YDM SG Off Exchange It identifies the members Blue Cross Blue Shield company or national account in order to properly route the claim. You can also call using Skype. Italiano | 1-866-977-7378. Tagalog | AIE BCBS of Michigan 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 Resource-based relative value scale (RBRVS) Claims adjudication system Claims Editors Payment Policies Payment policies Our Provider Integrity Oversight Committee reviews proposals for new payment policies and updates to our policies. 0000005570 00000 n 553 0 obj <> endobj Provider: please send us your office notes for this claim. Provider: send us the member's medical records for this claim. Select the area of the map that matches the color of the county where the service was performed. Access eContracting to view and sign agreement documents. 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. . Claims - SEBB - Regence ABY Carefirst BCBS Maryland AHI BCBS of Rhode Island Claims. providers: We process your claim as soon as we receive them. To ensure accurate claim processing, it is critical to capture all ID card data. Claim edits in place will identify those services previously billed and bundle ALL services on to a single Regence BlueShield. The dates-of-service (to and from - also referred to as beginning and ending dates) at a, The code/modifier shown in box 24D of the CMS-1500. 0000011774 00000 n 1/2022) v1 INSTRUCTIONS FOR FILING A CLAIMIMPORTANT: Ting Vit | hb``d``3g`c`P`eb@ !GCPI+""hr^eA ewJ?hx2-H IM:^7I,y ZPPTP J ! X,/ !q77p0P&{'LYr000 Management - prior auth/pre-service requests), Email: Members: Log in/register at MyBlue Customer eService, Regence BlueShield - FEPPO Box 21709Seattle, WA 98111. Box 25 Enter the applicable tax ID number. If you are deaf, hard of hearing, or have a speech disability, dial 711 for TTY relay services. We can process the claim after we receive that information. Sign the completed form where indicated at the bottom of this page and submit the completed claim form to: Regence BlueShield Attn: UMP Claims PO Box 1106 Lewiston, ID 83501-1106 or by fax to: 1 (877) 357-3418 Payments will be mailed to the address on file for the subscriber. UMP Customer ServicePhone: 1 (888) 849-3681 TRS: 711 Business hours: Monday through Friday 5 a.m. to 8 p.m. and Saturday 8 a.m. to 4:30 p.m. (Pacific)Chat Live: Sign in to your Regence account Monday through Friday 7 a.m. to 5 p.m. (Pacific) to access chat live. CYQ BCBS of IL 0000015026 00000 n AFM BCBS Minnesota DJR Anthem BCBS of Ohio . AEG Anthem BCBS of Ohio Lack of credentialing can be grounds for termination from Premeras network. Please request a current ID card from the member. Regence BlueCross BlueShield of Oregon | Regence Carpenters Retirement Plan Individual Account Pension Plan Pre-Retirement Planning Your Balances & Accruals. ABE BCBS Minnesota Utah - Blue Cross and Blue Shield's Federal Employee Program Regence Blue-Cross Blue-Shield: YAM-Unallocated/Not Assigned: YAN-Unallocated/Not Assigned: YAO-Unallocated/Not Assigned: YAP: Minnesota: Contact us - Asuris 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. If we do not receive a response within the specified period, the claim(s) is denied pending further information. Policy #s: Regular 10017241-0001, Transit 10017241-0004, Sheriff 10017241-0016 . CZM Highmark BCBS 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. AII BCBS of Louisiana P.O. Email: Medicare/Medicaid: PRmedicaremedicaid@bcidaho.com. . Who do I contact for EDI questions? 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. They will be satisfied when they properly use this insurance plan and fulfil overall requirements on the prompt assistance for claiming the insurance. This member wasn't eligible for services on the date of service. From there, you will be directed to a new site; at this site, enter in your login information, if you are not registered, please click on the Not Registered link to set up your account information. A billing issue is classified as a provider appeal because the issue directly impacts your write-off or payment amount. Paper Claim Form . Our Provider Integrity Oversight Committee reviews proposals for new payment policies and updates to our policies. 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. AEC BCBS of IL AAN Anthem Blue Cross of California Our Customer Care lines will re-open at 6 AM PT the following business day. Phone: 844-380-8838, 800-863-5488 (TTY) Once the claim is found, you can click on original EOP view to pull up this information. View your credentialing status in Payer Spaces on Availity Essentials. We recommend that you make copies of everything that is submitted for your personal records. 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. ** PPO in a suitcase logo, for eligible PPO members It is critical for confirming a patients membership and coverage. 