AFZ Anthem Blue Cross of California We can process the claim after we receive that information. If you bill your claims using the ANSI 837 electronic format, then you must include the Coordination of Benefits (COB) information from the primary coverage payer in your claim. When a member is the subscriber on more than one plan, when both plans have a COB provision, the plan with the earliest start date pays first (primary). When the conversion factor is multiplied by the total RVUs, it will yield the reimbursement rate for the specific service (or code). 0000001762 00000 n If we receive the complaint before the 365-day deadline, we review and issue a decision within 30 calendar days via letter or revised Explanation of Payment. Provider: please send us the member's lab results for this claim. When applicable, we will suspend payment until we determine which carrier is primary and which is secondary. | national customer service numbers at fepblue.org, Espaol | 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. AHE Empire BCBS 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. AAQ Anthem BCBS of Ohio ACX BCBS of IL you will need to contact Regence to update your account to ensure your claim processes correctly and timely. Regence BlueShield. The alpha prefix is critical for inquiries regarding the member, including eligibility and benefits, and is necessary for proper claim filing. 0000055309 00000 n Tagalog | The preferred process for submitting corrected claims is to use the 837 transaction Refer to your contract for further claims submission information. January 19, 2022 by tamble. In general, there are two categories of alpha prefixes namely account specific and plan specific alpha prefixes. ACL Anthem Blue Cross of California Regence BlueShield. treatment center. A fragmented or split professional billing is defined as professional services rendered by the same provider for the same date of service and submitted on multiple professional claim forms. . CWF BCBS of Georgia Bill all original lines-not including all of the original lines will cause the claim to be rejected. We can process the claim after we receive that information. This procedure is considered cosmetic. Most BCBS-branded ID cards display a three-character alpha prefix in the first three positions of the members ID number. You can submit claims daily, weekly, or monthly. ADJ Anthem BCBS of Missouri We forwarded this claim to the member's home plan for processing. ), Charges billed by physician/provider at a line item level, Amount allowed for service at a line item level, Adjudication explanation code(s) at a line item level and claim level (if applicable), Printed at the end of each claim, the line items are summed and an asterisk indicates the claim total line, Less Paid to Codes Listed as S or C, The sum of the claim total Payable Amounts which have a PD TO code of S or C, The sum of any amount withheld and applied to a prior refund or recovery. 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. AIA BCBS of Texas Applicable to facility claims only - reflects the APG code, DRG code, or room type that may relate to the reimbursement amounts. AEA BCBS of Texas For other language assistance or translation services, please call the customer service number for . CVK BCBS of Florida AGB Excellus BCBS Related . However, there are some exceptions. . Web: Regence BlueShield. 1-800-962-2731. Identifying members Easily identify the kind of coverage our members have. Deutsch | Your account number can be included in box 26 (Patient's Account Number) of the CMS-1500 form whether you submit electronically or on paper. CWK BCBS of MA AEQ BCBS of Michigan Email: Prproviderrelations@bcidaho.com. To do so, please submit the proposal in writing to your assigned Provider Network Executive (PNE) or Provider Network Associate (PNA). CZK Anthem BCBS of Virginia Both for dental and medical professional services, promises forms can be found. Find the correct address listed under the type of service received (see explanation). QMC Retail OFF Exchange However, name changes can be done only through your payroll or benefits office. Regence BlueShieldAttn: UMP ClaimsP.O. If you're a medical biller or a provider and going to submit BCBS plan member claim to the insurance, make sure to submit member ID including prefix. Review our pricing disputes and appeals information to ensure you are following the correct process. Receiving payment Send us other carrier's explanation of benefits. CYP BCBS of IL Find Contact Information. You can use Availity to submit and check the status of all your claims and much more. ABE BCBS Minnesota Blue-Cross Blue-Shield of Tennessee. AAY Wellmark BCBS Iowa/South Dakota AAZ Anthem Blue Cross of California 401 Fifth Ave. Regence BlueShield Attn: UMP ClaimsP.O. When members of Blue Plans arrive at your office or facility, be sure to ask them for their current Blue Plan membership identification card. 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 If you submit your claims electronically, you may receive electronic remittance for the following: Remittance is available online-just let us know. Be on . Providers. 0000018886 00000 n 02/16/2023 Retirement Workshop in Lacey on Feb. 18. . We use cookies on this website to give you the best experience and measure website usage. Tricare Phone Number and Claim Address; Molina Healthcare Phone Number claims address of Medicare and Medicaid. Michigan. Oregon Providers (non-contracted and contracted): If we fail to satisfy any of the above standards, commencing on the 31st day, well pay interest at a 12 percent annual rate on the unpaid or un-denied clean claim. 0000018992 00000 n Online Claim Submission. Where do I submit a preauthorization request? Italiano | AFO Arkanasa . AAK Anthem Blue Cross of California Level II appeals must be submitted in writing within 30 calendar days of the Level I appeal decision and can only pertain to a billing issue. Open 24 hours a day, 7 days a week. 0000009519 00000 n Management - prior auth/pre-service requests), Email: Members: Log in/register at MyBlue Customer eService, Regence BlueShield - FEPPO Box 21709Seattle, WA 98111. QMD Retail ON Exchange 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. 0000003603 00000 n Prescriptions. Prefixes with * include all characters for the 3rd position unless otherwise . Regence Group Administrators offers a complete suite of health risk management services in addition to benefit administration. We are now processing credentialing applications submitted on or before March 6, 2023. color, national origin, age, disability, sex, gender identity, or sexual orientation. The employer group name is usually associated with the alpha prefix of the account specific health insurance type. the lookout for future communications with more information about this exciting enhancement for submitting claim appeals through . 