Fax (provider credentialing applications and related documents): 205-220-9545. Are you a provider?Click to be directed to our Providers area. My Account, Forms in I have reviewed the following treatment plan. Questions? Out-of-network liability and balance billing. Dental Expense Claim Author: Blue Cross and Blue Shield of Alabama Subject: Dental Expense Claim Keywords: Dental Expense Claim,dental expense,dental,expense,claim Created Date: To continue to the HealthEquity website, click "Accept." This login is for your Employer Account. { We make completing any Dental Claim Form - Blue Cross And Blue Shield Of Alabama - Bcbsal easier. By clicking "Next", you are acknowledging that you would like to submit your application otherwise, click "Cancel". Listed below are claims payment policies and other information for Qualified Health Plans offered by Blue Cross and Blue Shield of Alabama. Blue Cross Blue Shield of Alabama. What is the dental number for Blue Cross Blue Shield of Alabama? Get your online template and fill it in using progressive features. Information contained in the external sites is not endorsed by BCBSAL. Failure to timely pay premium payments is not a special open enrollment event for later coverage under the plan. 2023, Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association. If you want to stay on the Blue Cross website, click "Cancel.". Regular Dental Program P O Box 830389 Birmingham, AL 35283-0389 Dental Expense Claim An Independent Licensee of the Blue Cross and Blue Shield Association TO BE COMPLETED BY SUBSCRIBER 1. Additionally, out-of-network providers have not contracted with us or any Blue Cross and/or Blue Shield plan for negotiated discounts and can bill you for amounts in excess of the allowed amounts under the plan. Thank you for your interest in our Short Term Plan. 450 Riverchase Parkway East 2023 New Directions Behavioral Health. MAIL US Corporate Office Address 450 Riverchase Parkway East Birmingham, Alabama 35244 Outside the United States. Name and Address of Carrier . Blue Cross Blue Shield of Oregon -Regence FEP Claims TLW13 USA Blue Cross Blue Shield of Rhode Island: CB870 W: USA Rev 3/2007 function() { Please review your information to continue. Please make sure you select the appropriate form to address your specific need. Enjoy smart fillable fields and interactivity. * Sign up today and get a plan that's accepted by over 1,700 In the left-hand column, locate the state where services were rendered. Provider Phone Numbers PEEHIP P.O. Blue Cross and Blue Shield of Alabama has an established appeals process for providers and physicians. If you have questions, please contact your local Blue Cross and Blue Shield company. Review Blue Cross and Blue Advantage medical and pharmacy policiesor comment on draft policies. Follow the simple instructions below: The days of distressing complex legal and tax forms have ended. Print and complete the form according to instructions on the front. Each time Blue Cross processes a claim submitted by you or your healthcare provider, we send you an Explanation of Benefits (EOB). As an Alfa representative, I agree to the payment terms and conditions of Blue Cross and Blue Shield of Alabama and will not collect any checking account, debit card or credit card information on behalf of the consumer for the purchase of health or dental insurance. //show the chat un-available image Attach pharmacy receipts for covered prescriptions. } Your member ID card is your key to using your medical plan benefits. As an Alfa representative, I agree to the payment terms and conditions of Blue Cross and Blue Shield of Alabama and will not collect any checking account, debit card or credit card information on behalf of the consumer for the purchase of health or dental insurance. You may access the Nondiscrimination and Accessibility notice, Navigate & Connect: Simplifying access to behavioral healthcare. Authorization to Release Information Form View PDF. } else { Node:bclrprvappp1002.corp.bcbsal.org:8080, Pre-Service Review for Out-of-Area Members, Anesthesia Sedation for Dental or Oral Surgery Procedures, Notification of Noncovered Dental Services, Predetermination of Benefits for Veneers and Anterior Crowns. To ask for a formal decision about the coverage if you disagree, print and complete the appropriate form below and fax it to 1-800-693-6703 or mail to Prime Therapeutics LLC, Attention: Part D Appeals Department, 1305 Corporate Center Dr. How to File a Claim Call Preferred Long-Term Care (LTC) Customer Service (1-888-331-4188) to complete the Claims Intake Form over