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. Units shown in box 24G of the CMS-1500 form. DHB Empire BCBS Service not a benefit of subscriber's contract, Investigational or experimental procedure. 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. (For example, if your service was provided on March 5, 2022, you have until December 31, 2023 to submit your claim). 0000001570 00000 n Please refer to your electronic billing manual for specific formatting for electronic claims. Pay or deny 95 percent of a provider's monthly volume of all claims within 60 days of receipt. Caused by another party (e.g., slip and fall, medical malpractice, etc. ADM BCBS of IL endstream endobj 554 0 obj <>/Metadata 28 0 R/Pages 27 0 R/StructTreeRoot 30 0 R/Type/Catalog/ViewerPreferences<>>> endobj 555 0 obj >/PageTransformationMatrixList<0[1.0 0.0 0.0 1.0 -306.0 -396.0]>>/PageUIDList<0 203>>/PageWidthList<0 612.0>>>>>>/Resources<>/Font<>/ProcSet[/PDF/Text/ImageB]/XObject<>>>/Rotate 0/StructParents 0/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>> endobj 556 0 obj <> endobj 557 0 obj <> endobj 558 0 obj <> endobj 559 0 obj <> endobj 560 0 obj <> endobj 561 0 obj <> endobj 562 0 obj [591 0 R] endobj 563 0 obj <>stream 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. Visit the Regence provider website, regence.com to learn more about: Claims and payment: Appeals. If you are not registered, please click on the Not Registered link to set up your account. Box 52890Bellevue WA 98015 or fax at 1-866-458-5488. Unclean claims will begin to accrue interest on the 16th day Diabetes. ABB BCBS of IL A subrogation provision is included in both member and physician/provider contracts. This claim is a duplicate of a previously submitted claim for this member. It is only after we determine a members eligibility or coverage that payment policies and edits are applied. DKD Wellmark BCBS Iowa/South Dakota, HPS Gordmans Inc. (formerly 1/2 Price Stores), How to Identify Members 3.1.1 Member ID Cards. AEA BCBS of Texas 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 Related . When you go to this page, you should see a dialog box that asks for your ZIP code. 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. A comprehensive list is posted in the Library under Reference Info. Regence BlueCross BlueShield of Utah. Some members may carry outdated identification cards that may not have an alpha prefix. STATE MAIL TO MAILING ADDRESS CITY, STATE ZIP Alabama Blue Cross and Blue Shield of Alabama 450 Riverside Parkway E Birmingham, AL 35298 . You have to bear in mind that the alpha prefix has three letters usually followed by the identification of member of BCBS. For most plans, we'll deny claims received more than 12 months after the date of service with no member responsibility. 0000009222 00000 n 10/18) v2. We can process the claim after we receive that information. If you know which division you would like to contact, you can also reach out directly using the following phone numbers and email addresses. You may request to have a customer service representative call you at a scheduled time during normal business hours for plan help. Pension & Retirement. Medical claims. 24/7 Nurse Line: 800-267-6729. However we have some guide to follow, using prefixes we could find the state of the BCBS and contact phone number to proceed further. AEQ BCBS of Michigan We do not request refunds for overpayments less than $25, but you may submit these voluntarily. The main identifier for out-of-area members is the alpha prefix. 1-877-764-8724 Email Us. Our medical staff reviewed this claim and determined that this continued stay doesn't meet the criteria for medical necessity. ABA BCBS of IL YUV SG ON Exchange You can use Availity to submit and check the status of all your claims and much more. Please reach out and we would do the investigation and remove the article. ** Remember: Member ID numbers must be reported exactly as shown on the ID card and must not be changed or altered. YDO Retail OFF Exchange How do I identify BlueCard Managed Care/POS members? Blue Cross and Blue Shield of Illinois (BCBSIL) members ID cards in the BlueCare Direct and Blue Choice Preferred PPO plans have been updated. P | Receiving payment The Federal Employee Program (FEP) NO LONGER uses the address below, and mail will discontinue to be forwarded to the correct address above. Review our pricing disputes and appeals information to ensure you are following the correct process. ABT Carefirst BCBS Maryland DJG Anthem BCBS of Ohio Premera Blue Cross & The Regence Group Common Alpha Plan Prefixes Last updated: 09/01/2016 Premera Blue Cross & Premera Blue Cross/NASCO Prefixes Western WA providers submit claims to Regence Blue Shield.