rights Reserved to AMA. Final Instructions about BCBS Prefix Lookup. How do I identify BlueCard Managed Care/POS members? Deutsch | 0000004716 00000 n Regence BlueShield - FEP PO Box 857 Lewiston, ID 83501. If you have questions about COB, contact Customer Service by calling the phone number on the back of the member's ID card. To find a health care provider in the KingCare network, go to Find a doctor and sign in to your Regence BlueShield account. DJE BCBS of Alabama If you have questions, please contact your local Blue Cross and Blue Shield company. An EDI representative will review the test claims with you or your vendor. 24/7 Nurse Line: 800-267-6729. Claims Submission Map | FEP | Premera Blue Cross If all pertinent information is obtained, the claim(s) will then be processed according to the member's contract benefits. AFL Anthem Blue Cross of California AGX Anthem BCBS of Virginia 0000010231 00000 n Because your primary doctor and your specialists may all work for different clinics, you may need to do more of your own care coordination. 0000008433 00000 n CZU Anthem Blue Cross of California ACR Anthem Blue Cross of California Please request a current ID card from the member. Need help with a claim? BCBS Alpha Prefix YAA-YZZ(2023) | Medical Billing RCM PO Box 52057 Contact us - BridgeSpan Health News. Claims determinationsThe plan will notify you of action taken on a claim within 30 days of the plan receiving it. AHK Anthem Blue Cross of California If the Level II appeal is timely and complete, the appeal will be reviewed. Log in to Availity Don't have an Availity account? Blue Cross and Blue Shield of Illinois P.O. YDW Retail OFF Exchange State Lookup. A comprehensive list is posted in the Library under Reference Info. It doesn't replace your tax ID number (TIN) or Drug Enforcement Administration (DEA) number. These weights are then multiplied by the dollar conversion factor we publish. AHA BCBS of IL All people who have BCBS health insurance policy have to make copies of their ID front and back and keep such records on hand. ** A local network identifier, (for example, BlueMark) Regence BlueShield of Idaho | Regence Join us! ADC BCBS of IL AGB Excellus BCBS Please ADD Anthem BCBS of Ohio 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. CUP CBA BLUE (BCBS VT) CZV BCBS of Alabama Electronic claims without a TIN are rejected as incomplete. Atlanta, GA 30348-5557. Postal Prescription Services Online: Your PPS account Phone: 1 (800) 552-6694 TRS: 711 Fax (for providers only): 1 (800) 723-9023 1fcZi=s6Z@n7;W^ugC:CGLi@0^pQY4#o0 y>_ To send an electronic claim, use the Availity clearinghouse with payer ID RGA01. AES BCBS of Alabama This service is considered a standard exclusion. CWJ BCBS of Alabama Get immediate member information by phone or fax . Prefix Plan Name, AAA BCBS of Alabama For more information, please visit regence.com, Interested in joining our provider network? Complaints received beyond the 365-day timeframe will not be reviewed and the appeals rights pertaining to the issue will be exhausted. Claims - PEBB - Regence Member identification prefixes were updated as part of that transition. (Field not populated for CMS-1500 claims. We accept electronic claims through Availity using payer ID RGA01. Professional example: GENERAL CLINIC is the provider of service. Care Management Programs. Send to Regence Blue Shield in accordance with the terms of your provider contract with Regence. QMF Retail ON Exchange AAK Anthem Blue Cross of California QAB. CZK Anthem BCBS of Virginia Employees:Contact your payroll or benefits office. Please refer to your electronic billing manual for specific formatting for electronic claims. 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
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