PDF HMO Networks - Blue Cross and Blue Shield of Illinois PDF Blue Cross and Blue Shield of Minnesota and Blue Plus Commercial Prior Baltimore, MD 21237 . In the District of Columbia and . BCBS Alpha Prefix list is useful for both providers and BCBS enrolled members/patients. Final Remarks about BCBS Prefix Lookup Directory. CareFirst IDs have plan codes 080/580 and 190/690. A2Z, G2A, J4K etc. 1 of 7. 777 0 obj <>stream One option is Adobe Reader which has a built-in reader. 'MNiXG]dRBC; 0'Va~9&c}Ag$Pge;\UY,$MtN BCBS Prefix List - Alpha Lookup by State 2022 - Finder 15388 0 obj <>/Encrypt 15364 0 R/Filter/FlateDecode/ID[]/Index[15363 94]/Info 15362 0 R/Length 122/Prev 932133/Root 15365 0 R/Size 15457/Type/XRef/W[1 3 1]>>stream BCBS alpha numeric prefix contains alphabets as well as digits ranging from 1 to 9. BCBS FEP Prefix BCBS Federal Employee Program is identified by the letter R followed by the number. To run such a large number of people, they divided Blue Cross Blue Shield Insurance Association into different departments which is employer specific or state wise. The notice also refers to a medical policy for more information to help clarify when and how prior authorization requirements may apply. 2021 Commercial Specialty Pharmacy Prior Authorization Drug List This list was updated with 14 new codes effective Jan. 1, 2021. TT$%b"Dg!h^`]-ce?i8xRiu1IrD-%oR#yt;JBOJ#"TXwD0L Fw,]xS_CU3zf]06_T} PNGCqWV^UET6X~`U Denials with solutions in Medical Billing, Denials Management Causes of denials and solution in medical billing, CO 4 Denial Code The procedure code is inconsistent with the modifier used or a required modifier is missing, CO 5 Denial Code The Procedure code/Bill Type is inconsistent with the Place of Service, CO 6 Denial Code The Procedure/revenue code is inconsistent with the patients age, CO 7 Denial Code The Procedure/revenue code is inconsistent with the patients gender, CO 15 Denial Code The authorization number is missing, invalid, or does not apply to the billed services or provider, CO 17 Denial Code Requested information was not provided or was insufficient/incomplete, CO 19 Denial Code This is a work-related injury/illness and thus the liability of the Workers Compensation Carrier, CO 23 Denial Code The impact of prior payer(s) adjudication including payments and/or adjustments, CO 31 Denial Code- Patient cannot be identified as our insured, CO 119 Denial Code Benefit maximum for this time period or occurrence has been reached or exhausted, Molina Healthcare Phone Number claims address of Medicare and Medicaid, Healthfirst Customer Service-Health First Provider Phone Number-Address and Timely Filing Limit, Kaiser Permanente Phone Number Claims address and Timely Filing Limit, Amerihealth Caritas Phone Number, Payer ID and Claim address, ICD 10 Code for Sepsis Severe Sepsis and Septic shock with examples, Anthem Blue Cross Blue Shield Timely filing limit BCBS TFL List, Workers Compensation Insurances List of United States, Workers Compensation time limit for filing Claim and reporting in United States. For Example: XYZ123456789. %%EOF View Medicare information Radiology utilization for Arkansas Blue Cross FEP hbbd```b``A$ You may also be interested to read about denial code 27 reason and solutions. Its critical to check member eligibility and benefits through the Availity Provider Portal or your preferred vendor portal prior to every scheduled appointment. A follow-up article with additional information on transition of member care was posted Dec. 4, 2020. ", Blue Cross and Blue Shield of Texas, aDivision of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association, PDF File is in portable document format (PDF). Policy number is a unique number, which is provided to their insured person by respective insurances in order for identification purposes and also for billing the healthcare claims. You may also want to know: United Healthcare Claims Address Information. %%EOF Use this guide to see prior approval information for members with ID card prefixes: AEE, AXC, EXX, XCB, XCQ, XCR View guides [pdf] Medicare plans Learn more about providing care for Medicare members. Last updated: 07/01/2022. Second Character G assigned to the BCBS Plan as well. hbbd```b``@$Df/i #D2lE``vd@ "@,iZ R R2H{v# k 365 0 obj <> endobj therapy) for medical policies and prior authorization requests . Although we regularly update the BCBS Prefix information but in case youre unable to get information about correct BCBS plan from our BCBS Prefix lookup, feel free to contact us OR call BCBS directory phone number at 800-676-2583. Curious to know what are national Accounts? Amerihealth Caritas Directory