Correct BCBS home plan can easily be identified using our BCBS prefix lookup directory. The following summary and related prior authorization lists were posted on the Support Materials (Commercial) page the Utilization Management section of our Provider website as of Jan. 1, 2021: Commercial Communications 8772287268 Mail Administrator P.O. 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. T. he Summary of Benefits and Coverage (SBC) document will help you choose a health. View Medicare information Radiology utilization for Arkansas Blue Cross FEP You may also want to know: United Healthcare Claims Address Information. 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. For Example: XYZ123456789. Lo-+J52(h' nKvo2>)*Y=}4i,+s[yL*2#kN@r115};|`R[5/iZ endstream endobj startxref But dont worry because our BCBS prefix finder include alpha numeric prefix information as well. 404 0 obj <>stream 2021 Commercial Outpatient Behavioral Health Prior Authorization Code List This list is a new addition on our website for 2021. hbbd```b``A$ All prefixes are unique. To identify correct department, they use 3 characters Prefix in the BCBS members plan ID. The policy number is a unique identifier which may cover multiple members under the same policy, such as a family or a group. If youre 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. Independence Blue Cross* Quick Reference Guide . Member identification numbers beginning with R belong to Federal Employee Program (FEP) and will not have a three-character prefix when filing. 0 1 of 7. It clarifies a utilization management vendor change for specific members. For 2021, there were no changes to overall care categories, but some of the codes within certain categories may have been updated. eviCore healthcare (eviCore) is an independent specialty medical benefits management company that provides utilization management services for BCBSIL. NBT . BCBS Alpha Prefix Its a three letter alpha prefix followed by id number. claims_and_billing/edi/ibc_ professional_payer_id.pdf 54704 -SX083 837I -12X26 Claims Address Claims Receipt Center Box 211184 Eagan, MN 55121 Adjustment Claims Inquiries P.O. 2021 Commercial Prior Authorization Requirements Summary (Updated December 2020) This document provides an overview of services/care categories for which prior authorization may be required for some commercial, non-HMO Blue Cross and Blue Shield of Illinois (BCBSIL) members. Please look for instructions or a phone number on the back of the member ID card. 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. Always make sure to submit claims to insurance company on time to avoid timely filing denial. q8-_?UT"X e+1?#7DMKHY]?R,-e;PE\mL CareFirst IDs have plan codes 080/580 and 190/690. bcbs prefix list PDF,Doc ,Images [PDF] Common Prefix Portal List PBC Premera Blue Cross Three Character Prefixes. If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly. For Federal Employee Program (FEP) precertification requirements, please see the separate FEP precertification list. If you have any questions, call the number on the members ID card. Our Health Choice plans are available to Arizonans who qualify for Medicaid. 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. Narrow Network: Provider participation is by invitation. These BCBS prefix may include alpha and numerical characters. Also, these BCBS prefixes helps providers and medical billers to reach the correct claims department for claims and benefits inquiry. We make it easy for you to offer the healthcare coverage that delivers for your business. K8Z : Page 2 . Final Remarks about BCBS Prefix Lookup Directory. A2Z, G2A, J4K etc. 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. BCBS alpha prefix only contains alphabets and each alpha prefix represents different BCBS home plan. Final Instructions about BCBS Prefix Lookup, United Healthcare Claims Address Information. For accurate and quick claims processing, it is necessary to get complete patient insurance information. 01/01/2021 . American Health Group (AHG) Call 1-800-847-7605 . Have a look at our BCBS alpha prefix and BCBS alpha numeric prefix directory below. eah xp`}L s1zIq%A9Zc~(Iz~HQu;AT#2$ Wp`Hlpp6NQIV0hg`,g H20[20* ": 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) . "Y24Oz>V ?I L r%dl=vHd z/;/X #k> Gq Availity provides administrative services to BCBSIL. And to manage such a big network, they divided it into different departments state wise or employer specific. PAJ. Blue Cross and Blue Shield of Illinois, P.O. hb``` eaXm.; `Umap@LDPpN jM*,BDu|m_(2*u x y-a`b` #; For Example: ABC, AQT, TXX, TEA, A2B, 2AB, 2A2, PAS, ZGP, XXU etc. Most Blue Cross Blue Shield (BCBS) member IDs begin with a three-character prefix. Checking eligibility and/or benefit information and/or the fact that a service has been prior authorized is not a guarantee of payment. Amerihealth Caritas Directory Healthcare, Health Insurance in United States of America, Place of Service Codes List Medical Billing. For example: ABC12345678 Here " ABC" is BCBS alpha prefix. BlueCard. 