One option is Adobe Reader which has a built-in reader. You may also be interested to read about denial code 27 reason and solutions. In addition, some sites may require you to agree to their terms of use and privacy policy. If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly. PAJ. 0 We have a track record of providing quality medical billing services to multiple healthcare organizations and specialty providers across USA. For more information, contact your Network Provider Consultant or call 406-437-6100. And to manage such a big network, they divided it into different departments state wise or employer specific. Title: You may see cards with four-character prefixes, e.g., HMSA Blue Cross Blue Shield of Hawaii uses four-character prefixes. Summaries and code lists are posted as a reference to help you determine when prior authorization may be required for non-HMO government programs members. BCBS is one of the biggest insurance companies in USA and serving more than 106 million people. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Xceed Billing Solutions is amedical billing company for outsourcing medical billing services. Prefix Group Address Group Name TPA Name & Address Claims Filing Claims & Benefit Contact Name Phone . PAH. Medicaid Box 14115 Lexington, KY 40512 Mail Administrator P.O. %PDF-1.6 % BCBS Railroad member IDs are assigned to members who served in railroad organizations. Due to the exceeding number of BCBS insurance members, Alpha-Only Prefix member IDs exhausted. CareFirst IDs have plan codes 080/580 and 190/690. 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 . nKvo2>)*Y=}4i,+s[yL*2#kN@r115};|`R[5/iZ bcbs prefix list PDF,Doc ,Images [PDF] Common Prefix Portal List PBC Premera Blue Cross Three Character Prefixes. Benefits will be determined once a claim is received and will be based upon, among other things, the members eligibility and the terms of the members certificate of coverage applicable on the date services were rendered. The notice also refers to a medical policy for more information to help clarify when and how prior authorization requirements may apply. Added to list, with AIM effective 04/01/2021 22802 Joint, Spine Surgery Post Fusion 7-12 Vert Seg SUR712.036 AIM Guidelines Lumbar Spinal Fusion Retire from BCBS PA effective 1/1/22; continue to request PA through AIM if applicable; Added to list, with AIM effective 04/01/2021 22804 Joint, Spine Surgery Post Fusion 13/> Vert Seg SUR712.036 AIM . %%EOF Prefix ZGP identifies Blue Cross Blue Shield of Texas PPO Product. 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. Have a look at our BCBS alpha prefix and BCBS alpha numeric prefix directory below. Suppose assume claims filed with an incorrect member ID number or BCBS prefix by Provider or Billing companies, then BCBS insurance will deny the claim stating Incorrect member ID, please submit with an correct member ID number. 761 0 obj <>/Filter/FlateDecode/ID[]/Index[741 37]/Info 740 0 R/Length 98/Prev 110535/Root 742 0 R/Size 778/Type/XRef/W[1 2 1]>>stream K8Y . Search for doctors near you and in your network. 2021 Prior Authorization Requirement Summaries, Code Lists and Related `xn_F-y(MQ&O!y1?-uZ=t'=E$r2$IA)gYWp&g` 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. endstream endobj 1230 0 obj <. Lo-+J52(h' Amerihealth Caritas Directory Healthcare, Health Insurance in United States of America, Place of Service Codes List Medical Billing. In the District of Columbia and . 777 0 obj <>stream PREFIXES . Blue KC Commercial Prior Authorization and Notification List If you have any questions, call the number on the members ID card. Suite S . 1 of 7. This new site may be offered by a vendor or an independent third party. 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. Learn more about timely filing limits and CO 29 Denial Code. 0 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. Regence Prefix List Form - Fill Out and Sign Printable PDF Template External link You are leaving this website/app (site). The member ID number may be different for each member covered under the same policy, and it is typically used when seeking medical services, submitting claims, or accessing healthcare benefits. endstream endobj 742 0 obj <. 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. It clarifies a utilization management vendor change for specific members. Check any internal documents you may have and update any references of "alpha prefix" to "prefix". This new site may be offered by a vendor or an independent third party. 'MNiXG]dRBC; 0'Va~9&c}Ag$Pge;\UY,$MtN Independence Blue Cross (BC) of Philadelphia (Phi) and the Southeastern Pennsylvania (PA) PAI. BCBS Alpha Prefix Lookup 2023 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. 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. By doing it may cause delay in processing or handling the claim. Prior-Authorization And Pre-Authorization | Anthem.com Here Letter R indicates BCBS FEP prefix. 