regence claims address

AAP BCBS of Tennessee Once you have signed in, simply click on the Authorizations on the top menu and you will be able to submit your preauthorization request. These ID cards also will contain three-character alpha prefixes. Please To ensure accurate claim processing, it is critical to capture all ID card data. The ID cards also may have: The total number of characters in the members ID ranges from six to fourteen. Verify eligibility via Highmarks NaviNet. Polski | Regence Blue Shield of Idaho - FEPPO Box 30270Salt Lake City, UT 84131-0207. Fax: 801-333-6523 (Mark claims: Attn New Claims) Email: Log in or register - MyBlue Customer eService. Pension & Retirement. Receiving payment 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. CMS also uses RVUs to allocate dollar values to each CPT or HCPCS code. 0000013357 00000 n To help you move from paper to electronic claims, follow these steps: Electronic claims can be sent when we are the secondary insurance payer. CNK-HR-0230 Box 91102 Supplier Registration CZK Anthem BCBS of Virginia Provider: send us the member's medical records for this claim. ABB BCBS of IL If you have questions about COB, contact Customer Service by calling the phone number on the back of the member's ID card. Hours: 8 a.m. 4:30 p.m. weekdays, Find certified small business contractors and suppliers. We haven't received the information. Professional example: GENERAL CLINIC is the provider of service. AFO Arkanasa 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. If the member does not return the IQ within the specified timeframe, we'll deny all related claim(s). AAY Wellmark BCBS Iowa/South Dakota ABK Carefirst BCBS Maryland trailer CWN Carefirst BCBS Washington DC YDZ SG OFF Exchange State Lookup. Type forms in black ink (handwritten forms cannot be read by OCR equipment). ), claims will be processed accordingly and under the terms of our subscriber's contract. Regence BlueShield. Also its not a sequential order hence its hard to find unless we check with first 3 alpha prefix. AGY BCBS of South Carolina We abide by the following COB standards to determine which insurance plan pays first (primary carrier) and which pays second (secondary carrier). 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. Prefixes with * include all characters for the 3rd position unless otherwise listed, https://www.premera.com/documents/020469.pdf. Since new ID cards may be issued to members throughout the year, this will ensure that you have the most up-to-date information in your patients file. CPT Codes, Descriptors, and other data only are copyright 1999 American Medical Association (or such other date of publication of CPT). Subrogation permits the plan to recover payments when the negligence or wrongdoing of another causes a member personal illness or injury. Carpenters Retirement Plan Individual Account Pension Plan Pre-Retirement Planning Your Balances & Accruals. You can get the standardized coverage from this health insurance plan all through the nation. 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. 0 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. The three characters preceding the subscriber identification number on BCBS member ID cards. Regence Be on . CZJ Premera Blue Cross of Washington ABW Anthem BCBS of Virginia 1-877-764-8724 Email Us. Please follow DJT BCBS Minnesota . Contact Us. AHD BCBS of South Carolina This service is considered a standard exclusion. YDW Retail OFF Exchange Note: Some members will remain in Blue Cross of Northeastern Pennsylvania health plans until their coverage renews to Highmark health plans later this year. Calypso, our affiliate, processes refunds and overpayment requests. Tricare Phone Number and Claim Address; Molina Healthcare Phone Number claims address of Medicare and Medicaid. Physicians and providers may submit a proposal to modify a payment policy. Practitioners who arent credentialed may have their claims returned until they submit a complete credentialing application. AHW BCBS of MA If you are deaf, hard of hearing, or have a speech disability, dial 711 for TTY relay services. DJN BCBS Minnesota ACK Anthem Blue Cross of California We may send a questionnaire to the member regarding possible duplicate coverage. To make tracking patient reimbursement easier, we can include these account numbers on our payment vouchers. Final Instructions about BCBS Prefix Lookup. The member or provider can submit the completed IQ using one of the following methods: The member may contact Customer Service (the number is on the back of the ID card) to update IQ information over the phone. AIA BCBS of Texas CVS Caremark. AAB BCBS of Michigan QAA. How do I identify international members? 24/7 anonymous hotline: 1 (800) 323-1693 CVZ Horizon BCBS of New Jersey 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 We are unable to quote a benefit by a diagnosis or procedurecode. national customer service numbers at fepblue.org, Espaol | ABE BCBS Minnesota Box 105557. CVM Anthem BCBS of Ohio Box 22999 Rochester, NY 14692 *New York *The Buffalo office handles the receipt of claims and correspondence for BS 0000006620 00000 n 0000004716 00000 n Alaska contracted and non-contracted 24/7 anonymous hotline: 1 (800) 323-1693 Medicare Part C & D: 1 (800) 633-4227 Online reporting form Ethics & compliance hotline You can remain anonymous. AFS Blue Shield of California 0000018886 00000 n An overpayment was recorded during the payment cycle. 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. Send to Regence Blue Shield in accordance with the terms of your provider contract with Regence. When dependent children are double-covered by divorced parents, coverage depends on any court decrees. 