regence claims address

0000018886 00000 n | 1-866-977-7378. CVB BCBS of Florida $25 will continue to accrue until it reaches that threshold or until December of each year. CZK Anthem BCBS of Virginia We can process the claim after we receive that information. 401 Fifth Ave. CWB BCBS of Georgia Claims Regence BlueShield Attn: UMP ClaimsP.O. Blue Advantage Administrators of 0000015111 00000 n This standard is called the "Birthday Rule.". Please treat these members the same as domestic Blue Plan members. We follow industry standard coding recommendations and guidelines from sources such as the CMS, CPT, and AMA, and other professional organizations and medical societies and colleges. ABF Healthnow of NY Buffalo You can get the standardized coverage from this health insurance plan all through the nation. Blue-Cross Blue-Shield of Tennessee. If that dialog box did not appear, click the "(change)" link next to the "ZIP code" label. Also its not a sequential order hence its hard to find unless we check with first 3 alpha prefix. Do not add or omit any characters from the member ID numbers. CZW BCBS of North Carolina 0000004941 00000 n AHI BCBS of Rhode Island AFP Anthem BCBS of Ohio ), claims will be processed accordingly and under the terms of our subscriber's contract. DKA Wellmark BCBS Iowa/South Dakota AAK Anthem Blue Cross of California Payment of this claim depended on our review of information from the provider. Professional example: GENERAL CLINIC is the provider of service. ABA BCBS of IL Provider: send us the NDC #, quantity and date span for this claim. Discover all the ways members can earn wellness incentives and rewards for taking an active role in their health. Availity supports the exchange of electronic remittance advice (ERA) files for Regence payers in the ASC X12 835 format. Claims determinationsThe plan will notify you of action taken on a claim within 30 days of the plan receiving it. AEX BCBS of IL 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 know which division you would like to contact, you can also reach out directly using the following phone numbers and email addresses. Deutsch | BCBS Provider Phone Number. Contact. 0000004602 00000 n Diabetes. Box 33 Enter the contract name of physician or provider who performed the service. Phone: 1-800-628-3481. *Follow instructions on these ID cards to verify eligibility, submit claims and obtain health plan contact information. 1-800-962-2731. We use cookies on this website to give you the best experience and measure website usage. 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. 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. CWH Anthem Blue Cross of California Only appeals received within this period will be accepted for review. Online Claim Submission. 0000009222 00000 n 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. ADE BCBS of IL Phone:800-562-1011Fax: 877-239-3390 (Claims and Customer Service)Fax: 877-202-3149 (Member Appeals)Fax: 866-948-8823 (FEP Care Management - prior auth/pre-service requests), Email: Idaho Regence BlueShield of Idaho PO Box 31603 Salt Lake City, UT 84131 Illinois BlueCross BlueShield of Illinois PO Box 1364 Chicago, IL 60690 Jun 29, 2010 | Medical billing basics | 6 comments. Featured In: May 2020 Empire Provider News. Examples: medical doctor, osteopath, optometrist, chiropractor, physical therapist, audiologist, independent laboratory, nurse practitioner, durable If your request for mediation is timely, both parties must agree upon a mediator. AGC MO BCBS MO, POB 419169 , Kansas City , MO , 64141-6169 888-989-8842, AHP Empire Empire BC, POB 5020 , Middletown , NY , 10940 800-772-2875, AHU PPO MD BC MD, 10455 Mill Run Circle , Owings Mills , MD , 21117 877-228-7268, AHW PA BCBS NE PA, 70 N Main St , Wilkes-Barre , PA , 18711 717-829-8500, AIU PA Independence BC, 1901 Market St , Philadelphia , PA , 19103 215-564-2100, AKM MI BC MI, POB 1618 , Detroit , MI , 48231 800-462-7237 The ID cards may also have: ** PPO in a suitcase logo, for eligible PPO members startxref This prefix is the part of the distinctive identification number. Asthma. Our process meets or exceeds the requirements set by the Office of the Insurance Commissioner. Saturday 7 a.m. to 8 p.m.; Sunday 7 a.m. to 7 p.m. (Pacific)Calling from outside the US: Dial exit code of your country (typically 00) plus the country code (1 for USA), then the area code (916), then the seven-digit US local phone number 635-7373. 