741 0 obj <> endobj %PDF-1.6 % The site may also contain non-Medicare related information. BCBS Alpha Numeric Prefix Its a three letter Alpha numeric prefix followed by id number. DIGNITY HEALTH YAVAPAI REGIONAL MEDICAL CENTER AND BLUE CROSS BLUE SHIELD OF ARIZONA REACH AGREEMENT, FIESTA BOWL AND BLUE CROSS BLUE SHIELD OF ARIZONA OPEN APPLICATIONS FOR FOURTH ANNUAL EMPOWERING DIVERSITY SCHOLARSHIP, PCMH PROGRAM DELIVERS HEALTHIER PATIENTS AND HAPPIER PROVIDERS. Its important to remember that benefit plans differ in their benefits, and details such as prior authorization requirements are subject to change. What is Medical Billing and Medical Billing process steps in USA? PDF Updated November 2021 - BCBSIL endstream endobj startxref Please look for claim filing instructions on the back of the ID card. PDF 2021 Commercial Prior Authorization Requirements Summary 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 Its critical to check member eligibility and benefits through the Availity Provider Portal or your preferred vendor portal prior to every scheduled appointment. BCBS Alpha prefix lookup contains all the Blue Cross Blue Shield alpha prefix along with their home plan and website. We offer a wide choice of individual plans to fit your health needs and budget. I have completed my Bachelor of Business Administration in Healthcare Management from University of Texas. Do not create one or use the BCBS prefix from another member ID card. BCBS Alpha Prefix List from PAA to PZZ Updated 2023 Customer Service: 1-800-409-9462 HCSC-PORT. Wheelchairs - Mobility Assistive Equipment (Manual & Power) & Scooters - Wheelchair Purchase only -Motorized) Wheelchair: E1050, E1060, E1070, E1083, E1084, E1085 . We update BCBS prefix list data on daily basis to provide latest BCBS prefix home plan information. =&m$ z90P&\:?$IRIj"c5l\"aD(@?Yuk>{8lkelu3X*FpT=6Rv;9'*4O-o|ELLG?-Yec,cqh(e96e4^QyD8H}'o(3 Plan Type: PPO . How To Identify Blue Cross Blue Shield Member? What is a member ID prefix? ;MTK 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 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. AZBlue - Blue Cross Blue Shield of Arizona - Health Insurance Plans There are two types of BCBS prefixes which are mentioned below: Plan Specific prefix are assigned by BCBS to each plan. To identify correct blue cross blue shield department, they use three characters BCBS prefix in the start of each BCBS member plan ID. To identify correct department, they use 3 characters Prefix in the BCBS members plan ID. Each BCBS alpha numeric prefix represents different BCBS home plan. Below in our BCBS prefix lookup directory, you can lookup all the BCBS prefix appropriate home plans and their contact information. Few times, BCBS plan members doesnt have prefix mentioned on their BCBS Insurance card. So, all BCBS plans, including Anthem prefix and Non-Anthem plans announced that member IDs will also be Alpha Numeric from 2018 onwards. This includes our Medicaid Blue Cross Community Health PlansSM (BCCHPSM) and Blue Cross Community MMAI (Medicare-Medicaid Plan)SM and Blue Cross Medicare Advantage (PPO)SM(MA PPO) members. PPO 837P Prefixes are also applicable, . NBT . Complete patient information, on the other hand, allows your claims to process without delays. Why does BCBSAZ update member accounts and . Narrow Network: Provider participation is by invitation. 0|kEMi_a*-Yfj#uqEcA/6 .M.6YNw4cyo>lESMC\)H~L 1B> Enter a location and search by doctor or hospital name, health condition, or specialty. 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. PDF HMO Networks - Blue Cross and Blue Shield of Illinois Box 805107, Chicago, Illinois 60680-4112. All prefixes are unique. 1229 0 obj <> endobj You may also want to know: United Healthcare Claims Address Information. These BCBS prefix may include alpha and numerical characters. PDF BCBSAZ/TPA Co-Administered Group Plans - AZBlue 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. In some case provider or billing company may file the claim to an incorrect address without checking the correct BCBS address. Prior authorization requirements are specific to each patients policy type and the procedure(s) being rendered. 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. This indicates that the claims are excluded from the BlueCard Program. (Note: For changes to come later this year, refer to this notice, posted Dec. 31, 2020: New Prior Authorization Requirements for Advocate Aurora Health Members Will Take Effect April 1, 2021.). %{!]/Ox^ A[BXe S#(Df hbbd```b``"`r9LLN`DR,>6l30&U$60D2HO rH+H f`bdV8J 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. Medical providers - Arkansas Blue Cross and Blue Shield There are three variants; a typed, drawn or uploaded signature. %%EOF Last updated: 07/01/2022. Coverage Period: 01/01/2021 - 12/31/2021 . Most Blue Cross Blue Shield (BCBS) member IDs begin with a three-character prefix. Account Specific Prefix are assigned by BCBS to national accounts. Working or retired, we'll help you every step of the way to find the right plan. TPA Name & Address. So the next time you need to identify accurate BCBS prefix home plan, remember to use the BCBS prefix list lookup finder. To get information about such member IDs, you can contact BCBS prefix directory phone number i.e. BCBS Prefix AAA Home Plan and Phone Number, BCBS Alpha Numeric Prefix from Y2A to Y9Z, BCBS Alpha Numeric Prefix from X2A to X9Z, BCBS Alpha Numeric Prefix from W2A to W9Z, BCBS Alpha Numeric Prefix from V2A to V9Z, Frequently Asked Questions Related to BCBS Prefix. Codes may chan ge, and this list may be updated throughout the year. 