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 800-676-2583. First Character Z assigned to the BCBS Plan. Checking eligibility and/or benefit information and/or the fact that a service has been prior authorized is not a guarantee of payment. 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. 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. 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. If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly. Benefits Administration Corporation, Inc. (BACI) 9411 Philadelphia RD. 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: Our Health Choice plans are available to Arizonans who qualify for Medicaid. Carefirst BCBS of Maryland the (MD), District of Columbia (DC) and the Northern Virginia (VA) hbbd```b``@$Df/i #D2lE``vd@ "@,iZ R R2H{v# k Most PDF readers are a free download. The three-character prefix at the beginning of the members identification number is the key element used to identify and correctly route out-of-state claims to the appropriate BCBS Plan. Plan Type: PPO . Infusion Site of Care Prior Authorization Drug List: New Codes Will Be Added, Effective Jan. 1, 2021 This notice was posted Dec. 28, 2020, to advise you of 14 new codes being added to our specialty pharmacy prior authorization drug list. 'MNiXG]dRBC; 0'Va~9&c}Ag$Pge;\UY,$MtN T. he Summary of Benefits and Coverage (SBC) document will help you choose a health. What is Medical Billing and Medical Billing process steps in USA? 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. You can also contact us for specialty medical billing services. 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. PDF Network Prefix List - CareFirst Provider %PDF-1.6 % A2Z, G2A, J4K etc. 15456 0 obj <>stream Decide on what kind of signature to create. Make sure to make copies of the front and back of member ID card. Note for Front Desk and Providers: When Blue Cross Blue Shield members comes to your facility or office, make sure to ask them for their active BCBS plan member ID card. 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. Prefix UTS assigned to University of Texas. Blue Shield (BS) of California. In case, you need any additional information related to BCBS prefix then feel free to reach out to us. The most important and easy way to identify BCBS member is his BCBS member ID alpha prefix. BCBS Alpha prefix are the three characters at the start of each BCBS insurance member ID. . BCBS alpha numeric prefix digits are usually in between the prefix e.g. 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. PDF 2021 Commercial Prior Authorization Requirements Summary But dont worry because our BCBS prefix finder include alpha numeric prefix information as well. Most Blue Cross Blue Shield (BCBS) member IDs begin with a three-character prefix. AZBlue - Blue Cross Blue Shield of Arizona - Health Insurance Plans A healthier Arizona is what we're all about. endstream endobj 742 0 obj <. ). 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. Here are links to some recent communications that were posted to notify you of important changes: Government Programs Prior Authorization Summary and Code Lists 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. Learn more about timely filing limits and CO 29 Denial Code. 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. Hi, Im Kim Keck! For example: A2A12345678 Here " A2A" is BCBS alpha numeric prefix. The notice also refers to a medical policy for more information to help clarify when and how prior authorization requirements may apply. Member identification numbers beginning with R belong to Federal Employee Program (FEP) and will not have a three-character prefix when filing. First Character P is symbolizing that member plan/product type is BCBS PPO. 0|kEMi_a*-Yfj#uqEcA/6 .M.6YNw4cyo>lESMC\)H~L 1B> BCBS prefix are easy to identify using our BCBS prefix lookup because they're part of every BCBS member ID and we included all of them here in the BCBS prefix list. We've provided the following resources to help you understand Anthem's prior authorization process and obtain authorization for your patients when it's required. Contact us to learn how we can improve your revenue cycle. There are several benefits of using our BCBS Prefix Lookup tool. 0 BCBS Prefix will not only have numbers and the digits 0 and 1. Box 14115 Lexington, KY 40512 Mail Administrator P.O. BCBS Prefix can be classified as follows: BCBS Alpha Prefix - It's a three letter alpha prefix followed by id number. ?