regence bcbs of oregon claims address

If the decision was after the 60-day timeframe, please include the reason you delayed filing the appeal. PO Box 52057 Examples: medical doctor, osteopath, optometrist, chiropractor, physical therapist, audiologist, independent laboratory, nurse practitioner, durable 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. If you have any questions about specific aspects of this information or need clarifications, please email press@bcbsa.com . Regence BlueCross BlueShield of Oregon offers health and dental coverage to 750,000 members throughout the state. About Regence BlueCross BlueShield of Oregon. Regence BlueShieldAttn: UMP ClaimsP.O. Please follow You have the right to make a complaint if we ask you to leave our plan. You are about to leave regence.com and enter another website that is not affiliated with or licensed by the Blue Cross Blue Shield Association. Rev 3/2007 Step 1: Start your internet browser, and then go to the official regence bluecross blueshield of oregon address website. | You must submit prescription drug claims within 12 months of purchase. For information on false claims, see False claims or statements in your certificate of coverage. Regence BlueShield of Idaho offers health and dental coverage to 142,000 members throughout the state. You are about to leave regence.com and enter another website that is not affiliated with or licensed by the Blue Cross Blue Shield Association. If your coverage changes, call UMP Customer Service and Washington State Rx Services. For knee and hip replacement and spine care. Learn more on the HCA website. TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m EST., Monday through Friday. 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. endobj Blue Cross and Blue Shield of Nevada will process the claim. 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. Lastly mail the completed claim form to the address provided. With a plan powered by the most trusted name in health insurance, youll have coverage tailored to your health. Follow the prompts to submit your claim online. Get Marvin Thomas's email address (m*****@regence.com) and phone number (253581..) at RocketReach. Visit the Regence provider website, regence.com to learn more about: Contact Us View information about who to contact for questions and issues. Though it is not required, you may want to include the UMP Appeals and Grievance form (for medical services) or the Washington State Rx Services Complaint and Appeal Form (for prescription drugs) with your appeal. For more specific contact information, choose from the following: Individuals and familiesMedicareEmployersProducersProviders. Claims must be submitted within 12 months of the date of service. First- and second-level appeals are part of an internal review process, while independent reviews are part of an external review process. To appeal by phone or if you have questions, contact UMP Customer Service at 1 (800) 628-3481 (TRS: 711) Monday through Friday 5 a.m. to 8 p.m. and Saturday 8 a.m. to 4:30 p.m. (Pacific). Please contact the Medicare Appeals Team at 1 (866) 749-0355 or submit the appeal in writing and stating you need a fast, expedited, or hot" review, or a similar notation on the paperwork. If you use mail-order pharmacy and your primary plan uses Costco Mail Order Pharmacy or Postal Prescription Services (PPS) as the network mail-order pharmacy, Costco Mail Order Pharmacy or PPS can process payments for both plans and charge only the remaining unpaid balance. 2. If you have questions about submitting a claim for services outside the U.S., call UMP Customer Service.. Claims determinations The plan will notify you of action taken on a claim within 30 days of the plan receiving it. You should wait until the primary plan has paid to submit a secondary claim to UMP, unless the primary plan's processing of the claim is delayed. Get 5 free searches. While it's a good idea to submit a complaint as soon as possible, there isn't a deadline to do so. You can send your appeal online today through DocuSign. Dental billing. You may need to submit a claim to UMP for payment if: UMP does not cover nor coordinate benefits with workers' compensation claims. Please do not submit attachments (e.g., X-rays, periodontal chartings) with your pretreatment estimate or initial claims submission. 