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. Any suggestions. However, name changes can be done only through your payroll or benefits office. This means that you may see cards with ID numbers between six and 14 numbers/letters following the alpha prefix. Visit the Regence provider website, regence.com to learn more about: Claims and payment: Appeals. P | If we processed the original claim incorrectly, you do not need to rebill. Complete the enrollment form on the following page to receive 835 ERA files from Regence payers . To help you move from paper to electronic claims, follow these steps: Electronic claims can be sent when we are the secondary insurance payer. 0000004073 00000 n You have to bear in mind that the alpha prefix has three letters usually followed by the identification of member of BCBS. Franais | DJC Anthem BCBS of Ohio DJE BCBS of Alabama AFS Blue Shield of California All people who have BCBS health insurance policy have to make copies of their ID front and back and keep such records on hand. When we are the primary carrier, we calculate and pay benefits routinely. UMP administered by Regence BlueShield (Medical only) (UMP Achieve 1, UMP Achieve 2, UMP High Deductible, UMP Plus) Online: Uniform Medical Plan for school employees. 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. Use the following codes: In the Original.Ref.Co segment of box 22 enter the original claim number. Provider: please send us your operative notes for this claim. AEJ Horizon BCBS of New Jersey 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. QAB. Your health care provider will require that you full and distribute these declare paperwork to UnitedHealthcare. QMC Retail OFF Exchange Verify benefits or eligibility for BlueCard members. Diabetes. An overpayment was recorded during the payment cycle. 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. Examples of ID numbers: As a provider servicing out-of-area members, you may find the following tips helpful: ** Ask the member for the most current ID card at every visit. AEC BCBS of IL YDW Retail OFF Exchange If the information is not captured correctly, you may experience a delay with the claim processing. To find a health care provider in the KingCare network, go to Find a doctor and sign in to your Regence BlueShield account. Franais | AGS Anthem Blue Cross of California Box 25 Enter the applicable tax ID number. All Excellus plans use this mailing address: Excellus BCBS Attn: Claims P.O. Attach a completed Corrected Claim - Standard Cover Sheet.. Your member ID card is your key to using your medical plan benefits. Electronic claims without a TIN are rejected as incomplete. Physicians and providers may submit a proposal to modify a payment policy. (Note: Claims received with an ICD-9 code will be rejected with a notice to re-bill using ICD-10.) BCBS Prefix List 2021 - Alpha. AGH Anthem Blue Cross of California 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. CZU Anthem Blue Cross of California CZP Anthem BCBS of Ohio Coordination of Benefits (COB) is a provision included in both member and physician and provider contracts. PO Box 1106. P.O. (BlueCard will request refunds regardless of the dollar amount.) You can verify your address by calling PEBB Customer Service at PO Box 52057 Eastern WA and Alaska providers submit to Premera. To send an electronic claim, use the Availity clearinghouse with payer ID RGA01. They will be satisfied when they properly use this insurance plan and fulfil overall requirements on the prompt assistance for claiming the insurance. 0000007198 00000 n STATE MAIL TO MAILING ADDRESS CITY, STATE ZIP Alabama Blue Cross and Blue Shield of Alabama 450 Riverside Parkway E Birmingham, AL 35298 . Only a member can request a Level I or Level II Appeal for a non-billing issue, unless the member has completed a release to allow the provider to act as their Representative. If we do not receive a response within the specified period, the claim(s) is denied pending further information. 0000012556 00000 n 1 (888) 675-6570 Prescription questions? State Lookup. Type forms in black ink (handwritten forms cannot be read by OCR equipment). Tricare Phone Number and Claim Address; Molina Healthcare Phone Number claims address of Medicare and Medicaid. Prefix Tool. Member identification prefixes were updated as part of that transition. For more specific contact information, choose from the following: Individuals and families Medicare Employers Producers Providers Fraud or abuse You can remain anonymous. If we need additional information for subrogation determine to pay or deny, the IQ will either be sent back to the member requesting the information, or subrogation will make two calls within five days of receiving the IQ. 1-800-676-BLUE (2583) (toll free) Blueline voice response unit. 0000128769 00000 n You will need special software to send insurance claims electronically. Anthem Blue-Cross Blue-Shield of Colorado. Media Contact: Lou Riepl Regence BlueCross BlueShield of Utah Regence BlueShield of . You may request to have a customer service representative call you at a scheduled time during normal business hours for plan help. To cancel or waive your coverage, visit the PEBB Program website using these links: Uniform Medical Plan (UMP) is a self-insured Preferred Provider Organization (PPO) medical plan offered through the Washington State Health Care Authority. CWR Anthem Blue Cross of California 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. 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. | ), 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 AGU Carefirst BCBS Maryland information. CYW Anthem BCBS of Ohio 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.*. DJH Wellmark BCBS Iowa/South Dakota We're here to help (651) 662-5200 1-800-262-0820 . The alpha prefix identifies the Blue Plan or National Account to which the member belongs. You have five UMP medical plan options: UMP Classic. Coronary Artery Disease. They must be sent hard copy. CVA Anthem BCBS of Ohio CUR Healthnow of NY Buffalo 0000003603 00000 n ADA Anthem Blue Cross of California All other related costs incurred by the parties shall be the responsibility of whoever incurred the cost. COB information is allowed when the primary coverage is with a commercial payer; this generally excludes Medicare and FEP. You must request mediation in writing within 30 days after receiving the Level II appeals decision on a billing dispute. The time period does not start until we receive a complete appeal. 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. Regence BlueShield of Idaho P. O. We use cookies on this website to give you the best experience and measure website usage. Regence BlueShield - FEP PO Box 1388 Lewiston, ID 83501 Customer Service. Unclean claims will begin to Claims filing information and provider service phone numbers are available in the December, January and February Provider Bulletins. 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. DJF Anthem BCBS of Virginia AGG Anthem BCBS of Ohio (Field not populated for CMS-1500 claims. A free form note with an explanation for the corrected/replacement claim, in loop 2300 claim note as: For professional and dental claims: segment NTE01 must contain ADD and segment NET02 must contain the note, for example: NTE*ADD*CORRECTED PROCEDURE CODE (or whatever data element was corrected/changed on the claim), For facility/institutional claims: segment NTE01 must contain UPI and segment NTE02 must contain the note, for example: NTE*UPI*CORRECTED LAB CHARGES (or whatever data element was corrected/changed on the claim), Premera Blue Cross Blue Shield of Alaska Participating (Traditional/Indemnity) and Preferred/BestCare (PPO), Dimensions (HeritagePlus, HeritageSelect, or Global), Validation to ensure that they are HIPAA-compliant, Detailed claim acceptance and rejection reporting. CZJ Premera Blue Cross of Washington Insurance Denial Claim Appeal Guidelines. CUW Anthem Blue Cross of California If you are unsure how to submit secondary claims electronically, contact your practice management system vendor or contact an EDI representative at 800-435-2715. AAP BCBS of Tennessee The conversion factor represents the dollar value of each relative value unit (RVU). AFI BCBS of Rhode Island The provider needs to submit itemized charges to us. CWE BCBS of Michigan This service is considered a standard exclusion. Kreyl Ayisyen | claim and apply additional edits if applicable. ABG BCBS of Georgia Church Street Station. To pay this claim, we needed to review information from the provider. Use search function and put your comment any alpha prefix not found here. To speed claims processing, we use document imaging and optical character recognition (OCR) equipment to read your claims. ABY Carefirst BCBS Maryland For other language assistance or translation services, please call the customer service number for . Call Customer Service and choose the Pharmacy option. Unclean claims will begin to accrue interest on the 16th day 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. Please provide a detailed description of the service for preauthorization to a member of our Customer Care Team at 1-866-738-3924 and they will let you know if the service requires preauthorization. Regence BlueShield serves select counties in the state of Washington and is an independent licensee of the Blue Cross and Blue Shield Association. Money was posted to your account during the payment cycle. Lastly mail the completed claim form to the address provided. DJN BCBS Minnesota Here are common reasons why claims suspend or reject: Contact Customer Service with questions regarding claims processing or send a copy of the voucher highlighting the claim in question and the inquiry reason. (For example, if your service was provided on March 5, 2022, you have until December 31, 2023 to submit your claim). Interest less than AHC Anthem BCBS of Missouri Medical claims. 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. When the conversion factor is multiplied by the total RVUs, it will yield the reimbursement rate for the specific service (or code). CZO Anthem BCBS of Ohio the instructions to determine where to send claims or correspondence. (Note: Claims received with an ICD-9 code will be rejected with a notice to re-bill using ICD-10.) ADQ Independence Blue Cross The ID cards also may have: Learn more about global periods, modifiers, virtual care, unlisted codes and NCCI bypass modifiers. CUP CBA BLUE (BCBS VT) These charges are included in the main anesthesia service. When dependent children are double-covered by divorced parents, coverage depends on any court decrees. By continuing to use this website, you consent to these cookies. For more information, please visit regence.com, AIH Anthem Blue Cross of California Check out the changes and updates to our plan in 2023. Once you have signed in, simply click on the Claim Search link. Because your primary doctor and your specialists may all work for different clinics, you may need to do more of your own care coordination. DJD BCBS of Nebraska 4. Sometimes an office returns a check to us that represents multiple claims because a portion (see Threshold below) of the payment may be incorrect. AFL Anthem Blue Cross of California View your credentialing status in Payer Spaces on Availity Essentials. BCBS Company. CUU BCBS of Texas DHP Excellus BCBS Portugus | note: Exclusions to paying interest may apply based on line of business. For complete plan details, seeBenefits Summaries. Please make copies of the front and back of the ID card, and pass this key information to your billing staff. Tricare Phone Number and Claim Address; Molina Healthcare Phone Number claims address of Medicare and Medicaid. RGA observes theholiday schedule below. We can process the claim after we receive that information. Where can I find an Explanation of Payment (EOP)? AHK Anthem Blue Cross of California | CYV Anthem BCBS of Missouri Postal Prescription Services Online: Your PPS account Phone: 1 (800) 552-6694 TRS: 711 Fax (for providers only): 1 (800) 723-9023 | Provider: send us medical records relating to prescription drug charges. KingCareSMuses a preferred provider organization (PPO) for its network. 0000055776 00000 n The most commonly occurring codes and messages are listed below. | 3. Access eContracting to view and sign agreement documents. 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 . QME Retail OFF Exchange 0000001762 00000 n Stay up to date on what's happening from Bonners Ferry to Boise. Provider who rendered the service. CVP Anthem BCBS of Ohio Care Management Programs. 0000010231 00000 n Every user of BCBS health insurance is assigned an alpha prefix that contains three letters. Regence BlueShield. 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. 1-800-962-2731. 0000018992 00000 n Paper Claim Form . ** Empty suitcase logo, for eligible Manage Care/POS, Traditional and Managed Care/HMO members. We can process the claim after we receive that information. For more information about RBRVS methodology visit the CMS website. The following are examples of ID numbers with the alpha prefix highlighted: Note : Guest members do not have an alpha prefix. 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). AET Anthem Blue Cross of California You can also call using Skype. Subrogation permits the plan to recover payments when the negligence or wrongdoing of another causes a member personal illness or injury. We may send a questionnaire to the member regarding possible duplicate coverage. CYY Premera Blue Cross of Washington Tagalog | DJK Empire BCBS

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