Healthcare, Health Insurance in United States of America, Place of Service Codes List Medical Billing, Empire Blue-Cross Blue-Shield of New York, Anthem Blue-Cross Blue-Shield of Kentucky, Maryland/District of Columbia/Northern Virginia, Highmark Blue-Cross Blue-Shield of Pennsylvania, Anthem Blue-Cross Blue-Shield of Connecticut, Anthem Blue-Cross Blue-Shield of Colorado, Anthem Blue-Cross Blue-Shield of New Hampshire, Anthem Blue-Cross Blue-Shield of Missouri, Blue-Cross Blue-Shield of Western New York, Independence Blue-Cross of Philadelphia and Southeastern Pennsylvania, Anthem Blue-Cross Blue-Shield of Virginia, Excellus Blue-Cross Blue-Shield of New York, Anthem Blue-Cross Blue-Shield of Wisconsin, Highmark Blue-Cross Blue-Shield of West Virginia, Horizon Blue-Cross Blue-Shield of New Jersey, Highmark Blue-Cross Blue-Shield of Delaware. To view this file, you may need to install a PDF reader program. AZBlue - Blue Cross Blue Shield of Arizona - Health Insurance Plans A healthier Arizona is what we're all about. To identify correct department, they use 3 characters Prefix in the BCBS members plan ID. By using this directory, you can ensure that you have the most up-to-date information about BCBS home plans and make more informed decisions about choosing right insurance plan. PDF CSS-E121 Blue Cross Select Silver 01012021 - bcbsal.org So the next time you need to identify accurate BCBS prefix home plan, remember to use the BCBS prefix list lookup finder. Always make sure to submit claims to insurance company on time to avoid timely filing denial. Follow the step-by-step instructions below to design your premiere blue cross amp the regency group three character prefixes: Select the document you want to sign and click Upload. We have a track record of providing quality medical billing services to multiple healthcare organizations and specialty providers across USA. Box 7930 Philadelphia, PA 19101-7930 PAGE : Amkor Technology, Inc. Group # 039176 : AmeriBen . q8-_?UT"X e+1?#7DMKHY]?R,-e;PE\mL Prior Authorization List for Blue Shield Effective April 1, 2023 Unraveling the Truth, United Healthcare Claims Address, Payer ID, Fax and Phone Number, BCBS Prefix List 2023 Alpha Prefix and Alpha Number Prefix Lookup, BCBS Alpha Numeric Prefix from L2A to L9Z (Updated 2023), BCBS Provider Phone Number for Claims and Eligibility Verification, Benefits and Eligibility Verification Services. The prior authorization information in this notice does not apply to requests for HMO members. T. he Summary of Benefits and Coverage (SBC) document will help you choose a health. Member identification numbers beginning with R belong to Federal Employee Program (FEP) and will not have a three-character prefix when filing. endstream endobj startxref ). It clarifies a utilization management vendor change for specific members. The main difference between BCBS alpha prefix and BCBS alpha numeric prefix is that BCBS alpha prefix only contains alphabets whereas BCBS alpha numeric prefix consists of alphabets as well as numbers ranging from 1 to 9. O}BAXv:OP)Qt9>PN,RG4uZu~?raYW+Q`|w[OD klW1Kg|'6'8=rRW00+,oD~`Ox(4DLMm,$Uy69r!$w0.<5>gJd'0?wf\2t| :\xQ cwh)}Ycb8I5vg~TQNnx^Y$M'JL+0?\:3Y(+Sb1:_%^uur(h>mS Prefix ZGP identifies Blue Cross Blue Shield of Texas PPO Product. The prefix may also route claim status inquiries and remit searches. Identifying BlueCard members - Regence External link You are leaving this website/app (site). We offer a wide choice of individual plans to fit your health needs and budget. The first two characters of such BCBS prefix spots member plan and the third character is to identify the type of product in which the BCBS member is enrolled. Enter a location and search by doctor or hospital name, health condition, or specialty. PDF Member account and prefix updates: Provider FAQs Prior-Authorization And Pre-Authorization | Anthem.com BCBS Prefix List AAA to AZZ - Alpha Lookup by State 2022 1229 0 obj <> endobj %PDF-1.6 % Now, with more than 15 years of experience as a medical biller and revenue cycle manager, I am on a mission to serve the medical billing industry with my vast knowledge and years of expertise. This can be especially helpful if youre in a rush or need to access your BCBS prefix home plan information quickly. BlueCard. Let's start with you. %{!]/Ox^ A[BXe S#(Df Individuals & Families We offer a wide choice of individual plans to fit your health needs and budget. PDF Independence Blue Cross Quick Reference Guide - Magellan Provider These BCBS prefix may include alpha and numerical characters. Commercial Communications The SBC shows you how you and the plan would share t. he cost for covered health care services. BlueCard Program Alpha Prefixes | Blue Cross and Blue Shield - BCBSTX by calling 1-844-377-1278 (BCN) or 1-800-728-8008 (Blue Cross) or by logging oncology and in to the AIM ProviderPortal. Not assigned prefix. 404 0 obj <>stream It allows you to quickly and easily identify your insurance home plan, saving you time and hassle. BCBS Prefix List 2021 - Alpha State Lookup BCBS Company; AAA: Alabama: Blue-Cross Blue-Shield of Alabama: AAB: Michigan: Blue-Cross Blue-Shield of Michigan: AAC: Illinois: Blue-Cross Blue-Shield of Illinois: AAD: South Carolina: Blue-Cross Blue-Shield of South Carolina: AAE: Nevada: Right after completing my degree in 2011, I started my job career as an Accounts Receivable in a medical billing company. BCBS alpha numeric prefix digits are usually in between the prefix e.g. Box 14115 Lexington, KY 40512 Mail Administrator P.O. What is the difference between BCBS alpha prefix and BCBS alpha numeric prefix? BCBS Prefix List 2021 - Alpha Numeric State Lookup BCBS Company; Z2A-Prefix Unallocated/Not Assigned: Z2B: Indiana: Anthem Blue-Cross Blue-Shield of Indiana: Z2C-Prefix Unallocated/Not Assigned: Z2D-Prefix Unallocated/Not Assigned: Z2E-Prefix Unallocated/Not Assigned: Z2F: Minnesota: ;MTK BCBS member ID have maximum 17 characters but most of the member IDs have 12 characters. endstream endobj startxref Wheelchairs - Mobility Assistive Equipment (Manual & Power) & Scooters - Wheelchair Purchase only -Motorized) Wheelchair: E1050, E1060, E1070, E1083, E1084, E1085 . To identify correct blue cross blue shield department, they use three characters BCBS prefix in the start of each BCBS member plan ID. b(f{YH^tn}u62\}TgT>ENWJB=J #=a$oXIq(n,tU+D'j}L(t#,w?!^oZUQR, 7a. %PDF-1.6 % "Y24Oz>V ?I L r%dl=vHd z/;/X #k> Gq BCBS Railroad member IDs are assigned to members who served in railroad organizations. Regence Prefix List Form - Fill Out and Sign Printable PDF Template Address: 11070 Katy Fwy, Houston, TX 77043, 2023 Xceed Billing Solution.com - All Rights Reserved, Blue Cross Blue Shield BCBS Prefix List Lookup. e@'SZD/KCbv*pKq~ Why does BCBSAZ update member accounts and . For Example: ABC, A2B, 2AB, 2A2 etc. %PDF-1.6 % Prior Authorization List for Blue Shield Effective April 1, 2023 (This list is updated monthly) blueshieldca.com 601 12th Street | Oakland, CA 94607 Blue Shield of California is an independent member of the Blue Shield Association April 1, 2023 Page 1 of 8 Policy Name/Program Procedure Code (To search, press Ctrl + F) . PAH. The purpose of this list is to assist WA and AK providers to determine plan [PDF] CareFirst Third Party Administrator (TPA)/Network Lease Accounts Prefix. These prefixes may include alpha and numerical characters. AIM Specialty Health (AIM) is an independent company that has contracted with BCBSIL to provide utilization management services for members with coverage through BCBSIL. For 2021, there were no changes to overall care categories, but some of the codes within certain categories may have been updated. Working or retired, we'll help you every step of the way to find the right plan. Blue Cross and Blue Shield of Illinois, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue . Commercial Prior Authorization Summary and Code Lists For more information, contact your Network Provider Consultant or call 406-437-6100. Secondly, it ensures that you have the most up-to-date information about each and every BCBS prefix home plan because we update the BCBS prefix list on daily basis. Do not create one or use the BCBS prefix from another member ID card. It means that BCBS members IDs prefix will must have alphabets and they may or may not have numbers. 800-676-2583. The following summaries and related prior authorization lists were posted on the Support Materials (Government Programs) page as of Jan. 1, 2021: Important Reminder: Check Eligibility and Benefits First BCBS Alpha Numeric prefix are three characters at the start of each BCBS insurance member ID. Three-Character Prefixes. BCBS Prefix List Lookup 2023 - Latest Blue Cross Blue Shield Directory In addition, some sites may require you to agree to their terms of use and privacy policy. bcbs prefix list PDF,Doc ,Images - pdfprof.com But dont worry because our BCBS prefix finder include alpha numeric prefix information as well. Complete patient information, on the other hand, allows your claims to process without delays. plan. This indicates that the claims are excluded from the BlueCard Program. Stand-alone dental products, vision and pharmacy when delivered through an intermediary model. Correct BCBS home plan can easily be identified using our BCBS prefix lookup directory. Search for doctors near you and in your network. The three-character prefix at the beginning of the member's identification number is the key element used to identify and correctly route out-of-state claims to the appropriate BCBS Plan. Blue Cross Select Silver. BCBS Prefix should be included along with ID number, exactly as it appears on the member ID card when filing the claims to insurance company. Have a look at our BCBS alpha prefix and BCBS alpha numeric prefix directory below. K8Y . In that case claim may be denied as Submit the claim to the correct address / Member ID not found. If you have any questions, call the number on the members ID card. Hi, Im Kim Keck! What is Medical Billing and Medical Billing process steps in USA? This new site may be offered by a vendor or an independent third party. It shows that these type of BCBS member IDs are different. PDF Updated November 2021 - BCBSIL Narrow Network: Provider participation is by invitation. Few times, BCBS plan members doesnt have prefix mentioned on their BCBS Insurance card. 0|kEMi_a*-Yfj#uqEcA/6 .M.6YNw4cyo>lESMC\)H~L 1B> Check any internal documents you may have and update any references of "alpha prefix" to "prefix". The above material is for informational purposes only and is not a substitute for the independent medical judgment of a physician or other health care provider. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Xceed Billing Solutions is amedical billing company for outsourcing medical billing services. for medical policies and prior authorization requests. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. To identify the plan that holds the members benefits, please call the Out-of-State Blues Plan Subscriber #: 1-800-676-BLUE (2583). BCBS prefix are easy to identify using our BCBS prefix lookup because theyre part of every BCBS member ID and we included all of them here in the BCBS prefix list. TPA Name & Address. endstream endobj 1230 0 obj <. Each BCBS alpha numeric prefix represents different BCBS home plan. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider. AZBlue - Blue Cross Blue Shield of Arizona - Health Insurance Plans 1254 0 obj <>/Filter/FlateDecode/ID[]/Index[1229 40]/Info 1228 0 R/Length 122/Prev 219460/Root 1230 0 R/Size 1269/Type/XRef/W[1 3 1]>>stream Does BCBS policy number same as BCBS member ID number? 0 For example: ABC12345678 Here " ABC" is BCBS alpha prefix. One option is Adobe Reader which has a built-in reader. BCBS prefix List plays a vital role in filing the health care claims properly to the correct BCBS address and also to verify members eligibility, health insurance coverage information and to reach the correct BCBS department to check the claim status or disputes of the claim. BCBS FEP Its indicated with letter R followed by the id number. Learn more about timely filing limits and CO 29 Denial Code. See the Medical oncology prior authorization list for Blue Cross and BCN commercial members for a supportive care drugs (other than CAR -T comprehensivelist of managed by AIM, and groupsincluded in the program. Group Name. endstream endobj 366 0 obj <>>>/Filter/Standard/Length 128/O(`iYJhD[>R`Xq)/P -1324/R 4/StmF/StdCF/StrF/StdCF/U(ETWBQcf )/V 4>> endobj 367 0 obj <>/Metadata 16 0 R/PageLayout/OneColumn/Pages 363 0 R/StructTreeRoot 28 0 R/Type/Catalog>> endobj 368 0 obj <>/Font<>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 369 0 obj <>stream eviCore healthcare (eviCore) is an independent specialty medical benefits management company that provides utilization management services for BCBSIL. On the other hand, the BCBS member ID number is a unique identifier assigned to each individual member covered under a BCBS health insurance policy. For providers and medical billers who are performing medical billing services, BCBS alpha prefix are helpful to identify the correct payer ID and address for claims submission. To accommodate our increasing lines of business, Blue Cross and Blue Shield of Montana (BCBSMT) has adopted several new three character prefixes as part of the member identification numbers. BCBS Prefix will not only have numbers and the digits 0 and 1. The three-character prefixes listed do not represent an exhaustive listing of prefixes. What If BCBS Member ID doesnt have Prefix mentioned on Card? Save my name, email, and website in this browser for the next time I comment. NBT . a'm You may see cards with four-character prefixes, e.g., HMSA Blue Cross Blue Shield of Hawaii uses four-character prefixes. `xn_F-y(MQ&O!y1?