the telephone. Precertification also does not mean that we have been paid all monies necessary for coverage to be in force on the date that services or supplies are rendered. What is the fax number for BCBS of Alabama claims? Box 3686, Scranton . Find your smile. *Please do not contact LifePlans unless you have already contacted Blue Cross and Blue Shield of Alabama to start your claim. $129 /month. Submit a separate claim for each patient. myBlueCross Member Login Contact Us: 1-888-543-9212 (TTY:711) myBlueCross Member Login Call 1-888-543-9212 TTY 711 . We must follow the IROs decision. For general inquiries, please call Blue Cross Blue Shield FEP Dental Customer Service at 1-855-504-BLUE (2583), 8 a.m. - 8 p.m. EST Monday - Friday (TTY 711) You can also submit an online inquiry regarding claims; ID cards; website assistance; grievance or appeal; or fraud, waste, and abuse. Shop On Exchange Shop Off Exchange HOW TO BUY AN AFFORDABLE CARE ACT (ACA) PLAN Please review the terms of use and privacy policies of the new site you will be visiting. You should be sure to check with your provider to confirm whether precertification has been obtained. Instructions: 1. We make it easy to manage your healthcare finances, claims and health information. HealthEquity has agreed to follow Blue Cross' privacy and security policies regarding the confidentiality and protection of your personal health information. A Qualified Health Plan is an insurance plan that has been certified by the Health Insurance Marketplace and provides essential health benefits, follows established limits on cost sharing and meets other requirements under the Affordable Care Act. Blue Cross and Blue Shield of Alabama If you believe you believe you have overpaid your premium due to our overbilling, please contact us by calling the Customer Service Department number on the back of your ID card. Expenses will be applied against your Plan of Care and reimbursed accordingly. Patient & Claim. There is a grace period of three months for all monthly premium payments after the initial premium payment. Questions? Your local company can help you to: Change your coverage Estimate the cost of a medical procedure File or check on claim Replace your member ID card Review your balance View your plan details Looking for Insurance? Don't have a User ID? All rights reserved. An EOB is not a bill. (For example, if your service was provided on March 5, 2022, you have until December 31, 2023 to submit your claim). If you purchased an individual plan through the health insurance marketplace and you are receiving advance payments of tax credits and/or cost sharing reductions in accordance with the Affordable Care Act, each of your monthly periodic payments is due on the first day of the month for that coverage period. BCBS FEP Dental Claim Form View PDF. Download the overseas medical claim form: CPT codes, descriptions and data copyright 2022 American Medical Association. url: "/ChatAvailabilityService/getAvailability?queueName=CID" Blue Cross and Blue Shield of Alabama. We reference sites that we think might be useful or of interest to you, but we are not responsible for the content or privacy practices used by other site owners. Claims Payment Policy & Other Information. If you do not know this information, please contact us at 205-220-7725 or fax your request to 205-220-6354. if (jsonStr.Availability === 'YES') { Address: CHIP P.O. Lastly mail the completed claim form to the address provided. These guidelines, in addition to the editor will assist you through the entire procedure. the page. contact your local Blue Cross and Blue Shield company. Dental. If you use a provider outside of our network, you'll need to complete and file a claim form to be reimbursed. Dental Blue Benefit Summary Plan Benefit In-Network Benefits Dental Blue 2500A Dental Blue 2000A Dental Blue 1500A Dental Blue 1500B Dental Blue 1000A Dental Blue 1000B MAJOR SERVICES (CONTINUED) Major Services - Prosthetic Services to deductibleInlays, onlays, veneers or crowns Fixed or removable bridges Full or . Enroll as a Blue Cross provider, update provider information, or begin the credentialing/recredentialing process. Get access to thousands of forms. If the out-of-network services are covered, in most cases, you will have to pay significantly more than what you would pay an in-network provider because of lower benefit levels and higher cost sharing. If you fail to pay in full all periodic monthly payments due and payable before the end of the grace period for those coverage periods, your coverage under the plan will be