regence claims address

To ensure accurate claim processing, it is critical to capture all ID card data. CVB BCBS of Florida Modifiers. AHW BCBS of MA Both for dental and medical professional services, promises forms can be found. 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. You have 365 calendar days to submit a complaint following the action that prompted the complaint. To obtain a UMP document in another format (such as Braille or audio), call UMP Customer Service. AFM BCBS Minnesota . CPT Codes, Descriptors, and other data only are copyright 1999 American Medical Association (or such other date of publication of CPT). ACU Anthem Blue Cross of California To make tracking patient reimbursement easier, we can include these account numbers on our payment vouchers. ACN BCBS of IL 1-800-962-2731. Regence Blue Shield of Idaho - FEPPO Box 30270Salt Lake City, UT 84131-0207. This prefix is the part of the distinctive identification number. For Providers | Regence Group Administrators | Healthcare Benefits As a beginner to alpha prefix of BCBS at this time, you like to know about the role of the alpha prefix and how to use this alpha prefix properly. Boise, ID 83707. Calypso, our affiliate, processes refunds and overpayment requests. Coding toolkit View our clinical edits and model claims editing. This service is considered a standard exclusion. 0000015026 00000 n ** Empty suitcase logo, for eligible Manage Care/POS, Traditional and Managed Care/HMO members. The most commonly occurring codes and messages are listed below. They include a request of medical records for review. Coordination of Benefits (COB) is a provision included in both member and physician and provider contracts. The SORA is generated when one of the following occurs during a payment cycle: Physicians and providers have the right to appeal certain actions of ours. 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 Medical Billing Question and Answer Terms, EVALUATION AND MANAGEMENT CPT code [99201-99499] Full List, Internal Medical Billing Audit how to do. ACQ BCBS of Georgia When you go to this page, you should see a dialog box that asks for your ZIP code. Box 91102 0000013357 00000 n hbbe`b``3 1x0@ t I This is a claim adjustment of a previously processed claim. ABC BCBS of Alabama Regence BCBS Oregon: YVK: Not Assigned Prefix: YVL: Regence BCBS Oregon: YVM: Regence BCBS Oregon: YVO: Regence Blue Cross Blue Shield Oregon: YVP: . If Workers' Compensation denies payment of such claims, Premera will pay according to the subscriber's contract benefits after receiving a copy of a valid denial. A members ID number includes the alpha prefix in the first three positions and all subsequent characters between 6 and 14 numbers or letters up to 17 characters total. A required waiting period must pass before we can provide benefits for this service. If the information received indicates an on-the-job illness or injury, both the member and physician/provider will receive a denial that states the Premera contract excludes work-related conditions. 6:00 AM - 5:00 PM ASTFax: 877-239-3390 (Claims and Customer Service)Fax: 877-202-3149 (Member Appeals only)Fax: 866-948-8823 (FEP Care 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. 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. CWR 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. Most BCBS-branded ID cards display a three-character alpha prefix in the first three positions of the members ID number. Washington - Blue Cross and Blue Shield's Federal Employee Program CZF BCBS of Rhode Island You must request mediation in writing within 30 days after receiving the Level II appeals decision on a billing dispute. the instructions to determine where to send claims or correspondence. Open 24 hours a day, 7 days a week. CZB Wellmark BCBS Iowa/South Dakota Monday-Friday, 8-5 Pacific (800) 552-0635 www.CarpentersBenefits.org. Kreyl Ayisyen | When two or more health plans cover a member, COB protects against double or over-payment. The conversion factor represents the dollar value of each relative value unit (RVU). AGE Independence Blue Cross UMP medical plans are administered by Regence BlueShield. AHB Anthem BCBS of Ohio . 0000055046 00000 n Prefix State/Area Plan Type Plan Name Provider and member service CMS contract, VOF NY MA HMO MediBlue HMO 1-800-499-9554 H3370 ACK Anthem Blue Cross of California Note : We have added some more prefixes in the list. Health . Carpenters Retirement Plan Individual Account Pension Plan Pre-Retirement Planning Your Balances & Accruals. Deutsch | This procedure is considered cosmetic. 0000055776 00000 n Electronic Transactions and Claim Payer ID, Resource-based relative value scale (RBRVS), Claims from Non-credentialed contracted providers, federal and Washington state civil rights laws, Subscriber's number and patient suffix number (including plan prefix) assigned by plan as shown on the member's identification card, Number assigned by the clinic for patient. Atlanta, GA 30348-5557. AIA BCBS of Texas This claim is a duplicate of a previously submitted claim for this member. However, fax submission is allowed at the ollowing fax numbers: 866-365-5504 or 303-764- 7123 for BCBS OF CA AND BCBS OF CO. Payment of this claim depended on our review of information from the provider. Congestive Heart Failure. However, name changes can be done only through your payroll or benefits office. Units shown in box 24G of the CMS-1500 form. These charges are included in the main anesthesia service. 