regence claims address

Our Customer Care lines will re-open at 6 AM PT the following business day. 3. Web: Regence BlueShield. Correspondence. . AGW BCBS of MA Please refer to the members ID card to determine if he/she has one of these products. P.O. P.O. Monday-Friday, 8-5 Pacific (800) 552-0635 www.CarpentersBenefits.org. BCBS Provider Phone Number. ADD Anthem BCBS of Ohio 0000005825 00000 n ** The alpha prefix is critical for the electronic routing of specific HIPAA transactions to the appropriate Blue Plan. For other language assistance or translation services, please call the customer service number for your local Blue Cross and Blue Shield company. Phone: 844-380-8838, 800-863-5488 (TTY) See our FAQs for more claim information and contacts. BCBS Provider Phone Number. A Level I Appeal is used for both billing and non-billing issues. CNK-HR-0230 DJT BCBS Minnesota Attach a completed Corrected Claim - Standard Cover Sheet.. . Ting Vit | 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. If that dialog box did not appear, click the "(change)" link next to the "ZIP code" label. Thank you for choosing Regence as your health plan administrator. | When members of Blue Plans arrive at your office or facility, be sure to ask them for their current Blue Plan membership identification card. If we processed the original claim incorrectly, you do not need to rebill. Blue cross Blue Shield association cannot accept Guest Membership claims electronically. Use our onboarding resource to quickly get started. All the articles are getting from various resources. AFZ Anthem Blue Cross of California Call the National Information Center at 1-800-411-BLUE (2583) weekdays from 8 a.m. to 8 p.m. Eastern time. APT DE BC DE, POB 8830 , Wilmington , DE , 19899-8830 800-342-2221 What you need to know about the disease and our commitment to ensuring you have access to the right care at the right time. There is a minimum threshold of $25 for monthly interest payments on delayed clean claims. Seattle, WA 98111-9202, Back to Medical Reference Manuals overview, Espaol | The dates-of-service (to and from - also referred to as beginning and ending dates) at a, The code/modifier shown in box 24D of the CMS-1500. Contact. The employer group name is usually associated with the alpha prefix of the account specific health insurance type. | The total number of characters in the members ID ranges from six to fourteen. ABU BCBS Minnesota | color, national origin, age, disability, sex, gender identity, or sexual orientation. To contact us without setting your ZIP code, call: Prescription questions?Call Customer Service and choose the Pharmacy option. ABT Carefirst BCBS Maryland Bellevue, WA 98004, Terms of Use | Privacy| Disclosure Notice Patient Protection Surprise Billing, An Independent Licensee of the Blue Cross Blue Shield Association Serving Select Counties in Washington. 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). We use cookies on this website to give you the best experience and measure website usage. To get information about such member IDs, you can contact BCBS prefix directory phone number i.e. 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). CWF BCBS of Georgia CWJ BCBS of Alabama Claims Address. Coding toolkit View our clinical edits and model claims editing. This standard is called the "Birthday Rule.". claims status, . Availity is an independent provider of health information network services that does not provide Blue Cross Blue Shield products or services. Type forms in black ink (handwritten forms cannot be read by OCR equipment). ), Tel:800-562-1011Fax: 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), Premera Blue Cross - FEPPO Box 33932Seattle, WA 98133, Retail Pharmacy Program We can process the claim after we receive that information. A billing issue is classified as a provider appeal because the issue directly impacts your write-off or payment amount. . You are about to leave regence.com and enter another website that is not affiliated with or licensed by the Blue Cross Blue Shield Association. Premera Blue Cross 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, (Note: Claims received with an ICD-9 code will be rejected with a notice to re-bill using ICD-10.) CWR Anthem Blue Cross of California https://www.bcnepa.com/Providers/providerrelations/ReferenceGuides/AlphaPrefixList.pdf. AHD BCBS of South Carolina You have 365 calendar days to submit a complaint following the action that prompted the complaint. They can take note of bcbs alpha prefix online in detail and gain knowledge of how to choose the right alpha prefix. Mental Health/Substance Use Disorder Precertification. We do not request refunds for overpayments less than $25, but you may submit these voluntarily. 0000004829 00000 n QMF Retail ON Exchange The main identifier for out-of-area members is the alpha prefix. You can learn more about credentialing by visiting the provider section of our website. Open 24 hours a day, 7 days a week. ID cards for the following products and programs do not have an alpha prefix: ** Stand-alone vision and pharmacy when delivered through an intermediary model*, ** The BCBS Federal Employee Program (FEP) The letter R appears in front of the ID number.*. The three characters preceding the subscriber identification number on BCBS member ID cards. You have five UMP medical plan options: UMP Classic. We will continue to update this section of our website to make sure you have the latest COVID-19-related information and helpful resources. This is a duplicate of a previously denied claim. To do so, please submit the proposal in writing to your assigned Provider Network Executive (PNE) or Provider Network Associate (PNA). ABZ Carefirst BCBS Maryland What do I do if a member has an identification card without an alpha prefix ? Identifying members Easily identify the kind of coverage our members have. By continuing to use this website, you consent to these cookies. Box 21267 M/S S518 Seattle, WA 98111-3267 Claims appeals, balance billing or pricing disputes The process for submitting an appeal depends on your issue. 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. 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. Email: Prproviderrelations@bcidaho.com. Designed by Elegant Themes | Powered by WordPress. Jun 29, 2010 | Medical billing basics | 6 comments. STATE MAIL TO MAILING ADDRESS CITY, STATE ZIP Alabama Blue Cross and Blue Shield of Alabama 450 Riverside Parkway E Birmingham, AL 35298 . Workers' Compensation will pay when the member's employer is liable to pay medical bills resulting from illness or injury arising out of, or in, the scope of employment. Portugus | CMS also uses RVUs to allocate dollar values to each CPT or HCPCS code. ABL BCBS of IL Costco Mail-Order PharmacyOnline: Sign in to your Costco accountPhone: 1 (800) 607-6861TRS: 711Fax: 1 (800) 633-0334Business 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. Any exceptions are documented as Payment Policies. 0000008643 00000 n Tricare Phone Number and Claim Address; Molina Healthcare Phone Number claims address of Medicare and Medicaid. ** Remember: Member ID numbers must be reported exactly as shown on the ID card and must not be changed or altered. CWN Carefirst BCBS Washington DC 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 AIA BCBS of Texas When this notification has occurred, change the indicator on your claims from (. Remember to include the leading three-character prefix and enter it in the appropriate field on the claim form. AEF BCBS of IL Our medical staff reviewed this claim and determined that this continued stay doesn't meet the criteria for medical necessity. ), claims will be processed accordingly and under the terms of our subscriber's contract. 4. We are now processing credentialing applications submitted on or before March 6, 2023. However, name changes can be done only through your payroll or benefits office. You will need special software to send insurance claims electronically. Need help with a claim? Appeals rights will be exhausted if not received within the required timeframe. BCBS Company. If you find anything not as per policy. accrue interest on the 31st day from receipt of the information. to 6:00 PM PT or log in to your RGA account and submit an electronic request. To find a health care provider in the KingCare network, go to Find a doctor and sign in to your Regence BlueShield account. QAB. If your organization is contracted with Premera, most practitioners must be credentialed, with the exception of hospital-based practitioners. QAA. 1/2022) v1 INSTRUCTIONS FOR FILING A CLAIMIMPORTANT: Be sure information lines up correctly within the respective fields (data that overlaps another field/box cannot be read accurately). AAZ Anthem Blue Cross of California 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. 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. DAU Anthem BCBS of Missouri Visit the Regence provider website, regence.com to learn more about: Claims and payment: Appeals. Your health care provider will require that you full and distribute these declare paperwork to UnitedHealthcare. 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. 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 Regence BlueShield Attn: UMP ClaimsP.O. 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. AGB Excellus BCBS The claim(s) will suspend and a processor will review to determine whether to send an Incident Questionnaire (IQ) to the member. ** PPOB in a suitcase logo, for PPO members with access to the BlueCard PPO Basic network Coordination of Benefits (COB) is a provision included in both member and physician and provider contracts. 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. They include a request of medical records for review. How do I identify international members? 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. AGL Premera Blue Cross of Washington AFC BCBS of IL CVT Anthem Blue Cross of California In general, there are two categories of alpha prefixes namely account specific and plan specific alpha prefixes. If you get the plan specific alpha prefix, then the first two characters in this prefix are used to identify your plan. We'll process the claim after we receive that information. 1-800-423-1973. If we do not receive a response within the specified period, the claim(s) is denied pending further information. These weights are then multiplied by the dollar conversion factor we publish. AFO Arkanasa (If no account number is assigned, the words No Patient Account # are noted. Colorado. Tennessee. Seattle, WA 98104 Availity is solely responsible for its products and services. Every user of BCBS health insurance is assigned an alpha prefix that contains three letters. CVZ Horizon BCBS of New Jersey AII BCBS of Louisiana Kreyl Ayisyen | CVX BCBS of IL Italiano | CVJ BCBS of Florida The ID cards may also have: ** PPO in a suitcase logo, for eligible PPO members ABF Healthnow of NY Buffalo If your request for mediation is timely, both parties must agree upon a mediator. We are now processing credentialing applications submitted on or before March 14, 2023. This claim was paid previously to the provider or applied to the member's deductible. Deutsch | Regence Blue Shield in accordance with the terms of your provider contract with Regence. Need information from the member's other insurance carrier to process claim. Interest less than They must be sent hard copy. Premera Blue Cross Access fee schedules. Below you will find a list of the 2015 BCNEPA plans with the corresponding Highmark Blue Cross Blue Shield plans for 2016. Box 7408. Premera Blue Cross & The Regence Group Common Alpha Plan Prefixes Last updated: 09/01/2016 Premera Blue Cross & Premera Blue Cross/NASCO Prefixes Western WA providers submit claims to Regence Blue Shield. 0000128769 00000 n Prefix Tool. Please follow Get help when you need it. They require completion and mailing of an Incident Questionnaire for possible accident investigation or a Workers Compensation injury (claims in subrogation). Centers of Excellence Program administered by Premera Phone: 1 (855) 784-4563 TRS: 711 Business hours: Monday through Friday 7 a.m. to 5 p.m. (Pacific), Puget Sound High Value NetworkPhone: 1 (855) 776-9503TRS: 711Business hours: Monday through Friday 7 a.m. to 7 p.m. (Pacific), UW Medicine Accountable Care NetworkPhone: 1 (888) 402-4237TRS: 711Business hours: Monday through Friday 5 a.m. to 8 p.m. (Pacific). If you submit your claims electronically, you may receive electronic remittance for the following: Remittance is available online-just let us know. 24/7 Nurse Line: 800-267-6729. What you need to know about the disease and our commitment to ensuring you have access to the right care at the right time. Call Customer Service and choose the Pharmacy option. BCBS Provider Phone Number. Carpenters Retirement Plan Individual Account Pension Plan Pre-Retirement Planning Your Balances & Accruals. On the Availity Web Portal, you can: Run transactions to obtain member benefit, eligibility and claims information. 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. YUV SG ON Exchange QMB SG ON Exchange Claims & payment Learn how to identify our members' coverage, easily submit claims and receive payment for services and supplies. No pre-authorization for COVID-19 vaccinations, testing and treatment, No member cost shares for COVID-19 vaccinations, testing and treatment. DHP Excellus BCBS note: Exclusions to paying interest may apply based on line of business. AFM BCBS Minnesota DJH Wellmark BCBS Iowa/South Dakota Our provider complaints and appeals process ensure we address a complaint or an appeal in a fair and timely manner. We can process the claim after we receive that information. Box 22999 Rochester, NY 14692 *New York *The Buffalo office handles the receipt of claims and correspondence for BS Where do I determine if a code is covered? 0000001921 00000 n | 1 (888) 675-6570 Prescription questions? AHX Horizon BCBS of New Jersey Claims filing information and provider service phone numbers are available in the December, January and February Provider Bulletins. ** A local network identifier, (for example, BlueMark) Boise, ID 83707. 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. CVA Anthem BCBS of Ohio Phoenix, AZ 85072, Retail Pharmacy Program State Lookup. DHA Excellus BCBS Utica When applicable, we will suspend payment until we determine which carrier is primary and which is secondary. Service not a benefit of subscriber's contract, Investigational or experimental procedure. P | When a Medicare patient received services that Medicare specifically requires to be submitted on separate claim forms, this one claim requirement will not apply. Unclean claims will begin to accrue interest on the 16th day Note that some processing systems may have a limitation regarding the number of characters recognized. Claims submitted that indicate possible Workers' Compensation illness or injuries are investigated. Examples: medical doctor, osteopath, optometrist, chiropractor, physical therapist, audiologist, independent laboratory, nurse practitioner, durable This is a claim adjustment of a previously processed claim. DKB Highmark BCBS AAS Anthem Blue Cross of California CUP CBA BLUE (BCBS VT) 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. YDO Retail OFF Exchange ** A correct member ID number includes the alpha prefix (first three positions) and all subsequent characters, up to 17 positions total. . That way, we can verify your account and start helping you as quickly as possible. Note : We have added some more prefixes in the list. 0000003471 00000 n We haven't received the information. 