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 Attn: Appeal UnitPO Box 40168Portland, OR 97240-0168. View our clinical edits and model claims editing. You can also call Washington State Rx Services with the information at 1 (888) 361-1611 (TRS: 711). Youll receive notice of the action on your complaint within 30 calendar days of our receiving it. <> Centers of Excellence and Washington State Prescription Services do not provide BlueCross BlueShield services and are separate companies solely responsible for their products/services. Care Management Programs. 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, or sexual orientation. Para asistencia en espaol, por favor llame al telfono de Servicio al Cliente en la parte de atrs de su tarjeta de miembro. See Complaints about quality of care in your certificate of coverage to learn more. For prescription drug coverage, show both plan cards to the pharmacy and make sure they know which plan to bill first. Send your claim or correspondence to the Blue Cross Blue Shield plan in the state where the ambulance picked up the patient.Example: An ambulance picks up the patient in Oregon and transports her to a care facility in Washington. Some of the limits and restrictions to prescription drug coverage will apply when UMP pays second to another plan. Coordination of benefits (COB) happens when you have health coverage through two or more groups (such as your employer and your spouses employer), and these two group health plans both pay a portion of your health care claims. The Regence Operations Trainer I would have two years' experience in operational areas to include customer service, claims, membership and/or delivering training in a matrixed environment or . 636 GRAND AVE DES MOINES, IA 50309 800-245-6105. We respond to pharmacy requests within 72 hours for standard requests and 24 hours for expedited requests. Those documents will include the specific rules, guidelines or other similar criteria that affected the decision. Learn more about global periods, modifiers, virtual care, unlisted codes and NCCI bypass modifiers. Complete the Prescription Drug Claim Form and send it with your pharmacy receipts to: Pharmacy Manual ClaimsP.O. Library Access our Administrative Manual and keep up to date with news. Other specialized services (home hospice, organ/tissue transplants, and clinical trials). Please include the following information when requesting an appeal: The plan will send confirmation when it receives your appeal. Learn about electronic funds transfer, remittance advice and claim attachments. You are about to leave regence.com and enter another website that is not affiliated with or licensed by the Blue Cross Blue Shield Association. We know it is essential for you to receive payment promptly. Get help when you need it. When we make a decision about what services we will cover or how well pay for them, we let you know. Regence Provider Appeal Form Special Message: Coming soon, you will be able to dispute (appeal) a claim on Availity from the claim status result page. In Washington, Premera Blue Cross and Regence BlueShield share responsibility for claims processing, customer service, and prior authorization requests based on where the patient receives the service and what kind of service was received. Make sure you contact the right company (see below). Uniform Medical Plan (UMP) is a self-insured Preferred Provider Organization (PPO) medical plan offered through the Washington State Health Care Authority. 3. Coding toolkit View our clinical edits and model claims editing. Premera Blue Cross Blue Shield of Alaska - FEP 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 The plan will notify you within the 30-day period that an extension is necessary, with a description of the information needed and why it is needed. Pre-authorization View services and supplies that require pre-authorization. Mail or fax both the claim form and the provider's claim document (or bill) to: Regence BlueShieldAttn: UMP ClaimsP.O. You can submit your appeal online, by email, by fax, by mail, or you can call using the number on the back of your member ID card. TTY users should call, 1-800-325-0778; or your Medicaid Office. See your certificate of coverage for more information on how to file a claim for specific services and supplies. %&xv}`kfg`O>=toy,y_bI)45T\ei@{65z9|i8NhI;nTSp~b5[iN_ pn+JsX;fz|4]R 8ZTJ.