553 46 553 0 obj <> endobj Contact us - Regence ADI Anthem Blue Cross of California All Excellus plans use this mailing address: Excellus BCBS Attn: Claims P.O. When this notification has occurred, change the indicator on your claims from (. Access fee schedules. BCBS Prefix List YAA to YZZ - Alpha Lookup by State 2022 BCBS Contact Info - Providers, Overseas, and More - FEP Blue 0000000016 00000 n Anthem Blue-Cross Blue-Shield of Colorado. We can process the claim after we receive that information. Caused by another party (e.g., slip and fall, medical malpractice, etc. Note: Some members will remain in Blue Cross of Northeastern Pennsylvania health plans until their coverage renews to Highmark health plans later this year. 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. The ID cards also may have: Pay or deny 95 percent of a provider's monthly volume of all claims within 60 days of receipt. Provider: please send us the member's lab results for this claim. <<1CC62891B116FE488EB50D904D0BD9AE>]/Prev 176800/XRefStm 1570>> 4. ADE BCBS of IL We can process the claim after we receive that information. Service not a benefit of subscriber's contract, Investigational or experimental procedure. Claims You can use Availity to submit and check the status of all your claims and much more. Hours: 8 a.m. 4:30 p.m. weekdays, Find certified small business contractors and suppliers. No pre-authorization for COVID-19 vaccinations, testing and treatment, No member cost shares for COVID-19 vaccinations, testing and treatment. CZR Wellmark BCBS Iowa/South Dakota Contact Us | FEP | Premera Blue Cross . | Click on the View Explanation of Payment link. Prompt Pay interest is currently calculated monthly for the previous month's paid claims. 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. | Federal Employee Program Overseas Claims P.O. Appeals rights will be exhausted if not received within the required timeframe. Get help when you need it. CZG Premera Blue Cross of Washington BCBS alpha prefixes list and claim submission address - Updated list In general, there are two categories of alpha prefixes namely account specific and plan specific alpha prefixes. Once the IQ is returned, all claims are reviewed and processed based on the information supplied. Learn how to contact your local Blue Cross and Blue Shield company, as well as other key areas. This standard is called the "Birthday Rule.". medical equipment supplier, ambulance services, applied behavior analysis services (ABA) or clinical social worker. 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. If the member does not return the IQ within the specified timeframe, we'll deny all related claim(s). Chronic Obstructive Pulmonary Disease. Physicians and providers may submit a proposal to modify a payment policy. 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. AAQ Anthem BCBS of Ohio To ensure prompt and accurate payment when Premera is the secondary carrier, we encourage you to send the secondary claims with the primary processing information as soon as you receive it. Alaska contracted and non-contracted (for both professional and facility claims) using claim frequency code 7. 4. ), 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. The employer group name is usually associated with the alpha prefix of the account specific health insurance type. 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. Any exceptions are documented as Payment Policies. Where do I submit a preauthorization request? The claim will be reprocessed and reflected on the payment voucher. CVG BCBS of Florida AEJ Horizon BCBS of New Jersey We're ready. Heres everything you need to know about it. CMS also uses RVUs to allocate dollar values to each CPT or HCPCS code. . 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). Blue-Cross Blue-Shield of Illinois. However we have some guide to follow, using prefixes we could find the state of the BCBS and contact phone number to proceed further. If there are no court decrees, the plan of the parent with custody is primary. STATE MAIL TO MAILING ADDRESS CITY, STATE ZIP Alabama Blue Cross and Blue Shield of Alabama 450 Riverside Parkway E Birmingham, AL 35298 . BCBS Provider Phone Number. DHA Excellus BCBS Utica There are three separate components that affect the value of each medical service or procedure: RVUs are assigned to each of these components. note: Exclusions to paying interest may apply based on line of business. Contact Us | Blue Cross and Blue Shield of Illinois - BCBSIL Make sure you have your Member ID card handy when you call us. YDV SG ON Exchange AGB Excellus BCBS Once we accept your level II appeal, we will respond within 15 days in writing or a revised Explanation of Payment. YDO Retail OFF Exchange CWI Blue Shield of California