0000011774 00000 n Be on . They will be satisfied when they properly use this insurance plan and fulfil overall requirements on the prompt assistance for claiming the insurance. Call 1 (855) 522-8894. The protection of your privacy will be governed by the privacy policy of that site. Provider: please send us the radiology reports for this 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. AIJ Empire BCBS ADJ Anthem BCBS of Missouri LAA. AEA BCBS of Texas 0000010898 00000 n | Heres everything you need to know about it. Does not determine the reimbursement dollar amount for any particular service (reimbursement is specific to the provider applicable fee schedule). AGR Anthem BCBS of Colorado CVP Anthem BCBS of Ohio You can find a claim by the members ID number or by the claim number. TINs are still a required element for claims. 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. Claims submission Learn more about billing and how to submit claims to use for payment. Physicians and providers may submit a proposal to modify a payment policy. National Correct Coding Initiative (NCCI) editing is followed when applicable. | While you pay for coverage through UW, the state designs the plans and contracts with Regence BlueShield and Washington State Rx Services to administer the plan. Tricare Phone Number and Claim Address; Molina Healthcare Phone Number claims address of Medicare and Medicaid. AFG BCBS of Nebraska 0000008433 00000 n Anthem Blue-Cross Blue-Shield of Colorado. 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. PO Box 52057 If you are a clinic or hospital-based physician or other qualified healthcare provider, use a CMS-1500 (02-12) form for claims for professional services and supplies related to: This includes claims for outpatient services and services performed by a hospital-based physician or other qualified healthcare provider. A subrogation provision is included in both member and physician/provider contracts. Find helpful phone, fax and email information for assistance. There is no charge to healthcare providers who submit electronic claims directly to us. Log in to Availity Don't have an Availity account? New York, New York 10008-3876. 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. ACR Anthem Blue Cross of California Units shown in box 24G of the CMS-1500 form. ** PPO in a suitcase logo, for eligible PPO members Regence 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. Blue-Cross Blue-Shield of Illinois. Retirees and PEBB Continuation Coverage members:Phone: 1 (800) 200-1004TRS: 711Business hours: Monday through Friday 8 a.m. to 4:30 p.m. (Pacific). Completion of the credentialing process takes 30-60 days. Paper Claim Form . AEM Highmark BCBS Blue Cross and Blue Shield of Illinois P.O. DKA Wellmark BCBS Iowa/South Dakota DJP BCBS of Nebraska (BlueCard will request refunds regardless of the dollar amount.) It is only after we determine a members eligibility or coverage that payment policies and edits are applied. P.O. Continue to submit paper claims until you are told to stop. <<1CC62891B116FE488EB50D904D0BD9AE>]/Prev 176800/XRefStm 1570>> These claim editors evaluate billing information and coding accuracy on submitted claims and assists in achieving consistent, accurate, and timely processing of physician and provider payments. . As a KingCare member, your care is covered at a higher level inside the network, but the plan also pays a smaller amount toward your bill if you see a doctor outside of the KingCare PPO network. DJE BCBS of Alabama ** Empty suitcase logo, for eligible Manage Care/POS, Traditional and Managed Care/HMO members. Caused by another party (e.g., slip and fall, medical malpractice, etc. Claims How do I determine if a diagnosis or procedure code needs preauthorization? Kreyl Ayisyen | If you know which division you would like to contact, you can also reach out directly using the following phone numbers and email addresses. Medical claims. 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. AGV BCBS of MA Subrogation permits the plan to recover payments when the negligence or wrongdoing of another causes a member personal illness or injury. All people who have BCBS health insurance policy have to make copies of their ID front and back and keep such records on hand. AID Anthem BCBS of Ohio 0000018383 00000 n You can also use the Office of Financial Management MyPortal to update your address.
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