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). 0000011774 00000 n If we processed the original claim incorrectly, you do not need to rebill. AHQ Anthem BCBS of Ohio information. (Note: Claims received with an ICD-9 code will be rejected with a notice to re-bill using ICD-10. Electronic claims without a TIN are rejected as incomplete. 0000007198 00000 n Caused by another party (e.g., slip and fall, medical malpractice, etc. Before implement anything please do your own research. Eligibility, enrollment, and address/name changes. AAT Anthem Blue Cross of California . 0000008643 00000 n We require that you verify the information about your practice and the networks you participate in at least every 90 days. Be sure to submit a paper CMS-1500 claim form or electronic 837P claim form that is complete and accurately filled out. They must be sent hard copy. It doesn't replace your tax ID number (TIN) or Drug Enforcement Administration (DEA) number. Member identification prefixes were updated as part of that transition. Claim Forms; Get to know your member ID card. Example: 001-916-635-7373. The Prefix tool determines where you should submit a medical claim, either Blue Cross of Idaho or Regence Blue Shield of Idaho, based on an prefix. DAD Anthem BCBS of Ohio Please review the terms of use and privacy policies of the new site you will be visiting. Availity is an independent provider of health information network services that does not provide Blue Cross Blue Shield products or services. Tricare Phone Number and Claim Address; Molina Healthcare Phone Number claims address of Medicare and Medicaid. FAQs & Resources What type of EDI transactions does RGA accept? 1-800-962-2731. H\@F. Enter a ZIP code in that box. Washington Regence Blue Shield (800) 552-0733 (Member) (877) 668-4651 (Provider) (800) 344-2227 (866) 873-9743: Wisconsin (800) 242-9635 (800) 860-2156 (800) 424-4011 (800) 711-2225: If you are interested in purchasing a new computer system, ask us for a list of vendors that submit claims to us in the HIPAA standard ANSI 837 format. CVP Anthem BCBS of Ohio Enter the three digit alphanumeric prefix located on the member's ID card, and the tool provides the correct insurance carrier for you. AIJ Empire BCBS QMF Retail ON Exchange Italiano | The provider appeals process does not apply to FEP, BlueCard Home Claims, Medicare Supplement plans, or Medicare Advantage plans. 0000000016 00000 n PO Box 52080 Regence BlueShield serves select counties in the state of Washington and is an independent licensee of the Blue Cross and Blue Shield Association. CZY BCBS of North Carolina ADM BCBS of IL What do I do if a member has an identification card without an alpha prefix ? DJY Anthem BCBS of Ohio ACV BCBS of Georgia We can't process this claim because we haven't received the necessary information we requested from your provider. Please 0000008433 00000 n If you need more information about the NPI mandate, Medicare timelines, and/or the enumeration process, visit the CMS website. When this notification has occurred, change the indicator on your claims from (. Where can I find an Explanation of Payment (EOP)? For more information about RBRVS methodology visit the CMS website. Our electronic claims process electronically separates and routes only valid claims for processing. The earlier you submit claims, the earlier we process them. 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). 24/7 anonymous hotline: 1 (800) 323-1693 To get information about such member IDs, you can contact BCBS prefix directory phone number i.e. You can learn more about credentialing by visiting the provider section of our website. Payments are issued under a separate voucher and mailed to the address on the original claim. Physicians and providers may submit a proposal to modify a payment policy. DJE BCBS of Alabama account number and claim number handy when you call. If the member does not return the IQ within the specified timeframe, we'll deny all related claim(s). to 6:00 PM PT or log in to your RGA account and submit an electronic request. A subrogation provision is included in both member and physician/provider contracts. The following are examples of ID numbers with the alpha prefix highlighted: Note : Guest members do not have an alpha prefix. | Alpha Prefix, The three-character alpha prefix at the beginning of the members identification number is the key element used to identify and correctly route claims. You can verify your address by calling PEBB Customer Service at or sexual orientation.Premera Blue Cross HMO complies with applicablefederal and Washington state civil rights lawsand does not discriminate on the basis of race, When completing the CMS-1500 form, note the following: HIPAA's Administration Simplification provision requires a standard unique identifier for each covered healthcare provider (those that transmit healthcare information in an electronic form in connection with HIPAA-standard claim transactions). View your credentialing status in Payer Spaces on Availity Essentials. Box 22999 Rochester, NY 14692 *New York *The Buffalo office handles the receipt of claims and correspondence for BS Asthma. QMB SG ON Exchange DJC Anthem BCBS of Ohio Discover all the ways members can earn wellness incentives and rewards for taking an active role in their health. DJD BCBS of Nebraska CVJ BCBS of Florida In these cases, please don't return the check to us. ABU BCBS Minnesota 0000004968 00000 n The main identifier for out-of-area members is the alpha prefix. 1-800-423-1973. If we do not receive a response within the specified period, the claim(s) is denied pending further information. 2023 Regence BlueShield. 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 . This member wasn't eligible for services on the date of service. 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. 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. AGV BCBS of MA Provider: please send us the radiology reports for this claim. All services rendered by the same provider for the same patient for the same date of service must be submitted on one claim form. YDZ SG OFF Exchange We regularly update (at least quarterly) our claims editors to keep pace with changes in medical technology, as well as CPT codes, HCPCS codes, and ICD-10-CM/PCS Diagnosis and Procedure code changes, standards, and complexities. It is only after we determine a members eligibility or coverage that payment policies and edits are applied. If you are unable to submit claims electronically, you can submit paper claims on CMS-1500 or UB-04 forms. CVG BCBS of Florida ** Remember: Member ID numbers must be reported exactly as shown on the ID card and must not be changed or altered. Regence Blue-Cross Blue-Shield: YAM-Unallocated/Not Assigned: YAN-Unallocated/Not Assigned: YAO-Unallocated/Not Assigned: YAP: Minnesota: