regence claims address

All the contents and articles are based on our search and taken from various resources and our knowledge in Medical billing. | 0000001570 00000 n Web: Regence BlueShield. ** Verify with the member that the ID number on the card is not his/her Social Security Number. AAB BCBS of Michigan CZQ Anthem BCBS of Ohio DJY Anthem BCBS of Ohio We will continue to update this section of our website to make sure you have the latest COVID-19-related information and helpful resources. The earlier you submit claims, the earlier we process them. AIJ Empire BCBS An overpayment was recorded during the payment cycle. CVQ BCBS of Georgia 0000018383 00000 n Mailing address: Blue Cross of Idaho. 0000004829 00000 n ** Do not add/delete characters or numbers within the member ID. (Field not populated for CMS-1500 claims. CVP Anthem BCBS of Ohio 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. AGW BCBS of MA Please review the terms of use and privacy policies of the new site you will be visiting. Blue Cross and Blue Shield of Illinois P.O. We are now processing credentialing applications submitted on or before March 6, 2023. AHC Anthem BCBS of Missouri Alaska contracted and non-contracted Most BCBS-branded ID cards display a three-character alpha prefix in the first three positions of the members ID number. Heres everything you need to know about it. DJH Wellmark BCBS Iowa/South Dakota It doesn't replace your tax ID number (TIN) or Drug Enforcement Administration (DEA) number. Our Provider Integrity Oversight Committee reviews proposals for new payment policies and updates to our policies. Tricare Phone Number and Claim Address; Molina Healthcare Phone Number claims address of Medicare and Medicaid. The plan doesn't cover cosmetic services. Contact us - Asuris Join us! Box 22999 Rochester, NY 14692 *New York *The Buffalo office handles the receipt of claims and correspondence for BS If you submit your claims electronically, you may receive electronic remittance for the following: Remittance is available online-just let us know. Box 7408. national customer service numbers at fepblue.org, Espaol | To make tracking patient reimbursement easier, we can include these account numbers on our payment vouchers. We recommend that you make copies of everything that is submitted for your personal records. CUP CBA BLUE (BCBS VT) BCBS Prefix List HAA to HZZ - Alpha Lookup by State 2022 Access fee schedules. Availity is solely responsible for its products and services. ADT BCBS Minnesota ADY BCBS of South Carolina APT DE BC DE, POB 8830 , Wilmington , DE , 19899-8830 800-342-2221 KingCare - King County BCBS Prefix List 2021 - Alpha. 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. H\@F. 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. Kreyl Ayisyen | 0000001240 00000 n The alpha prefix is critical for inquiries regarding the member, including eligibility and benefits, and is necessary for proper claim filing. Every user of BCBS health insurance is assigned an alpha prefix that contains three letters. Diabetes. ), 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. Policy #s: Regular 10017241-0001, Transit 10017241-0004, Sheriff 10017241-0016 . Lack of credentialing can be grounds for termination from Premeras network. Its often confused that BCBS have lot of prefixes and where to contact. 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. DJN BCBS Minnesota You can submit a complaint about one of our actions (verbally or in writing) to one of our employees. You may have invested in the account specific alpha prefix health insurance plan from BSBS at this time. This service is considered a standard exclusion. Management - prior auth/pre-service requests), Email: Members: Log in/register at MyBlue Customer eService, Regence BlueShield - FEPPO Box 21709Seattle, WA 98111. ACX BCBS of IL 598 0 obj <>stream They include a request of medical records for review. AAC BCBS of IL Availity supports the exchange of electronic remittance advice (ERA) files for Regence payers in the ASC X12 835 format. Find the correct address listed under the type of service received (see explanation). 0000125980 00000 n ADL Anthem BCBS Kentucky DKC BCBS of Texas ACU Anthem Blue Cross of California 553 0 obj <> endobj We can't process this claim until the incident questionnaire we sent the member is fully completed, signed and returned. CVM Anthem BCBS of Ohio BCBS Prefix List LAA to LZZ - Alpha Lookup by State 2022 Our Customer Care lines will re-open at 6 AM PT the following business day. You can find a claim by the members ID number or by the claim number. DJJ Horizon BCBS of New Jersey 0000015111 00000 n Regence BlueShieldAttn: UMP ClaimsP.O. CVJ BCBS of Florida 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. Fax: 801-333-6523 (Mark claims: Attn New Claims) Email: Log in or register - MyBlue Customer eService. Learn how to contact your local Blue Cross and Blue Shield company, as well as other key areas. CUQ Blue Shield of California AEF BCBS of IL PO Box 3876. 