retroactively canceled back to the last day of the first month of the grace period. Home - provider.bcbsal.org Patient & Claim Payment & Refund Visit our COVID-19 Provider Update Center for the latest information about testing, treatment and telehealth coverage. The plan will only pay for care that is medically necessary and not investigational, as determined by us. In most cases, you can prevent a retroactive denial by paying your premiums on time and/or by promptly notifying the plan or, if applicable, the marketplace of changes in your eligibility status for the plan. 2023, Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association. A healthy smile is an important part of your family's overall health. Overseas members must file claim forms for any covered medical or pharmacy servicesreceived outside of the United States. Be sure the data you add to the Dental Claim Form - Blue Cross And Blue Shield Of Alabama - Bcbsal is up-to-date and accurate. To determine your premium, call us I am a Broker or Blue Plan partner that wants to visit the Partner Portal. Note: If you are a Blue Cross and Blue Shield of Alabama customer and need to reach us by phone, please use the telephone number (s) on the back of your ID card. Applicable FARS/DFARS apply. Liferay.on( Include itemized bills for covered services or supplies. Drug exceptions timeframes and enrollee responsibilities. 2023, Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association. You can also find our claim forms on our website at: Claims must be submitted and received by us within 24 months after the service takes place to be eligible for benefits. Access a wealth of healthcare resources and tools with MyBlue. Or mail a paper copy, along with proof that you paid a Medicare Part B premium, to: Complete the form following the instructions on the back. Learn more >, New Directions complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. **Dental Blue Plus is a Health Insurance Marketplace plan. Providing us with your name and email address allows us to contactyou. gives you access to exams, X-rays and routine cleaningsat no To continue to this website, click "Accept." HealthEquity is our business associate and is an independent company that provides account-based plan services to Blue Cross. Blue Plus **. By clicking "Next", you are acknowledging that you would like to submit your application and continue onto the payment page otherwise, click "Cancel". Claims must be submitted and received by us within 24 months after the service takes place to be eligible for benefits. USLegal fulfills industry-leading security and compliance standards. To determine your premium, call us at 1-855-488-2515 or click the "Get Started" link to compare your plans today. The protection of your privacy will be governed by the privacy policy of that site. Discover all the ways members can earn wellness incentives and rewards for taking an active role in their health. Include proof that you paid a Medicare Part B premium. A retroactive denial is the reversal of a previously paid claim. All rights reserved. All rights reserved. Find your plan. It's easy to protect your smile to the fullest with dental coverage that if (userAction === 'onclick') { Generally, if precertification is required and not obtained, no benefits will be payable under the plan. 3. } Applicable FARS/DFARS apply. Patient. Box 3836, Scranton, PA 18505; Blue Cross Medicare Advantage, c/o Provider Services, P.O. For standard policies - all Qualified LTC expenses will be paid in full until you reach your Maximum Monthly Benefit (31 x your Daily Benefit Amount). Are you reporting a new case? Claims Administrator (You can fill the form in electronically or complete it by hand.). Submit a separate claim for each member. Information contained in the external sites is not endorsed by BCBSAL. Technology, Power of An assessment will be scheduled and performed by a Blue Cross representative to determine if your situation and health needs meet claims benefit eligibility. . When we receive an electronic claim, you will automatically be set up as an out-of-state provider in our system and can register to use our provider website, ProviderAccess: Once . Heres everything you need to know about it. } Get Started Preservice and concurrent appeals should continue to be submitted to the member's Home Plan. Claim entry screens are divided into five categories: Patient, Claim Information, LineInformation, Other Insurance and Adjustments. checkChatAvailability('onload'); window.open('https://cicchat.bcbsal.org/I3Root/chatpopup.html?qname=cid_chat&fromUrl='+fromUrl, '', 