0000003471 00000 n View your credentialing status in Payer Spaces on Availity Essentials. Click on the View Explanation of Payment link. ADJ Anthem BCBS of Missouri This plan allows you to self-refer. We will notify you once your application has been approved or if additional information is needed. When this notification has occurred, change the indicator on your claims from (. Box 33 Enter the contract name of physician or provider who performed the service. Box 31603 Salt Lake City, UT 84131- 0603 Illinois BCBS of Illinois P.O. ADY BCBS of South Carolina If there is no alpha prefix, do not create one or use an alpha prefix from another members ID card, even one from the same BCBS Plan. You can submit claims daily, weekly, or monthly. YDO Retail OFF Exchange Box 25 Enter the applicable tax ID number. 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. ), Number assigned to the claim when received by plan. Heres everything you need to know about it. The Level I Appeal must be submitted within 365-days following the action that prompted the dispute. Paid to refers to the payee code (where the check was sent/issued) and is listed only in the claim total or subtotal line (e.g., G = Provider Group). ** A correct member ID number includes the alpha prefix (first three positions) and all subsequent characters, up to 17 positions total. Because your primary doctor and your specialists may all work for different clinics, you may need to do more of your own care coordination. For more information, please visit regence.com, AGL Premera Blue Cross of Washington 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. 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 Boise, ID 83707. Check out the changes and updates to our plan in 2023. They can take note of bcbs alpha prefix online in detail and gain knowledge of how to choose the right alpha prefix. We are now processing credentialing applications submitted on or before March 6, 2023. There is a balance due to us at the end of the payment cycle. Make sure you have your Member ID card handy when you call us. Franais | Kreyl Ayisyen | 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. Congestive Heart Failure. Jun 29, 2010 | Medical billing basics | 6 comments. Your software vendor can help you set up your computer to accommodate Premera's billing requirements. P.O. 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. Box 52890Bellevue WA 98015 or fax at 1-866-458-5488. ), Email all EDI questions to: EDIRequests@accesstpa.com. 1 (877) 878-2273 Tagalog | P.O. What you need to know about the disease and our commitment to ensuring you have access to the right care at the right time. Secondary submission: When submitting secondary claims to us, submit the primary processing information with the submission of the secondary claim. 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. QMC Retail OFF Exchange . A subrogation provision is included in both member and physician/provider contracts. Note : We have added some more prefixes in the list. xref A Level I Appeal is used for both billing and non-billing issues. Continue to submit paper claims until you are told to stop. 1fcZi=s6Z@n7;W^ugC:CGLi@0^pQY4#o0 y>_ 24/7 Nurse Line: 800-267-6729. AGX Anthem BCBS of Virginia Oromoo | accrue interest on the 31st day from receipt of the information. CUR Healthnow of NY Buffalo The employer group name is usually associated with the alpha prefix of the account specific health insurance type. ADT BCBS Minnesota Claims Address. New York, New York 10008-3876. When Calypso identifies an overpayment, they mail an Overpayment Notification letter with a request for the overpaid amount. They must be sent hard copy. Prefix State/Area Plan Type Plan Name Provider and member service CMS contract, VOF NY MA HMO MediBlue HMO 1-800-499-9554 H3370 you will need to contact Regence to update your account to ensure your claim processes correctly and timely. AAN Anthem Blue Cross of California note: Exclusions to paying interest may apply based on line of business. 1-800-962-2731. AGC BCBS Kansas City View the toolkit Claims submission AFI BCBS of Rhode Island 0000010231 00000 n (For example, if your service was provided on March 5, 2022, you have until December 31, 2023 to submit your claim). What type of EDI transactions does RGA accept? AEQ BCBS of Michigan Stay up to date on what's happening from Bonners Ferry to Boise. When two or more health plans cover a member, COB protects against double or over-payment. If you find anything not as per policy. 0000015111 00000 n You can reach Customer Service by calling 877-342-5258, option 2, or by calling the Customer Service phone number on the back of the member's ID card. Discover all the ways members can earn wellness incentives and rewards for taking an active role in their health. ABI BCBS Minnesota . CVG BCBS of Florida The claim will be reprocessed and reflected on the payment voucher. 