#fdP]^RP|z~-3KT\n:)O68m+zm96th+/5O6=%7;s"(CTF fZTreF`Tzq`a=6>GGW[tXudM+W6`m~yuCCu xd!XDmSdoQ/= y?ck r1rMc.c0>'1|\a{ enTc |GBl]|mCxr,. Read the "Guidelines for prescription drugs UMP covers" section of your certificate of coverage for details. Regence BlueShield serves select counties in the state of Washington and is an Independent Licensee of the Blue Cross and Blue Shield Association. Box 995 Birmingham, AL 35298 Arkansas Arkansas BCBS PO Box 2181 Little Rock AR 72203 -2181 Arizona BCBS of Arizona . For services outside this area, please contact customer service directly at 1 (800) 365-3155 as your claim will require special handling. Regence BlueCross BlueShield of Oregon. We will notify you if we need more time to respond. A complaint or grievance is an oral statement or written document submitted by or on behalf of a member regarding: Note: If your issue is regarding a denial, reduction, or termination of payment or non-provision of medical services, it is an appeal. An appeal is a request from a member, or an authorized representative, to change a decision we have made about: Other matters included in your plan's contract with us or as required by state or federal law, Someone who has insurance through an employer, and any dependents they choose to enroll. A retroactive decision to deny coverage based on eligibility. Claims determinationsThe plan will notify you of action taken on a claim within 30 days of the plan receiving it. Many issues may be resolved with a phone call. Blue cross blue shield address Medicaid Address and phone number - List 1 Medicaid claim submission address - List 2 Medicare . Usually we will send you an Explanation of Benefits (EOB) statement or a letter explaining our decision about a pre-authorization request. 2 0 obj Stay up to date on what's happening from Bonners Ferry to Boise. 1-800-962-2731. Coverage decisionsA coverage decision is a decision we make about what well cover or the amount well pay for your medical services or prescription drugs. P | medical equipment supplier, ambulance services, applied behavior analysis services (ABA) or clinical social worker. You must submit prescription drug claims within 12 months of purchase. See what were doing in your community to keep people safe and healthy. Regence BlueCross BlueShield of Utah. Find the right fit for your next chapter with top-rated coverage and care you can trust. The following information must appear on the provider's itemized bill for the plan to consider the claim for payment: a. FAQs & Resources Espaol | Make sure you submit your complaint to the right company (see below). You are about to leave regence.com and enter another website that is not affiliated with or licensed by the Blue Cross Blue Shield Association. You can also download the appeal form and submit your written appeal by email, fax, or mail:Email: UMPMemberAppeals@regence.comFax: 1 (877) 663-7526, Mail:UMP Appeals and GrievancesRegence BlueShieldPO Box 91015Seattle, WA 98111-9115. Media Contact: Lou Riepl Regence BlueCross BlueShield of Utah Regence BlueShield of . 24/7 anonymous hotline: 1 (800) 323-1693 Medicare Part C & D: 1 (800) 633-4227 Online reporting form Ethics & compliance hotline | Circumstances beyond the plans control. Claims not submitted to UMP within 12 months of the date of service will not be paid. Regence Blue Shield in accordance with the terms of your provider contract with Regence. PO BOX 25956 SALT LAKE CITY, UT 84125 800-662-0876. See the About UMP High Deductible Health Plan and If you have other HDHP coverage sections in the UMP High Deductible certificate of coverage for more information on secondary health plans and limitations. Send to Regence Blue Shield in accordance with the terms of your provider contract with Regence. PO Box 91102Seattle, WA 98111-9202. The quality of care you received from a provider or facility. Find the correct address listed under the type of service received (see explanation). Is this your business? Call customer service and web support at 800-607-0546 between 8 a.m. and 6 p.m., Monday through Friday, Pacific Time. Complete and mail or fax a WSRxS Multiple Pharmacy Coverage Inquiry Form (Drug Coordination of Benefits) to Washington State Rx Services. Coding toolkit Complete and send your appeal entirely online. Diabetes. Yelp users haven't asked any questions yet about Regence Blue Cross Blue Shield of Oregon. Make sure you have your Member ID card handy when you call us. See Occupational injury or illness (workers' compensation) claims in your certificate of coverage. The Centers for Medicare & Medicaid Services values your feedback and will use it to continue to improve the quality of the Medicare program. Regence BlueCross BlueShield of Oregon is an independent licensee of the Blue Cross and Blue Shield Association. Open 24 hours a day, 7 days a week. Find forms that will aid you in the coverage decision, grievance or appeal process. State/Alpha Prefix Claims Filing Address Alabama BCBS of Alabama P.O. As one of the state's largest health insurers, Regence BlueCross BlueShield of Oregon is committed to addressing current and emerging health needs for the nearly one million Oregonians we serve. Instructions: 1. Box 1106Lewiston, ID 83501-1106. Regence: The most trusted name in health insurance Experience life with Blue With a plan powered by the most trusted name in health insurance, you'll have coverage tailored to your health. You must submit the claim to Regence as a medical claim. Dissatisfaction with service provided by the health plan. Claims determinationsThe plan will notify you of action taken on a claim within 30 days of the plan receiving it. You can also get information and assistance on how to submit an appeal by calling the Customer Service number on the back of your member ID card. Search jobs. Premera Blue Cross Blue Shield of Alaska FEP PO Box 33932 Seattle, WA 98133-0932, Phone:800-562-1011 All from Regence, a company committed to service, community and this place we call home. Lack of information. If you wish to appoint someone to act on your behalf, you must complete an appointment of representative form and send it to us with your prescription coverage determination form. Member's name and member ID number, including the alpha prefix (three letters and the "W" before member ID number), b. Claims payment, processing, or reimbursement for health care services or supplies. You are about to leave regence.com and enter another website that is not affiliated with or licensed by the Blue Cross Blue Shield Association. A list of reciprocal partners as well as membership benefits can be found at lifeflight.org. When you use a network provider or network pharmacy, you dont need to submit a claimthe provider or pharmacy will do it for you. Locate a network pharmacy by using the Pharmacy Locator Tool. All claims must be submitted to UMP within 12 months of the date of service or purchase to prevent denial of the claim. REGENCE BS OF WASHINGTON. 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. These forms explain what information should be included with your appeal and list the address and fax number of where to send your appeal. Stay up to date on what's happening from Salt Lake to St. George. The ambulance claim will be processed by Blue Cross Blue Shield of Oregon. Step 3: Next, enter your Username/Password in the appropriate fields. You may need to submit your own claim if you buy drugs at a non-network pharmacy, dont show your ID card, or have other prescription coverage that pays first and UMP is secondary. That way, we can verify your account and start helping you as quickly as possible. Your life. Contact informationMedicare Advantage/Medicare Part D Appeals and GrievancesPO Box 1827, MS B32AGMedford, OR 97501, FAX_Medicare_Appeals_and_Grievances@regence.com, Oral coverage decision requests1 (855) 522-8896, To request or check the status of a redetermination (appeal): 1 (866) 749-0355, Fax numbersAppeals and grievances: 1 (888) 309-8784Prescription coverage decisions: 1 (888) 335-3016. THIS AMENDMENT, effective January 01, 2023, hereby amends the Medical Group Agreement ("Agreement" or as otherwise defined in the Agreement) and any and all amendments, addenda, attachments or exhibits thereto by and between Regence BlueCross BlueShield of Oregon (Regence or as otherwise defined in the Agreement and hereafter referred to as Note: If you submit your claim by mail, be sure to make copies of your documents for your records. First, you'll need to gather these documents: An itemized bill from your provider that describes the services and charges. Prescription questions?Call Customer Service and choose the Pharmacy option. Manage your claimsGet your prescription claims history, view your benefits and claims information, and more by logging in to your Washington State Rx Services Account. In the left-hand column, locate the state where services were rendered. x][o%~`C?3=k7A I87ggglM"_Unx9d,*Wdx cwU74/_C&$jTD/ew|/_t_~suJo~/X7/fTjz=u?|1w_k;vZ]!w??!~pw!cw DG6JOw{v?M.>~h9{/|0 _&CrOL%be_/WWc9U~;?