'width=700, height=600'); Adults age 19+. Features expanded pediatric benefits for children up to the end of the month in which the member turns 19. Information on Explanations of Benefits (EOBs). Forms, Real Estate Member Services For general inquiries, you can reach us by calling the number below. For questions about claims payments, health, and dental benefits, or to order insurance cards, please call Blue Cross and Blue Shield of Alabama at 1-800-760-6851. } at 1-855-488-2515 or click the "Get Started" link to compare your plans today. }. Download your FREE dental guide to learn more about & Estates, Corporate - COB provisions determine which plan is primary and which is secondary. Patient Eligibility and Benefits; Pre-Service Review; Pre-Service Review for Out-of-Area Members . View the latest providernews. Node:bclrprvappp1001.corp.bcbsal.org:8080, Pre-Service Review for Out-of-Area Members, PRO-81 Professional Reimbursement Appeal Form, PRO-82 Utilization Management Appeal Form. Register Now. 2023, BlueCross and BlueShield of Alabama is an independent licensee of the BlueCross and BlueShield Association. This function gets loaded when everything, including the portlets, is on #1 Internet-trusted security seal. Complete the form following the instructions on the back. 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. You are about to leave Blue Cross and Blue Shield of Alabama's website and enter a website operated by Prime Therapeutics, LLC. Us, Delete All rights reserved. **Dental Blue Plus is a Health Insurance Marketplace plan. Claim Statements Reimbursements Contract and Dependent Information Other Insurance Coverage Deductible & Out of Pocket Costs View Benefits and Coverage Resources Review and Pay my Bill ID Cards Forms and Materials Covered Immunizations Health Insurance Basics Policies and Guidelines Preventive Services Caregiver Resources This link takes you to another website. The first column represents the states of the US and the second column is the insurance name and the Third column represents the Phone number. { Access the most extensive library of templates available. If services were rendered in New York or Pennsylvania, then use the state-specific file address PDF. How to file a dental claim with Blue Cross Blue Shield Alabama? Choose between our 3 dental plans today! What is the fax number for BCBS of Alabama Dental Claims? A powerhouse editor is already at your fingertips supplying you with a range of useful instruments for filling out a Dental Claim Form - Blue Cross And Blue Shield Of Alabama - Bcbsal. Download and complete the appropriate form below, then submit it by December 31 of the year following the year that you received service. Upon completion of your Waiting Period, you will be eligible to begin receiving reimbursement of your benefits. Find out More CDT codes, descriptions and data copyright 2022 American Dental Association. 2023, BlueCross and BlueShield of Alabama is an independent licensee of the BlueCross and BlueShield Association. Some information on our siteis secure; log in to ensure youre seeingall the news. Be sure the data you add to the Dental Claim Form - Blue Cross And Blue Shield Of Alabama - Bcbsal is up-to-date and accurate. If your provider does not file your claim for you, you can call our Customer Service Department at the number on the back of your ID card and ask for a claim form. As an Alabama Health Guidance representative, I agree to the payment terms and conditions of Blue Cross and Blue Shield of Alabama and will not collect any checking account, debit card or credit card information on behalf of the consumer for the purchase of health or dental insurance. Emergency services are not covered out-of-network under our dental plans. Double-check every area has been filled in correctly. Print and mail the form to the Blue Cross and Blue Shield company in the state that the services were rendered by December 31 of the year following the year you received service. You can view your personal EOBs through your MyBlue account. Choose between our 3 dental plans today! Quality Care That's Right for YouWhether you need a routine check-up or a specialty procedure, you want the best care you can find.BCBS recognizes doctors and hospitals for their expertise and exceptional quality in delivering care. Child up to age 19. With Blue Cross and Blue Shield of Alabama, all of our dental plans include regular dental exams, x-ray and routine cleaning - at no extra cost. Guarantees that a business meets BBB accreditation standards in the US and Canada.