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. 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. 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). View the instructions for verifying your information and notifying us of changes. 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. Washington - Blue Cross and Blue Shield's Federal Employee Program Is distinct from our medical policy, which sets forth whether a procedure is medically necessary/appropriate, investigational or experimental and whether treatment is appropriate for the condition treated. (BlueCard will request refunds regardless of the dollar amount.) ADD Anthem BCBS of Ohio ), claims will be processed accordingly and under the terms of our subscriber's contract. To ensure accurate claim processing, it is critical to capture all ID card data. CUZ Anthem BCBS of Ohio account number and claim number handy when you call. 0000008433 00000 n We can't process this claim because we haven't received your response to our request for information. Uniform Medical Plan (UMP) | Washington State Health Care Authority P | Contact Us. Seattle, WA 98104 Caused by another party (e.g., slip and fall, medical malpractice, etc. AEK Independence Blue Cross Our medical staff reviewed this claim and determined that this continued stay doesn't meet the criteria for medical necessity. BCBS Provider Phone Number. 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. Employees:Contact your payroll or benefits office. 02/16/2023 Retirement Workshop in Lacey on Feb. 18. . Completion of the credentialing process takes 30-60 days. Secondary submission: When submitting secondary claims to us, submit the primary processing information with the submission of the secondary claim. Provider Contacts | Provider | Premera Blue Cross (If no account number is assigned, the words No Patient Account # are noted. Send us other carrier's explanation of benefits. 0000018992 00000 n When two or more health plans cover a member, COB protects against double or over-payment. Does not determine the reimbursement dollar amount for any particular service (reimbursement is specific to the provider applicable fee schedule). Contact us - Regence Regence BlueShield - FEP PO Box 857 Lewiston, ID 83501. The most commonly occurring codes and messages are listed below. AHE Empire BCBS 4. AGS Anthem Blue Cross of California Provider: please send us your operative notes for this claim. Health . However we have some guide to follow, using prefixes we could find the state of the BCBS and contact phone number to proceed further. 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. QAA. Units shown in box 24G of the CMS-1500 form. CZB Wellmark BCBS Iowa/South Dakota Email: Medicare/Medicaid: [email protected]. See our FAQs for more claim information and contacts. We can't process this claim because we haven't received the necessary information we requested from your provider. They are identified by Guest Member on their health plan ID card. 0000003471 00000 n Calypso, our affiliate, processes refunds and overpayment requests. you will need to contact Regence to update your account to ensure your claim processes correctly and timely. The following are examples of ID numbers with the alpha prefix highlighted: Note : Guest members do not have an alpha prefix. Practitioners who arent credentialed may have their claims returned until they submit a complete credentialing application. AFA Anthem BCBS of Virginia If you have questions regarding the enrollment process, contact Availity Client Services at 1.800.AVAILITY (282.4548). ABY Carefirst BCBS Maryland AFK Empire BCBS Coronary Artery Disease. When you go to this page, you should see a dialog box that asks for your ZIP code. Polski | If the Level II appeal is timely and complete, the appeal will be reviewed. Included with the interest voucher is a summary report detailing We can process the claim after we receive that information. We'll process the claim after we receive that information. Invalid claims are reported back to the provider with rejection details. Regence Bluecross Blueshield of Oregon - Dun & Bradstreet To get information about such member IDs, you can contact BCBS prefix directory phone number i.e. Applicable to facility claims only - reflects the APG code, DRG code, or room type that may relate to the reimbursement amounts. DAD Anthem BCBS of Ohio Our medical staff reviewed this claim and determined that this service isn't covered by the plan. Visit the Regence provider website, regence.com to learn more about: Claims and payment: Appeals. providers: We process your claim as soon as we receive them. Coding toolkit View our clinical edits and model claims editing. View remittance advices. Box 105557. 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. Note: Some members will remain in Blue Cross of Northeastern Pennsylvania health plans until their coverage renews to Highmark health plans later this year. To obtain a UMP document in another format (such as Braille or audio), call UMP Customer Service. 10700 Northup Way, Suite 100 1-800-423-1973. DHA Excellus BCBS Utica ), Email all EDI questions to: [email protected]. 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 CZJ Premera Blue Cross of Washington AGU Carefirst BCBS Maryland Regence BlueCross BlueShield of Oregon accrue interest on the 31st day from receipt of the information. DBT BCBS of Michigan 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. Click on the Submit a Preauthorization Request link. Modifiers. DJS Blue Cross of Idaho (Boise) (for both professional and facility claims) using claim frequency code 7. Phoenix, AZ 85072, Phone:800-562-1011 BCBS Company. Use our onboarding resource to quickly get started. CWQ Anthem BCBS of Ohio If all pertinent information is obtained, the claim(s) will then be processed according to the member's contract benefits. 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. YUV SG ON Exchange We also apply the following prompt pay standards set by Washington's Office of the Insurance Commission to our claims adjudication process in order to: If the above standards are met, the regulation does not require interest for those individual claims paid outside of the 95 percent threshold. You can get the standardized coverage from this health insurance plan all through the nation. If you have questions about COB, contact Customer Service by calling the phone number on the back of the member's ID card. We use cookies on this website to give you the best experience and measure website usage. DCY BCBS of Florida Doing so may cause delays in the handling of your inquiries and claims. 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). Physicians and other healthcare providers receive an Explanation of Payment (EOP), which describes our determination of the payment for services. If you know which division you would like to contact, you can also reach out directly using the following phone numbers and email addresses. 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 Italiano | See our FAQs for more claim information and contacts. Jun 29, 2010 | Medical billing basics | 6 comments. (Note: Claims received with an ICD-9 code will be rejected with a notice to re-bill using ICD-10.) 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. Portugus | The claim will be reprocessed and reflected on the payment voucher. Your software vendor can help you set up your computer to accommodate Premera's billing requirements. Complete the enrollment form on the following page to receive 835 ERA files from Regence payers . CWN Carefirst BCBS Washington DC Precertification remains the responsibility of the provider for all Empire HMO network members. 1-877-764-8724 Email Us. PO Box 52080 or sexual orientation.Premera Blue Cross HMO complies with applicablefederal and Washington state civil rights lawsand does not discriminate on the basis of race, ACN BCBS of IL PO Box 52057 The conversion factor represents the dollar value of each relative value unit (RVU). 0000010231 00000 n 401 Fifth Ave. Download and complete the appropriate form below, then submit it by December 31 of the year following the year that you received service. Carpenters Retirement Plan Individual Account Pension Plan Pre-Retirement Planning Your Balances & Accruals. We will send the member an IQ if the claim(s) is potentially accident-related. Provider Contact Center. ** When filing a claim, always enter the ID number, including the alpha prefix, exactly as it appears on the members card. Atlanta, GA 30348-5557. PDF Member Reimbursement Claim Form - beonbrand.getbynder.com They require completion and mailing of an Incident Questionnaire for possible accident investigation or a Workers Compensation injury (claims in subrogation). AAY Wellmark BCBS Iowa/South Dakota Contact us - BridgeSpan Health If you feel some of our contents are misused please mail us at medicalbilling4u at gmail dot com. 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. The charges for this service have been combined into the primary procedure based on the provider's contract. The main identifier for out-of-area members is the alpha prefix. 0000009222 00000 n CYN Highmark BCBS If you are outside the U.S. and need to find a local provider, make an appointment or be hospitalized, call Blue Cross Blue Shield Global Core at 1-800-810-2583 or call collect at 1-804-673-1177, 24 hours a day, 7 days a week. Once the IQ is returned, all claims are reviewed and processed based on the information supplied. If you get the plan specific alpha prefix, then the first two characters in this prefix are used to identify your plan. Our provider complaints and appeals process ensure we address a complaint or an appeal in a fair and timely manner. Asthma. CUU BCBS of Texas 0000055309 00000 n Where do I determine if a code is covered? The 2015 member identification prefixes for individual Medicare Advantage plans are listed below. For more specific contact information, choose from the following: Individuals and families Medicare Employers Producers Providers Fraud or abuse You can remain anonymous. Federal Employee Program Overseas Claims P.O. Your health care provider will require that you full and distribute these declare paperwork to UnitedHealthcare. This is a duplicate of a previously denied claim. Unclean claims will begin to Regence BlueShield of Idaho P. O. 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. 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. Uprise Health General Access . the lookout for future communications with more information about this exciting enhancement for submitting claim appeals through . Regence BlueShield serves select counties in the state of Washington and is an Independent Licensee of the Blue Cross and Blue Shield Association. Postal Prescription Services Online: Your PPS account Phone: 1 (800) 552-6694 TRS: 711 Fax (for providers only): 1 (800) 723-9023 All our content are education purpose only. Idaho Regence BlueShield of Idaho PO Box 31603 Salt Lake City, UT 84131 Illinois BlueCross BlueShield of Illinois PO Box 1364 Chicago, IL 60690 YDZ SG OFF Exchange Use search function and put your comment any alpha prefix not found here. 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. 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. BCBS Provider Phone Number. 1 (877) 878-2273 CZP Anthem BCBS of Ohio YDM SG Off Exchange Franais | ** A correct member ID number includes the alpha prefix (first three positions) and all subsequent characters, up to 17 positions total. 0000004073 00000 n Coordination of Benefits (COB) is a provision included in both member and physician and provider contracts. Claims. From there, you will be directed to a new site; at this site, enter in your login information. Box 805107 Chicago, IL 60680-4112 Iowa . BCBS Prefix List PAA to PZZ - Alpha Lookup by State 2022 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.*. CYP BCBS of IL AIE BCBS of Michigan 0000011774 00000 n To submit a Level I, Level II or Mediation Appeal (see above to submit a Complaint), send complete documentation to: Physician and Provider Appeals 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. They can take note of bcbs alpha prefix online in detail and gain knowledge of how to choose the right alpha prefix. AAP BCBS of Tennessee Deutsch | Professional Services are performed by a doctor or other healthcare professional. 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. When a Medicare patient received services that Medicare specifically requires to be submitted on separate claim forms, this one claim requirement will not apply. Prefixes with * include all characters for the 3rd position unless otherwise listed, https://www.premera.com/documents/020469.pdf. There is a balance due to us at the end of the payment cycle. QMG SG OFF Exchange. Interested in joining our provider network? Payments are issued under a separate voucher and mailed to the address on the original claim. 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. CYS BCBS of IL CVK BCBS of Florida Claims Submission Map | FEP | Premera Blue Cross Refund total overpayment amounts within 60 days of initial notice to avoid having outstanding refund amounts offset against future payments. For Example: XYZ123456789. 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. Your office staff can then post this remittance manually or electronically (if your software has electronic posting capability). To help you move from paper to electronic claims, follow these steps: Electronic claims can be sent when we are the secondary insurance payer. If you are deaf, hard of hearing, or have a speech disability, dial 711 for TTY relay services.

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