#*bX Fz-w~7`e_ :5ZmLme'UFSgs\\@=~!r)Q;ZDf}Z1^W8qw`v0]wcEo5tLBn-4%x\I[s$8eBM:)$2dY9s>E;& If MAXIMUS disagrees with our decision, we authorize or pay for the requested services within the timeframe outlined by MAXIMUS. The member can appeal, or a representative the member chooses, including an attorney or, in some cases, a doctor. TRS: 711Business hours: Monday through Friday 8 a.m. to 4:30 p.m. (Pacific). In addition, you cannot obtain a brand-name drug for the copayment that applies to the generic drug. Note:TovieworprintaPDFdocument,youneed AdobeReader. Your provider should supply clinically relevant information, such as medical records for services denied based on medical necessity or for other clinical reasons. Allied professionals, including behavioral health, vision, chiropractic and other complementary service providers: Contact your allied provider relations representatives & consultants. You must continue to use network pharmacies until you are disenrolled from our plan to receive prescription drug coverage under our formulary. For any appeals that are denied, we will forward the case file to MAXIMUS Federal Services for an automatic second review. You can submit feedback about your Medicare health plan or prescription drug plan directly to Medicare. Asthma. If your prescribing physician asks for a faster decision for you, or supports you in asking for one by stating (in writing or through a phone call to us) that he or she agrees that waiting 72 hours could seriously harm your life, health or ability to regain maximum function, we will give you a decision within 24 hours. You or your authorized representative (including a relative, friend, advocate, attorney, or provider) may submit an appeal by using the methods described in the Where to send complaints or appeals section below or by calling UMP Customer Service (medical appeals) or WSRxS Customer Service (prescription drug appeals). Regence BlueShield. Learn more about billing and how to submit claims to us for payment, including claims for BlueCross and BlueShield Federal Employee Program (BCBS FEP) members. Please reference your agents name if applicable. Requests to find out if a medical service or procedure is covered. Regence Blue Shield of Idaho - FEPPO Box 30270Salt Lake City, UT 84131-0207. 0. If UMP is secondary, you must include a copy of your primary plan's Explanation of Benefits, which lists the services covered and how much the other plan paid. Open 24 hours a day, 7 days a week. Seattle, WA 98121, Support Phone Number: 1.888.427.0470 (toll free), Mon-Fri, 7:00 a.m. to 5:00 p.m. (PT), 1.800.AVAILITY (1.800.282.4548) (toll free), Run transactions to obtain member benefit, eligibility and claims information, Access eContracting to view and sign agreement documents, Our online newsletter (6 issues per year). %PDF-1.5 Grievances must be filed within 60 days of the event or incident. treatment center. If you have . Choose the right company to process your complaints and appeals: To appeal online, sign in to your Regence account, select Programs & Resources, and select Appeals. Be on the lookout for future communications with more information about this exciting enhancement for submitting claim appeals through Availity. Regency Blue Cross Blue Shield Of Oregon (541) 772-8906 Visit Website Map & Directions 2057 Commerce Dr Medford, OR 97504 Write a Review. BCBS State by State | Blue Cross Blue Shield. Box 30805 Salt Lake City, UT 84130- 0805 *Pennsylvania BCNEPA P.O. The plan will not pay claims for prescription drugs submitted more than 12 months after purchase or prescription drugs purchased from an excluded pharmacy. Blue Cross and Blue Shield of Montana will process the claim. Chronic Obstructive Pulmonary Disease. Regence BlueShield of Idaho. For more information about dual coverage, read the If you have other medical coverage (or UMP High Deductible "If you have other HDHP coverage") section in your plans certificate of coverage. TTY/TDD users can call 1-877-486-2048, 24 hours a day/7 days a week. Washington State Rx ServicesPO Box 40168Portland, OR 97240-0168. Box 999Appleton, WI 54912-0999Fax: 1 (855) 668-8550. Lastupdated01/23/2023Y0062_2023_M_MEDICARE. You may send a complaint to us in writing or by calling Customer Service. You are about to leave regence.com and enter another website that is not affiliated with or licensed by the Blue Cross Blue Shield Association. Oregon Regence BCBS of Oregon P. O. Were proud to stand with you during this challenging time. 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. In every state and every community, BCBS companies are making a difference not just for our members, but For the Health of America. Kreyl Ayisyen | If you wish to appoint someone to act on your behalf, you must complete an appointment of representative form (PDF) and send it to us with your grievance form (PDF). Rocketreach finds email, phone & social media for 450M+ professionals. Your life. You must submit first-level and second-level appeals no more than 180 days after receiving the previous decision. If you or your dependents have other insurance, you must let UMP Customer Service and Washington State Rx Services know so claims are paid correctly. Professional Services are performed by a doctor or other healthcare professional. You can submit a marketing complaint to us by calling the phone number on the back of your member ID card or by calling 1-800-MEDICARE (1-800-633-4227). Din kehji k'eyeedgo, t' shdi k anidaalwoi bi bsh bee hane ninaaltsoos bee atah nilinigii bined bik. Tagalog | See reviews, salaries & interviews from Regence employees in Lewiston, ID. View your credentialing status in Payer Spaces on Availity Essentials. PO Box 1271 MS C7APortland, OR 97207-1271 This form is to be used only for services in Oregon and Clark County, WA. If you have questions, contact Washington State Rx Services Customer Service at 1 (888) 361-1611 (TRS: 711) Monday through Friday 7:30 a.m. to 5:30 p.m. (Pacific). stream The second high-deductible health plan cannot include an HSA. People with a hearing or speech disability can contact us using TTY: 711. Para humingi ng tulong sa Tagalog, pakitawagan ang numero ng telepono ng Serbisyo sa Kostumer (Customer Service) na nakasulat sa likod ng inyong kard bilang miyembro. ** We respond to medical coverage requests within 14 days for standard requests and 72 hours for expedited requests. If requested, we will supply copies of the relevant records we used to make our initial decision or appeal decision for free. They are also available outside these hours with limited services. When UMP pays second, you must still pay your deductible before UMP pays benefits. Learn more about global periods, modifiers, virtual care, unlisted codes and NCCI bypass modifiers. complies with applicable Federal and Washington state civil rights laws, Determine the county where the service was performed* (see exceptions below). Join us! If you have questions about eligibility and enrollment:Employees:Contact your payroll or benefits office.SEBB Continuation Coverage members:Call the SEBB ProgramPhone: 1 (800) 200-1004 If an initial phone call does not resolve your complaint, you may submit your complaint over the phone or by email, fax, or mail. If you have other medical or prescription coverage, Washington State Rx Services Complaint and Appeal Form, WSRxS Multiple Pharmacy Coverage Inquiry Form (Drug Coordination of Benefits). endobj Learn about dental billing information to help ensure your dental claims are processed quickly and correctly. For more information about authorizing a representative to request an appeal for you, read the Confidentiality of your health information section of your plans certificate of coverage. See "Appeals related to eligibility" section of your plan's. Learn about Regence Lewiston, ID office. Ask your provider. Regence BlueCross BlueShield of Utah offers health and dental coverage to 528,000 members throughout the state. Regence BlueCross BlueShield of Oregon providers located in Clark County, Washington: Within 24 months after payment of the claim or notice that the claim was denied or within 30 months for claims subject to coordination of benefits. Coordination of Benefits, Medicare crossover and other party liability or subrogation. Username. For member appeals that qualify for a faster decision, there is an expedited appeal process. To see if you qualify for Extra Help, call: 1-800-633-4227. Call the phone number on the back of your member ID card. **If you, or your prescribing physician, believe that waiting for a standard decision (which will be provided within 72 hours) could seriously harm your life, health or ability to regain maximum function, you can ask for an expedited decision. Congestive Heart Failure. Your budget. Learn more about when, and how, to submit claim attachments. <> All features have been transitioned to the Availity Provider Portal. 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 You are about to leave regence.com and enter another website that is not affiliated with or licensed by the Blue Cross Blue Shield Association.

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