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. This article offers an overview of 2021 prior authorization support materials and related communications that may apply for some of our non-HMO commercial and government programs members, effective Jan. 1, 2021. Blue Shield (BS) of California. Always use the BCBS prefix on the members current ID card followed by the member id number. Xceed Billing Solutions motive is to create ease for providers, medical billers, patients and everyone who is involved in revenue cycle process. 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 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. Prefix ZGP identifies Blue Cross Blue Shield of Texas PPO Product. Independence Blue Cross (BC) of Philadelphia (Phi) and the Southeastern Pennsylvania (PA) PAI. We always make sure to keep BCBS prefix list and BCBS provider phone numbers directory up to date. PREFIXES . Correct BCBS home plan can easily be identified using our BCBS prefix lookup directory. Additionally, the following services require Prior Authorization regardless of place of service or level of care: To submit a prior authorization request you may also fax or mail your request. The three-character prefixes listed do not represent an exhaustive listing of prefixes. therapy) for medical policies and prior authorization requests . It shows that these type of BCBS member IDs are different. Customer Service: 1-800-409-9462 HCSC-PORT. BCBS is one of the biggest insurance companies in USA and serving more than 106 million people. External link You are leaving this website/app (site). Account Specific Prefix are assigned by BCBS to national accounts. So the next time you need to identify accurate BCBS prefix home plan, remember to use the BCBS prefix list lookup finder. 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. 1268 0 obj <>stream 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. No, the BCBS policy number is not typically the same as the BCBS member ID number. BCBS alpha numeric prefix contains alphabets as well as digits ranging from 1 to 9. 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 Not assigned prefix. BCBS Alpha Numeric Prefix Its a three letter Alpha numeric prefix followed by id number. Learn more about timely filing limits and CO 29 Denial Code. endstream endobj startxref Each BCBS alpha numeric prefix represents different BCBS home plan. It is used to identify and track the healthcare coverage and benefits for that specific member. By knowing the details of BCBS home plan, including BCBS insurance plan benefits, coverage options, and costs, you can make better decisions about your healthcare needs. This indicates that the claims are excluded from the BlueCard Program. Prefix Group Address Group Name TPA Name & Address Claims Filing Claims & Benefit Contact Name Phone . 'MNiXG]dRBC; 0'Va~9&c}Ag$Pge;\UY,$MtN BCBS Alpha Numeric prefix are three characters at the start of each BCBS insurance member 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. In case, you need any additional information related to BCBS prefix then feel free to reach out to us. by calling 1-844-377-1278 (BCN) or 1-800-728-8008 (Blue Cross) or by logging oncology and in to the AIM ProviderPortal. Benefits Administration Corporation, Inc. (BACI) 9411 Philadelphia RD. This can be especially helpful if youre in a rush or need to access your BCBS prefix home plan information quickly. Most PDF readers are a free download. 2021 Commercial Specialty Pharmacy Prior Authorization Drug List This list was updated with 14 new codes effective Jan. 1, 2021. a'm These BCBS prefix may include alpha and numerical characters. ", 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). Coverage Period: 01/01/2021 - 12/31/2021 . To view this file, you may need to install a PDF reader program. %%EOF Wheelchairs - Mobility Assistive Equipment (Manual & Power) & Scooters - Wheelchair Purchase only -Motorized) Wheelchair: E1050, E1060, E1070, E1083, E1084, E1085 . Coverage For: Individual + Family. The site may also contain non-Medicare related information. BCBSIL makes no endorsement, representations or warranties regarding any products or services provided by third party vendors such as eviCore, AIM or Availity. TT$%b"Dg!h^`]-ce?i8xRiu1IrD-%oR#yt;JBOJ#"TXwD0L Fw,]xS_CU3zf]06_T} PNGCqWV^UET6X~`U

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