-uZ=t'=E$r2$IA)gYWp&g` This step will help you determine if prior authorization may be required for a specific member and service. (Note: For changes to come later this year, refer to this notice, posted Dec. 28, 2020: Commercial Prior Authorization Code Changes, Effective April 1, 2021. Account-specific prefixes are assigned to centrally processed national accounts, which are employer groups that have offices or branches in more than one area, but offer uniform . All prefixes are unique. Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. BCBS Alpha prefix lookup contains all the Blue Cross Blue Shield alpha prefix along with their home plan and website. So, to accomplish our goal, we have listed down the complete BCBS alpha prefix list so that you can easily identify correct BCBS plan. Prior Authorization Services For Fully Insured and ASO, Prior Authorizations Lists for Blue Cross Medicare Advantage (PPO) and Blue Cross Medicare Advantage (HMO), Prior Authorizations Lists for Designated Groups, Prior Authorization Exemptions (Texas House Bill 3459), Medicare Advantage Private Fee-for-Service (PFFS), Eligibility and Benefits Inquiry (HIPAA 270/271), Behavioral Health Care Management Program, Quality Care Partner With Your Patients, Preventive Care Guidelines/Patient Wellness Guidelines, Health Equity and Social Determinants of Health (SDoH), Prescription Drug List and Prescribing Guidelines, Prior Authorization and Step Therapy Programs, Medical Policy and Pre-certification/Pre-authorization Information for Out-of-Area Members, Consolidated Appropriations Act and Transparency in Coverage Final Rule, Blue Cross Blue Shield of Texas provider website. These plans provide health insurance coverage for railroad employees, retirees, and their eligible dependents. 0 We recently received a query from a provider that how I can identify that patient is BCBS health insurance member. First, it saves you time and hassle by allowing you to quickly identify correct BCBS insurance home plan without having to call customer service. 2021, for some of our commercial non-HMO members, such as those listed below: - PPO - Blue Choice Preferred PPO(SM) - Blue Choice PPO(SM) - Blue Options(SM)/Blue Choice Options(SM) - Blue High Performance Network(SM) [Blue HPN(SM)] This is not an exhaustive listing of all codes. External link You are leaving this website/app (site). Note: Current three-character, alpha-only prefixes will not be affected by this change. PDF Traditional Coverage - BCBSIL Medical providers - Arkansas Blue Cross and Blue Shield Always use the BCBS prefix on the members current ID card followed by the member id number. We offers a wide range of RCM solutions to improve your healthcare services financial health and allows you to focus on patients care rather than collecting payments from insurances and patients for services performed. %%EOF To view this file, you may need to install a PDF reader program. BCBS is one of the largest medical insurance company by total members of more than 45 million. Here Letter R indicates BCBS FEP prefix. The BCBS prefix lookup directory is regularly updated with the latest BCBS insurance plan information, so you can be sure that the information youre viewing is 100% accurate. If you have any questions or need help submitting a prior authorization, please call 816-395-3989 for assistance. BCBS prefix is a three character prefixes followed by the id number except for the following products and programs. For Example: ABC, AQT, TXX, TEA, A2B, 2AB, 2A2, PAS, ZGP, XXU etc. BCBS Prefix List Z2A to Z9Z - Alpha Numeric Lookup 2022 Independence Blue Cross (BC) of Philadelphia (Phi) and the Southeastern Pennsylvania (PA) PAI. Health Equity and Social Determinants of Health (SDoH), Over the Counter Equivalent Exclusion Program, Prior Authorization and Step Therapy Programs, Consolidated Appropriations Act & Transparency in Coverage, Medical Policy/Pre-certification: Out-of-area Members, 2021 Commercial Prior Authorization Requirements Summary, 2021 Commercial Outpatient Medical Surgical Prior Authorization Code List, 2021 Commercial Specialty Pharmacy Prior Authorization Drug List, 2021 Commercial Outpatient Behavioral Health Prior Authorization Code List, New Prior Authorization Requirements for Some Custom Account Members Will Take Effect Jan. 1, 2021, 2021 Medicaid Prior Authorization Requirements Summary, 2021 Medicaid Prior Authorization Code List, 2021 MA PPO Prior Authorization Requirements Summary, 2021 MA PPO Prior Authorization Code List, BCBSIL Provider Network Consultant (PNC) team, Update: Utilization Management Change for Advocate Aurora Health Members, Effective Jan. 1, 2021 This News and Updates was posted Dec.15, 2020, and updated Dec. 31, 2020 to reflect a corrected phone number.
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