BCBS alpha prefixes list and claim submission address - Updated list Provider home - Asuris TINs are still a required element for claims. However, there are some exceptions. Workers' Compensation will pay when the member's employer is liable to pay medical bills resulting from illness or injury arising out of, or in, the scope of employment. DKD Wellmark BCBS Iowa/South Dakota, HPS Gordmans Inc. (formerly 1/2 Price Stores), How to Identify Members 3.1.1 Member ID Cards. 7:00 AM - 6:00 PM PSTFax: 877-239-3390 (Claims and Customer Service)Fax: 877-202-3149 (Member Appeals only)Fax: 866-948-8823 (FEP Care 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. Paper Claim Form . 0000008944 00000 n See our FAQs for more claim information and contacts. ), Email all EDI questions to: EDIRequests@accesstpa.com. Monday-Friday, 8-5 Pacific (800) 552-0635 www.CarpentersBenefits.org. Please use comment section to add or Modify further. You can also submit claims via mail to our claims address P.O. AGL Premera Blue Cross of Washington 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. BCBS Provider Phone Number. To pay this claim, we needed to review information from the provider. *Follow instructions on these ID cards to verify eligibility, submit claims and obtain health plan contact information. YDV SG ON Exchange CWH Anthem Blue Cross of California Box 33 Enter the contract name of physician or provider who performed the service. CWJ BCBS of Alabama CYW Anthem BCBS of Ohio Deutsch | Join us! Management - prior auth/pre-service requests), Email: Members: Log in/register at MyBlue Customer eService, Regence BlueShield - FEPPO Box 21709Seattle, WA 98111. Units shown in box 24G of the CMS-1500 form. You have five UMP medical plan options: UMP Classic. CVY BCBS of Louisiana 0000008616 00000 n The main identifier for out-of-area members is the alpha prefix. View your credentialing status in Payer Spaces on Availity Essentials. When you go to this page, you should see a dialog box that asks for your ZIP code. | Note: When submitting an email inquiry, please include your tax identification number (TIN) and/or Organizational NPI number. ABE BCBS Minnesota When submitting claims, transfer the members identification (ID) number exactly as printed on the ID card. Review our pricing disputes and appeals information to ensure you are following the correct process. These charges are included in the main anesthesia service. threshold. 0000006620 00000 n If you need more information about the NPI mandate, Medicare timelines, and/or the enumeration process, visit the CMS website. Provider: please send us the radiology reports for this claim. AID Anthem BCBS of Ohio Availity is an independent provider of health information network services that does not provide Blue Cross Blue Shield products or services. In some contracts, we use a RBRVS methodology, developed by CMS, to calculate its fee-for-service fee schedule. Our electronic claims process electronically separates and routes only valid claims for processing. ABV Anthem BCBS of Ohio DJE BCBS of Alabama Example: 001-916-635-7373. 0000055776 00000 n For more information, view our privacy policy. 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. Box 805107 Chicago, IL 60680-4112 Iowa . If we do not receive the EOB and are unable to obtain the primary payment information by phone, the claim will be denied with a request for a copy of the primary EOB before processing can be completed. Claim Submission and Payments | Provider | Premera Blue Cross We notify you in writing if the Level II appeal is not timely and your appeal rights will be exhausted. The ID cards also may have: FAQs & Resources What type of EDI transactions does RGA accept? All services rendered by the same provider for the same patient for the same date of service must be submitted on one claim form. New York, New York 10008-3876. You can verify your address by calling PEBB Customer Service at Unclean claims will begin to accrue interest on the 16th day Our medical staff reviewed this claim and determined that this service isn't covered by the plan. Claims Submission Map | FEP | Premera Blue Cross 0000056226 00000 n Contact us - Regence We'll coordinate the benefits of the members plan with those of other plans to make certain that the total payments from all plans aren't more than the total allowable expenses. Regence BlueShield. 1 (877) 878-2273 This member wasn't eligible for services on the date of service. Claims and clinical appeals address: PO Box 21702 Eagan, MN 55121 Care management Phone: 844-996-0329 Fax: 888-302-9325 2023 holiday closures January 2 May 29 July 4 September 4 November 23 November 24 December 25 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. CVM Anthem BCBS of Ohio note: Exclusions to paying interest may apply based on line of business. They must be sent hard copy. . DAU Anthem BCBS of Missouri Asthma. Refer to your contract for further claims submission information. Your member ID card is your key to using your medical plan benefits. ABN Anthem BCBS of Virginia Calypso, our affiliate, processes refunds and overpayment requests. 24/7 anonymous hotline: 1 (800) 323-1693 Medicare Part C & D: 1 (800) 633-4227 Online reporting form Ethics & compliance hotline You can remain anonymous. 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. Members and Providers: 1-800-395-1616 Email Us. 