Asthma. DJP BCBS of Nebraska Enter the three digit alphanumeric prefix located on the member's ID card, and the tool provides the correct insurance carrier for you. YDM SG Off Exchange For more information, view our privacy policy. The alpha prefix identifies the Blue Plan or National Account to which the member belongs. Mail this claim to: Regence BlueShieldPO Box 1106Lewiston, Idaho 83501 Or Fax claim to: (888) 606-6582 FORM PD020-WA Page 2 of 3 (Eff. View your credentialing status in Payer Spaces on Availity Essentials. Box 25 Enter the applicable tax ID number. Contact Us | Regence Group Administrators | Healthcare Benefits Third You can verify your address by calling PEBB Customer Service at The earlier you submit claims, the earlier we process them. the lookout for future communications with more information about this exciting enhancement for submitting claim appeals through . Management - prior auth/pre-service requests), Members: Log in or register - MyBlue Customer eService, Retail Pharmacy Program PO Box 52057 Phoenix, AZ 85072, Retail Pharmacy Program PO Box 52080 Phoenix, AZ 85072, Phone:800-552-0733Fax: 801-333-6523 (Mark claims: Attn New Claims)Email: Log in or register - MyBlue Customer eService, Regence BlueShield - FEPPO Box 857Lewiston, ID 83501, Regence BlueShield - FEPPO Box 1388Lewiston, ID 83501Customer Service. to 6:00 PM PT or log in to your RGA account and submit an electronic request. Pay clean claims within 30 days of receipt; and, Pay unclean claims within 15 days after receipt of information, Pay unclean claims within 30 days after receipt of information. Unclean claims will begin to accrue interest on the 16th day Please make copies of the front and back of the ID card, and pass this key information to your billing staff. If you have questions, please contact your local Blue Cross and Blue Shield company. 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 ** PPO in a suitcase logo, for eligible PPO members When members of Blue Plans arrive at your office or facility, be sure to ask them for their current Blue Plan membership identification card. View the instructions for verifying your information and notifying us of changes. AHD BCBS of South Carolina QMG SG OFF Exchange. Mail a completed Overpayment Notification form (found in our online library under Forms) and mark the box requesting a voucher deduction to recover the overpayment on future claim payments. AAT Anthem Blue Cross of California Polski | Premera Blue Cross Blue Shield of Alaska FEP PO Box 33932 Seattle, WA 98133-0932, Phone:800-562-1011 PO Box 3876. To pay this claim, we needed to review information from the provider. We can't process this claim because we haven't received your response to our request for information. P | PO Box 1106. FEP claims - Provider - REG - Regence AAP BCBS of Tennessee RBRVS is a method of reimbursement that determines allowable fee amounts based on established unit values as set norms for various medical and surgical procedures, and further based on weights assigned to each procedure code. AEK Independence Blue Cross Box 3004 Naperville, IL 60566-9747. Box 31603 Salt Lake City, UT 84131- 0603 Illinois BCBS of Illinois P.O. PO Box 52057 We will continue to update this section of our website to make sure you have the latest COVID-19-related information and helpful resources. ABN Anthem BCBS of Virginia The alpha prefix is critical for inquiries regarding the member, including eligibility and benefits, and is necessary for proper claim filing. QAB. Thank you for the care you provide to our members and people in our communities. ** The alpha prefix is critical for the electronic routing of specific HIPAA transactions to the appropriate Blue Plan. 1-866-977-7378. CUU BCBS of Texas Guardian Employees . Membership Address. All the articles are getting from various resources. We'll coordinate the benefits of the members plan with those of other plans to make certain that the total payments from all plans aren't more than the total allowable expenses. We can't process this claim until the questionnaire we recently sent the member is completed and returned to us. AEQ BCBS of Michigan Contact us - Asuris An EDI representative will review the test claims with you or your vendor. An interest check is issued only for months in which the accumulated interest is equal to or greater than the minimum threshold of $25. We are unable to quote a benefit by a code. . You will need special software to send insurance claims electronically. Availity supports the exchange of electronic remittance advice (ERA) files for Regence payers in the ASC X12 835 format. BCBS Prefix List XAA to XZZ - Alpha Lookup by State 2022 Send to Regence Blue Shield in accordance with the terms of your provider contract with Regence. ADW Carefirst BCBS Maryland CVC Anthem BCBS of Ohio DJN BCBS Minnesota ** A local network identifier, (for example, BlueMark) Postal Prescription Services Online: Your PPS account Phone: 1 (800) 552-6694 TRS: 711 Fax (for providers only): 1 (800) 723-9023 Illinois. Provider: send us the member's medical records for this claim. (For example, if your service was provided on