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. plan. For Example: ABC, AQT, TXX, TEA, A2B, 2AB, 2A2, PAS, ZGP, XXU etc. The three-character prefix identifies the Blue Cross and Blue Shield Plan to which the member belongs. 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. 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. Member ID cards with no prefix Some member ID cards may not have a prefix. BCBS Prefix List 2023 - Alpha Prefix and Alpha Number Prefix Lookup BCBS Alpha Prefix are first three letters of BCBS Member ID to identify correct Blue Cross Blue Shield department responsible for managing the patient eligibility, benefits and claims etc. BCBS Prefix List Lookup 2023 - Latest Blue Cross Blue Shield Directory BCBS Railroad member IDs starts with a letter R. Our Health Choice plans are available to Arizonans who qualify for Medicaid. PDF Blue Cross and BCN utilization management medical drug list - BCBSM Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider. 2021 Commercial Outpatient Behavioral Health Prior Authorization Code List This list is a new addition on our website for 2021. First, it saves you time and hassle by allowing you to quickly identify correct BCBS insurance home plan without having to call customer service. Northwest Arizona Employee Benefit Trust (NAEBT) Group # 037461 . Infusion Site of Care Prior Authorization Drug List: New Codes Will Be Added, Effective Jan. 1, 2021 This notice was posted Dec. 28, 2020, to advise you of 14 new codes being added to our specialty pharmacy prior authorization drug list. 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. B}hJu`n+Z9>)2B~feo,TV [ZI^ylRr8DGo;ckrA;X2SjUlW]$4_vN(Tvh6#moc0!pbJ;oW)A'oR&bH=`1K}P(u3gD9:#1!m2saW1SD5/p2 'Su &x@`N.e#U(Fne]4;$"o*k;$~gn-Sd"mjdTY2R*I:w8w3;fpCfQH& BCBS Prefix can be classified as follows: BCBS Alpha Prefix - It's a three letter alpha prefix followed by id number. eah xp`}L s1zIq%A9Zc~(Iz~HQu;AT#2$ Wp`Hlpp6NQIV0hg`,g H20[20* ": Prior Authorization for Some Commercial Members Will Transition from eviCore to AIM, Effective Jan. 1, 2021 This notice was posted Oct. 1, 2020, to alert you of a utilization management vendor change. Final Instructions about BCBS Prefix Lookup, United Healthcare Claims Address Information. Baltimore, MD 21237 . Independence Blue Cross* Quick Reference Guide . 1268 0 obj <>stream BCBS Prefix List AAA to AZZ - Alpha Lookup by State 2022 First Character P is symbolizing that member plan/product type is BCBS PPO. Prior Authorization List for Blue Shield Effective April 1, 2023 So, to answer this query, we have mentioned below few important points to consider. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. 15363 0 obj <> endobj Yes, Policy number same as member ID number and also known as subscriber ID number. %PDF-1.5 % Box 7930 Philadelphia, PA 19101-7930 There are several benefits of using our BCBS Prefix Lookup tool. New BCBS Alpha Numeric Prefixes | My Payer Directory We have the right plan for you to keep you and your family covered. Member identification numbers beginning with R belong to Federal Employee Program (FEP) and will not have a three-character prefix when filing. 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. A2Z, G2A, J4K etc. BCBS prefix lookup directory is a valuable resource for anyone who is looking for right Blue Cross Blue Shield home plan. ?} AN 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 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. Second Character G assigned to the BCBS Plan as well. Blue Cross and Blue Shield of Illinois, 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). endstream endobj startxref 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. Also, pre-authorization information and medical policy for out of state plans may be found on the Blue Cross Blue Shield of Texas provider website section under Standards and Requirements, and then select "Medical Policy and Precertification/Preauthorization for Out of Area Members. Note: BCBS FEP (Federal Employee Program) ID starts with the alphabet R follow by the insured ID number (For Example: R987654321). 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: hb``` eaXm.; `Umap@LDPpN jM*,BDu|m_(2*u x y-a`b` #; BCBS Railroad refers to Blue Cross Blue Shield health insurance plans that are specifically designed for members who are affiliated with railroad organizations in the United States. Does BCBS Cover Wegovy for Weight Loss? by calling 1-844-377-1278 (BCN) or 1-800-728-8008 (Blue Cross) or by logging oncology and in to the AIM ProviderPortal. American Health Group (AHG) Call 1-800-847-7605 . 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. What If BCBS Member ID doesnt have Prefix mentioned on Card? BCBS member ID have maximum 17 characters but most of the member IDs have 12 characters. Commercial Communications Decide on what kind of signature to create. An incorrect or missing three-character prefix may cause possible delays in the processing of your claims. PDF Provider Quick Reference Guide - CareFirst Correct BCBS home plan can easily be identified using our BCBS prefix lookup directory.