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. Lack of credentialing can be grounds for termination from Premeras network. View the instructions for verifying your information and notifying us of changes. AHK Anthem Blue Cross of California AHX Horizon BCBS of New Jersey national customer service numbers at fepblue.org, Espaol | All of our contracts exclude coverage for care covered under the Workers' Compensation Act. When we are the primary carrier, we calculate and pay benefits routinely. We use cookies on this website to give you the best experience and measure website usage. DJW Wellmark BCBS Iowa/South Dakota Once you have signed in, simply click on the Claim Search link. Regence Blue Cross Blue Shield of Oregon - Yelp These ID cards also will contain three-character alpha prefixes. Illinois. Box 1106Lewiston, ID 83501-1106Fax: 1 (877) 357-3418 If you have questions about submitting a claim for services outside the U.S., call UMP Customer Service. Because your primary doctor and your specialists may all work for different clinics, you may need to do more of your own care coordination. Discover all the ways members can earn wellness incentives and rewards for taking an active role in their health. QMG SG OFF Exchange. COB information is allowed when the primary coverage is with a commercial payer; this generally excludes Medicare and FEP. The protection of your privacy will be governed by the privacy policy of that site. Below you will find a list of the 2015 BCNEPA plans with the corresponding Highmark Blue Cross Blue Shield plans for 2016. 0000001762 00000 n 0000009222 00000 n ** The alpha prefix is critical for the electronic routing of specific HIPAA transactions to the appropriate Blue Plan. REGENCE BLUE CROSS BLUE SHIELD OF OREGON - 12 Reviews - 100 SW Market Str, Portland, Oregon - Health & Medical - Phone Number - Yelp Regence Blue Cross Blue Shield of Oregon 12 reviews Unclaimed Health & Medical Write a review Add photo Photos & videos Add photo You Might Also Consider Sponsored TLC Laser Eye Centers 29 Please providers: We process your claim as soon as we receive them. Generally, if the court decrees financial responsibility for the child's healthcare to one parent, that parent's health plan always pays first. UMP members: If you are outside the U.S. and you have questions about your benefits and coverage, you can contact UMP Customer Service by signing into your Regence account and selecting chat live or email through the Message Center. The three characters preceding the subscriber identification number on BCBS member ID cards. If you are not registered, please click on the Not Registered link to set up your account. endstream endobj 597 0 obj <>/Filter/FlateDecode/Index[30 523]/Length 41/Size 553/Type/XRef/W[1 1 1]>>stream Before discussing member claim information, the Customer Service representative must verify the identity of the caller. | On the Availity Web Portal, you can: Run transactions to obtain member benefit, eligibility and claims information. 4. Supplier Registration That's why Anthem uses Availity, a secure, full-service web portal that offers a claims clearinghouse and real-time transactions at no charge to healthcare professionals. ADD Anthem BCBS of Ohio ADW Carefirst BCBS Maryland | Seattle, WA 98104 For Providers | Regence Group Administrators | Healthcare Benefits We can process the claim after we receive that information. 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. Provider: send us the NDC #, quantity and date span for this claim. Use find (Ctrl + F) and enter the prefix to find the BCBS state. Prefix Tool. This service is considered a standard exclusion. ABJ BCBS Minnesota See our FAQs for more claim information and contacts. We recommend that you make copies of everything that is submitted for your personal records. AGC BCBS Kansas City For other language assistance or translation services, please call the customer service number for . Service not a benefit of subscriber's contract, Investigational or experimental procedure. An EDI representative will review the test claims with you or your vendor. ACA BCBS of Alabama In these cases, please don't return the check to us. Management - prior auth/pre-service requests), Members: Log in or register - MyBlue Customer eService, Retail Pharmacy Program PO Box 52057 Phoenix, AZ 85072, Retail Pharmacy Program PO Box 52080 Phoenix, AZ 85072, Phone:800-552-0733Fax: 801-333-6523 (Mark claims: Attn New Claims)Email: Log in or register - MyBlue Customer eService, Regence BlueShield - FEPPO Box 857Lewiston, ID 83501, Regence BlueShield - FEPPO Box 1388Lewiston, ID 83501Customer Service. ACH Wellmark BCBS Iowa/South Dakota AGH Anthem Blue Cross of California RGA observes theholiday schedule below. AGY BCBS of South Carolina Call customer service and web support at 800-607-0546 between 8 a.m. and 6 p.m., Monday through Friday, Pacific Time. 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. Alaska contracted and non-contracted Box 260070 Pembroke Pines, FL 33026 . Many offices assign their own account numbers to patients. 0000008433 00000 n This traditional, broad network includes a wide variety of doctors and specialists across the United States. Tagalog | CZK Anthem BCBS of Virginia Saturday 7 a.m. to 8 p.m.; Sunday 7 a.m. to 7 p.m. (Pacific)Calling from outside the US: Dial exit code of your country (typically 00) plus the country code (1 for USA), then the area code (916), then the seven-digit US local phone number 635-7373. It is critical for confirming a patients membership and coverage. DJM BCBS of Texas 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. 0000004716 00000 n You can make a complaint verbally to Customer Service or in writing to Customer Service Correspondence.