regence claims address

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. 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. Tricare Phone Number and Claim Address; Molina Healthcare Phone Number claims address of Medicare and Medicaid. Our medical staff reviewed this claim and determined that this admission doesn't meet the criteria for medical necessity. Call the National Information Center at 1-800-411-BLUE (2583) weekdays from 8 a.m. to 8 p.m. Eastern time. You can submit claims daily, weekly, or monthly. Claims Address. Were ready. Paper Claim Form . You can also call using Skype. QMD Retail ON Exchange 0000018650 00000 n AFZ Anthem Blue Cross of California The Level I Appeal must be submitted within 365-days following the action that prompted the dispute. Hours: 8 a.m. 4:30 p.m. weekdays, Find certified small business contractors and suppliers. All other related costs incurred by the parties shall be the responsibility of whoever incurred the cost. CZK Anthem BCBS of Virginia AHJ Independence Blue Cross 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 The National Uniform Claim Committee (NUCC) has developed a 1500 Reference Instruction Manual detailing how to complete the claim form to help nationally standardize how the form is completed. 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) Regence and other health insurers share responsibility for Blue Cross and Blue Shield Federal Employee Program (BCBS FEP) claims information, claims processing and customer service based on the location of where the services were performed and the type Find a doctorContact us Sign in 0000001762 00000 n On the Availity Web Portal, you can: Run transactions to obtain member benefit, eligibility and claims information. startxref 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. We recommend that you make copies of everything that is submitted for your personal records. Phoenix, AZ 85072, Phone:800-562-1011 ACV BCBS of Georgia To ensure accurate claim processing, it is critical to capture all ID card data. Completion of the credentialing process takes 30-60 days. contracted): If we fail to satisfy any of the above standards, commencing on the 31st day, well pay interest at a 15 percent annual rate on the unpaid or un-denied clean claim. Refund total overpayment amounts within 60 days of initial notice to avoid having outstanding refund amounts offset against future payments. DBT BCBS of Michigan You can recognize Managed Care/POS members who are enrolled in out-of-area networks through the member identification card as you do for all other BlueCard members. AFY BCBS of IL A Statement of Overpayment Recoveries (SORA) is included with an Explanation of Payment (EOP) when we've processed an overpayment recovery activity within a payment cycle. Is distinct from our medical policy, which sets forth whether a procedure is medically necessary/appropriate, investigational or experimental and whether treatment is appropriate for the condition treated. 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 0000000016 00000 n You have five UMP medical plan options: UMP Classic. Our provider complaints and appeals process ensure we address a complaint or an appeal in a fair and timely manner. View your credentialing status in Payer Spaces on Availity Essentials. When the member completes and returns the IQ form to Calypso Subrogation department, a representative will screen the document to determine if another party is responsible for processing claims prior to the health carrier stepping in. YDM SG Off Exchange If we do not receive a response within the specified period, the claim(s) is denied pending further information. Polski | BCBS Federal Phone Number; Ambetter Claims address and Phone Number; Healthfirst Customer Service-Health First Provider Phone Number-Address and Timely Filing Limit; Kaiser Permanente Phone Number . Availity is an independent provider of health information network services that does not provide Blue Cross Blue Shield products or services. AIA BCBS of Texas ACR Anthem Blue Cross of California ADT BCBS Minnesota Kreyl Ayisyen | State Lookup. AEM Highmark BCBS Our medical staff reviewed this claim and determined that this continued stay doesn't meet the criteria for medical necessity. Thank you for choosing Regence as your health plan administrator. Prefixes with * include all characters for the 3rd position unless otherwise . We send the member a questionnaire requesting information to determine if benefits are available. 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. Its often confused that BCBS have lot of prefixes and where to contact. ), Email all EDI questions to: EDIRequests@accesstpa.com. Examples: medical doctor, osteopath, optometrist, chiropractor, physical therapist, audiologist, independent laboratory, nurse practitioner, durable 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. ACK Anthem Blue Cross of California 0000014956 00000 n AFA Anthem BCBS of Virginia Claims filing information and provider service phone numbers are available in the December, January and February Provider Bulletins. AEG Anthem BCBS of Ohio Italiano | This alpha prefix of BCBS plays the major role behind the proper way to claim the health insurance plan without delay and difficulty. The provider appeals process does not apply to