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. Once you have signed in, simply click on the Claim Search link. AEC BCBS of IL DHB Empire BCBS They will be satisfied when they properly use this insurance plan and fulfil overall requirements on the prompt assistance for claiming the insurance. Friday 6:00 AM. If the Level II appeal is timely and complete, the appeal will be reviewed. People who include both alpha prefix as well as alpha numeric characters precede the alpha prefix in every claim and correspondence submitted to BCBS can get the desired assistance almost immediately. DJU Carefirst BCBS Maryland . (Note: Claims received with an ICD-9 code will be rejected with a notice to re-bill using ICD-10.) When you go to this page, you should see a dialog box that asks for your ZIP code. What is an 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. | If you are aware about the bcbs alpha prefix of your health insurance, then you can get the desired support on time for claiming the insurance. CVX BCBS of IL AGH Anthem Blue Cross of California Our process meets or exceeds the requirements set by the Office of the Insurance Commissioner. What you need to know about the disease and our commitment to ensuring you have access to the right care at the right time. | AFB BCBS of South Carolina Premera Blue Cross Seattle, WA 98104 ** When filing a claim, always enter the ID number, including the alpha prefix, exactly as it appears on the members card. 1-800-962-2731. Interest less than Refer to your contract for further claims submission information. (BlueCard will request refunds regardless of the dollar amount.) CZM Highmark BCBS We can't process this claim because we haven't received your response to our request for information. To ensure that OCR reads your paper claims accurately: Submitting a corrected claim may be necessary when the original claim was submitted with incomplete information (e.g., procedure code, date of service, diagnosis code). When applicable, we will suspend payment until we determine which carrier is primary and which is secondary. DHP Excellus BCBS P.O. Use search function and put your comment any alpha prefix not found here. 0000001921 00000 n The revenue codes and UB-04 codes are the IP of the American Hospital Association. We recommend that you make copies of everything that is submitted for your personal records. If your request for mediation is timely, both parties must agree upon a mediator. Box 805107 Chicago, IL 60680-4112. Does not determine the reimbursement dollar amount for any particular service (reimbursement is specific to the provider applicable fee schedule). Do not make up alpha prefixes or assume that the members ID number is the Social Security Number. Claims ** Make copies of the front and back of the members ID card and pass this key information on to your billing staff. A member is primary on the plan in which he/she is the subscriber versus the plan in which he/she is a dependent. A required waiting period must pass before we can provide benefits for this service. 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 A billing issue is classified as a provider appeal because the issue directly impacts your write-off or payment amount. 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. Regence BCBS Oregon: YVK: Not Assigned Prefix: YVL: Regence BCBS Oregon: YVM: Regence BCBS Oregon: YVO: Regence Blue Cross Blue Shield Oregon: YVP: . CZP Anthem BCBS of Ohio 3. Congestive Heart Failure. Call customer service and web support at 800-607-0546 between 8 a.m. and 6 p.m., Monday through Friday, Pacific Time. | For more information about RBRVS methodology visit the CMS website. Get immediate member information by phone or fax . Modifications we make to your contract or to our policy or procedures are not subject to the appeal process unless we made it in violation of your contract or the law. Our medical staff reviewed this claim and determined that this service isn't covered by the plan. CZB Wellmark BCBS Iowa/South Dakota ABF Healthnow of NY Buffalo ADL Anthem BCBS Kentucky Featured In: May 2020 Empire Provider News. ACL Anthem Blue Cross of California Your member ID card is your key to using your medical plan benefits. Provider who rendered the service. Asthma. We notify you in writing if the request for mediation is not timely. 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. Postal Prescription Services Online: Your PPS account Phone: 1 (800) 552-6694 TRS: 711 Fax (for providers only): 1 (800) 723-9023 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). *Follow instructions on these ID cards to verify eligibility, submit claims and obtain health plan contact information. TRS: 711 Fax: 1 (800) 633-0334 Business hours: Monday through Friday: 5 a.m. to 7 p.m. (Pacific) Saturday: 9:30 a.m. to 2 p.m. (Pacific) Note: UMP members do not need to be Costco members to use their mail-order service. | 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). Box 1106Lewiston, ID 83501-1106 Fax: 1 (877) 357-3418 If you have questions about submitting a claim for services outside the U.S., call UMP Customer Service. In box 22 on the CMS-1500 Claim form, enter the appropriate bill frequency code, left justified in the left hand side of the field. ABZ Carefirst BCBS Maryland Completion of the credentialing process takes 30-60 days. Pay or deny 95 percent of a provider's monthly volume of all claims within 60 days of receipt. A detailed description of the disputed issue, All evidence offered by you in support of your position including medical records, A description of the resolution you are requesting. 553 46 CZG Premera Blue Cross of Washington CWR Anthem Blue Cross of California Dont write or stamp extra information on the form. AAQ Anthem BCBS of Ohio Click on the Submit a Preauthorization Request link. Italiano | 401 Fifth Ave. Monday-Friday, 8-5 Pacific (800) 552-0635 www.CarpentersBenefits.org. AEO MI BC MI, POB 1618 , Detroit , MI , 48231 800-462-7237, AFM PA BC PA, 5th Ave Pl Ste 2012L , Pittsburgh , PA , 15222 800-489-4484 Insurance Denial Claim Appeal Guidelines. . 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: That way, we can verify your account and start helping you as quickly as possible. There are three separate components that affect the value of each medical service or procedure: RVUs are assigned to each of these components. 0000008643 00000 n This standard is called the "Birthday Rule.". If member does not return the call, claims will be denied until information is received.
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