March 5, 2022, you have until December 31, 2023 to submit your claim). To send an electronic claim, use the Availity clearinghouse with payer ID RGA01. APT DE BC DE, POB 8830 , Wilmington , DE , 19899-8830 800-342-2221 ABU BCBS Minnesota 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 may have invested in the account specific alpha prefix health insurance plan from BSBS at this time. 1fcZi=s6Z@n7;W^ugC:CGLi@0^pQY4#o0 y>_ Always use the alpha prefix on the members current ID card. Providers. AEP Carefirst BCBS Maryland BCBS Prefix List QAA to QZZ - Alpha Lookup by State 2022 Contact Provider Relations | Blue Cross of Idaho - bcidaho.com Sometimes an office returns a check to us that represents multiple claims because a portion (see Threshold below) of the payment may be incorrect. 2. This member wasn't eligible for services on the date of service. CVM Anthem BCBS of Ohio You can print and assist the member in completing the form, but it's important to review the instructions included with the form because the patient must complete the form and then sign it. Payment policy: You can find our payment policies on our website in the Library, under Reference Info. They can take note of bcbs alpha prefix online in detail and gain knowledge of how to choose the right alpha prefix. 0000004716 00000 n 0000018383 00000 n Some members may carry outdated identification cards that may not have an alpha prefix. View your credentialing status in Payer Spaces on Availity Essentials. In some contracts, we use a RBRVS methodology, developed by CMS, to calculate its fee-for-service fee schedule. (BlueCard will request refunds regardless of the dollar amount.) Completion of the credentialing process takes 30-60 days. Verify benefits or eligibility for BlueCard members. 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 Retail pharmacy services Claims 0000003603 00000 n ** The empty suitcase logo 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. CWA Carefirst BCBS Washington DC ALR AR BC AR, PO Box 2181 , Little Rock , AR , 72203-2180 888-847-1400, AMU RI BCRI, 444 Westminister St , Providence , RI , 02903-3279 401-831-7300, AMZ KY BC KY, POB 37690 , Louisville , KY , 40233 800-925-0135, AON IL BC IL, POB 1364 , Chicago , IL , 60690 800-972-8088, APT DE BC DE, POB 8830 , Wilmington , DE , 19899-8830 800-342-2221 All Blue Plans replaced Social Security numbers on member ID cards with an alternate, unique identifier. The plan doesn't cover cosmetic services. Physicians and other healthcare providers receive an Explanation of Payment (EOP), which describes our determination of the payment for services. To help your office complete year-end accounting, each December we'll issue you a check for the accrued interest we owe you, even if the amount is below the 0000010898 00000 n Regence Blue-Cross Blue-Shield: ZBU: Illinois: Blue-Cross Blue-Shield of Illinois: ZBV: Wisconsin: Anthem Blue-Cross Blue-Shield of Wisconsin: ZBW: South Dakota/Iowa: The 2015 member identification prefixes for individual Medicare Advantage plans are listed below. Log in to Availity Don't have an Availity account? CZP Anthem BCBS of Ohio When submitting claims, transfer the members identification (ID) number exactly as printed on the ID card. Company Description: Regence BlueCross BlueShield of Oregon provides health insurance products and other managed care services to some 750,000 members in Oregon and Washington's Clark County. ABT Carefirst BCBS Maryland They will be satisfied when they properly use this insurance plan and fulfil overall requirements on the prompt assistance for claiming the insurance. We will notify you once your application has been approved or if additional information is needed. LAA. Congestive Heart Failure. It is critical for confirming a patients membership and coverage. ADD Anthem BCBS of Ohio DJH Wellmark BCBS Iowa/South Dakota 0000010231 00000 n Management - prior auth/pre-service requests), Email: Members: Log in/register at MyBlue Customer eService, Regence BlueShield - FEPPO Box 21709Seattle, WA 98111. CYJ Horizon BCBS of New Jersey 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. Regence BlueCross BlueShield of Oregon | Regence P.O. AGT Blue Shield of California What you need to know about the disease and our commitment to ensuring you have access to the right care at the right time. CZC Anthem BCBS of Ohio AIJ Empire BCBS The IQ is available in the Provider Library under Forms. Contact us for health care providers Contact us for healthcare providers. ** Verify with the member that the ID number on the card is not his/her Social Security Number. hb``d``3g`c`P`eb@ !GCPI+""hr^eA ewJ?hx2-H IM:^7I,y ZPPTP J ! X,/ !q77p0P&{'LYr000 ABW Anthem BCBS of Virginia Regence BlueShield in accordance with the terms of your Provider contract with Regence. ** Members who are part of the FEP will have the letter R in front of their member ID number. CUR Healthnow of NY Buffalo You can also call using Skype. 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 . Join us! AET Anthem Blue Cross of California We haven't received the information.

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