FEP, BlueCard Home Claims, Medicare Supplement plans, or Medicare Advantage plans. If we processed the original claim incorrectly, you do not need to rebill. User the HIPAA 837 standard claims transaction including the following information: Frequency code of 7 in look 2300, CLM05-3 segment to indicate a corrected/replacement of a previously processed claim. AGF Anthem BCBS of Ohio Regence BlueShield of Idaho P. O. This prefix is the part of the distinctive identification number. You have 365 calendar days to submit a complaint following the action that prompted the complaint. ** Verify with the member that the ID number on the card is not his/her Social Security Number. Generally, if the court decrees financial responsibility for the child's healthcare to one parent, that parent's health plan always pays first. It is critical for confirming a patients membership and coverage. ABY Carefirst BCBS Maryland All Excellus plans use this mailing address: Excellus BCBS Attn: Claims P.O. 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. Correspondence. 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. CZW BCBS of North Carolina Care Management Programs. Once you have signed in, simply click on the Authorizations on the top menu and you will be able to submit your preauthorization request. Please provide a detailed description of the service being provided and the code to a member of our Customer Care Team at 1-866-738-3924 and they will provide you with an accurate benefit quote. Please reach out and we would do the investigation and remove the article. Claims submitted that indicate possible Workers' Compensation illness or injuries are investigated. | CUZ Anthem BCBS of Ohio ), Covered under the provisions of motor vehicle medical policy, personal injury protection (PIP), medical payments (Medpay), Uninsured (UIM) and/or underinsured (UM) motorist or other similar coverage (e.g., homeowners, commercial medical premises), Checks for eligibility of the member listed on the claim, Compares the services provided on the claim to the benefits in the subscribers contract, Applies industry standard claim edits and applicable payment policy criteria, Applies to professional and facility claims. YDZ SG OFF Exchange If you have questions about COB, contact Customer Service by calling the phone number on the back of the member's ID card. BCBS Provider Phone Number. Where do I submit a preauthorization request? If your organization is contracted with Premera, most practitioners must be credentialed, with the exception of hospital-based practitioners. For more information about RBRVS methodology visit the CMS website. 0000008616 00000 n providers: We process your claim as soon as we receive them. For general inquiries and questions about the Service Benefit Plan, our overseas and pharmacy coverage or fraud assistance, you can call us toll-free nationwide. AAK Anthem Blue Cross of California (Field not populated for CMS-1500 claims. Every user of BCBS health insurance is assigned an alpha prefix that contains three letters. (For example, if your service was provided on March 5, 2022, you have until December 31, 2023 to submit your claim). 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. Type forms in black ink (handwritten forms cannot be read by OCR equipment). ABA BCBS of IL Completion of the credentialing process takes 30-60 days. 2. Membership Address. Where do I determine if a code is covered? the lookout for future communications with more information about this exciting enhancement for submitting claim appeals through . Filing your claims should be simple. Find helpful phone, fax and email information for assistance. YDO Retail OFF Exchange They are identified by Guest Member on their health plan ID card. Doing so may cause delays in the handling of your inquiries and claims. New York, New York 10008-3876. To help you move from paper to electronic claims, follow these steps: Electronic claims can be sent when we are the secondary insurance payer. An EDI representative will review the test claims with you or your vendor. ** Always include the members ID number, including the alpha prefix, on any documents pertaining to services to ensure accurate handling by the BCBS Plan. 1 (888) 675-6570 Prescription questions? CVK BCBS of Florida ADI Anthem Blue Cross of California ABV Anthem BCBS of Ohio AAQ Anthem BCBS of Ohio 1-866-977-7378. CZU Anthem Blue Cross of California Note that some processing systems may have a limitation regarding the number of characters recognized. View your credentialing status in Payer Spaces on Availity Essentials. 0000009222 00000 n Box 22999 Rochester, NY 14692 *New York *The Buffalo office handles the receipt of claims and correspondence for BS ADW Carefirst BCBS Maryland 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. ), claims will be processed accordingly and under the terms of our subscriber's contract. Many offices assign their own account numbers to patients. | AHE Empire BCBS Empire BlueCross moved Individual (non-group) Medicare Advantage members to a single claims processing system Jan. 1, 2015. DJR Anthem BCBS of Ohio Medical Billing Question and Answer Terms, EVALUATION AND MANAGEMENT CPT code [99201-99499] Full List, Internal Medical Billing Audit how to do. 0000004968 00000 n View the toolkit Claims submission We will continue to update this section of our website to make sure you have the latest COVID-19-related information and helpful resources. However we have some guide to follow, using prefixes we could find the state of the BCBS and contact phone number to proceed further. Employees:Contact your payroll or benefits office. 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 Members: Log in/register at MyBlue Customer eService, Regence Blue Cross Blue Shield of Oregon - FEPPO Box 31105Salt Lake City, UT 84131, Regence Blue Cross Blue Shield of Oregon - FEPPO Box 1269Portland, OR 97207, Find Instead, deposit the check, circle the claim in question on the Explanation of Payment (EOP) and include a short explanation as to why there was an overpayment. Provider: please send us your operative notes for this claim. Mail this claim to: Regence BlueCross BlueShield of Utah PO Box 1106 Lewiston, Idaho 83501 Or Fax claim to: (888) 606-6582 FORM PD020-UT Page 2 of 3 (Eff. Need information from the member's other insurance carrier to process claim. ABB BCBS of IL Regence ABD Blue Shield of California Subrogation permits the plan to recover payments when the negligence or wrongdoing of another causes a member personal illness or injury. 800-676-2583. The following are examples of ID numbers with the alpha prefix highlighted: Note : Guest members do not have an alpha prefix. . It is only after we determine a members eligibility or coverage that payment policies and edits are applied. Physicians and other healthcare providers receive an Explanation of Payment (EOP), which describes our determination of the payment for services. The main identifier for out-of-area members is the alpha prefix. CZQ Anthem BCBS of Ohio Interest less than 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). from receipt of the information. For Example: XYZ123456789. Our Provider Integrity Oversight Committee reviews proposals for new payment policies and updates to our policies. Franais | ACD BCBS of Michigan Provider: please send us the member's lab results for this claim. ABK Carefirst BCBS Maryland Our process meets or exceeds the requirements set by the Office of the Insurance Commissioner. DKC BCBS of Texas 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. Email: Prproviderrelations@bcidaho.com. DJM BCBS of Texas Your member ID card is your key to using your medical plan benefits. CYW Anthem BCBS of Ohio Note : We have added some more prefixes in the list. ** Make copies of the front and back of the members ID card and pass this key information on to your billing staff. To make tracking patient reimbursement easier, we can include these account numbers on our payment vouchers. Blue Cross and Blue Shield of Illinois P.O. You must request mediation in writing within 30 days after receiving the Level II appeals decision on a billing dispute. AFP Anthem BCBS of Ohio ** Empty suitcase logo, for eligible Manage Care/POS, Traditional and Managed Care/HMO members. Phone: 1-800-628-3481. If you have questions, please contact your local Blue Cross and Blue Shield company. 0000008298 00000 n Secondary submission: When submitting secondary claims to us, submit the primary processing information with the submission of the secondary claim. 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. ABI BCBS Minnesota Pay or deny 95 percent of a provider's monthly clean claims within 30 days of receipt; and. Use 8 to void a claim billed in error, The initial claim number (in loop 2300, REF01 must contain F8 and REF02 must contain the claim number). ADD Anthem BCBS of Ohio AHQ Anthem BCBS of Ohio CUR Healthnow of NY Buffalo If there are no court decrees, the plan of the parent with custody is primary. The alpha prefix identifies the Blue Plan or National Account to which the member belongs. DKB Highmark BCBS You have to avoid this idea when you have geared up for successfully using the health insurance plan. Ideally, we'd like you to submit claims within 60 calendar days of the covered services, but no later than 365 calendar days from the date of submission. It is critical for confirming a patients membership and coverage. This member wasn't eligible for services on the date of service. When the conversion factor is multiplied by the total RVUs, it will yield the reimbursement rate for the specific service (or code). 1-877-764-8724 Email Us. Pension & Retirement. Please refer to the members ID card to determine if he/she has one of these products. 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 Lack of credentialing can be grounds for termination from Premeras network. ACH Wellmark BCBS Iowa/South Dakota Washington Help Center: Important contact information for Premera Blue Cross, and Regence BlueShield. Get immediate member information by phone or fax . CWA Carefirst BCBS Washington DC ** A correct member ID number includes the alpha prefix (first three positions) and all subsequent characters, up to 17 positions total. ADY BCBS of South Carolina 1-800-423-1973. 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. CWR Anthem Blue Cross of California This review is necessary to determine whether the claim(s) should be covered by a first-party carrier (e.g., PIP, Med Pay or similar coverage - homeowners or a commercial medical premise policy).

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