} AN To identify correct department, they use 3 characters Prefix in the BCBS members plan ID. External link You are leaving this website/app (site). nKvo2>)*Y=}4i,+s[yL*2#kN@r115};|`R[5/iZ External link You are leaving this website/app (site). A follow-up article with additional information on transition of member care was posted Dec. 4, 2020. Account Specific Prefix are assigned by BCBS to national accounts. PDF Member account and prefix updates: Provider FAQs And to manage such a big network, they divided it into different departments state wise or employer specific. Availity provides administrative services to BCBSIL. BCBS Prefix will not only have numbers and the digits 0 and 1. 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. The SBC shows you how you and the plan would share t. he cost for covered health care services. BCBS Prefix will not only have numbers and the . K8Z : Page 2 . Note: Current three-character, alpha-only prefixes will not be affected by this change. Let's start with you. 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) . For Example: ABC, AQT, TXX, TEA, A2B, 2AB, 2A2, PAS, ZGP, XXU etc. In order to get rid of this denial or sometimes delay in processing, Provider or Billing companies has to find out the correct address by BCBS prefix from the above list before filing the claim. You may also want to know: United Healthcare Claims Address Information. Correct BCBS home plan can easily be identified using our BCBS prefix lookup directory. 741 0 obj <> endobj BCBS Railroad member IDs starts with a letter R. This indicates that the claims are excluded from the BlueCard Program. So, to answer this query, we have mentioned below few important points to consider. Medicaid Yes, Policy number same as member ID number and also known as subscriber ID number. 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. Each BCBS alpha numeric prefix represents different BCBS home plan. eO\v; tU9kN@]fh:~q:Fye{Q)ihJ HP/VD/_oy\ H ~fa4L?!ekF(\0>o PAJ. BCBS prefix is a three character prefixes followed by the id number except for the following products and programs. endstream endobj startxref These plans provide health insurance coverage for railroad employees, retirees, and their eligible dependents. 389 0 obj <>/Encrypt 366 0 R/Filter/FlateDecode/ID[<8909369792D16D43815F0147FF33489A><8FFDC42F54ADC847B845BC8E43A10252>]/Index[365 40]/Info 364 0 R/Length 117/Prev 191516/Root 367 0 R/Size 405/Type/XRef/W[1 3 1]>>stream Have a look at our BCBS alpha prefix and BCBS alpha numeric prefix directory below. Call 1-800-388-3193 . PAH. American Health Group (AHG) Call 1-800-847-7605 . 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& For example: ABC12345678 Here " ABC" is BCBS alpha prefix. NBT . a'm I have completed my Bachelor of Business Administration in Healthcare Management from University of Texas. eviCore healthcare (eviCore) is an independent specialty medical benefits management company that provides utilization management services for BCBSIL. The three-character prefixes listed do not represent an exhaustive listing of prefixes. Prefix Group Address Group Name TPA Name & Address Claims Filing Claims & Benefit Contact Name Phone . We make it easy for you to offer the healthcare coverage that delivers for your business. 2021 Commercial Outpatient Behavioral Health Prior Authorization Code List This list is a new addition on our website for 2021. To get information about such member IDs, you can contact BCBS prefix directory phone number i.e. Member ID cards with no prefix Some member ID cards may not have a prefix. 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. To identify the plan that holds the members benefits, please call the Out-of-State Blues Plan Subscriber #: 1-800-676-BLUE (2583). Stand-alone dental products, vision and pharmacy when delivered through an intermediary model. PDF HMO Networks - Blue Cross and Blue Shield of Illinois Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. Blue Cross Select Silver. BCBS Prefix List - Alpha Lookup by State 2022 - Finder Regence Prefix List Form - Fill Out and Sign Printable PDF Template BCBS Alpha Numeric Prefix - It's a three letter Alpha numeric prefix followed by id number. Final Instructions about BCBS Prefix Lookup, United Healthcare Claims Address Information. The site may also contain non-Medicare related information. Current prefixes will still be valid once the new alpha-numeric prefixes are issued, unless there is another need to change or remove a prefix . The prior authorization information in this notice does not apply to requests for HMO members. Choose My Signature. Correct BCBS home plan can easily be identified using our BCBS prefix lookup directory. TT$%b"Dg!h^`]-ce?i8xRiu1IrD-%oR#yt;JBOJ#"TXwD0L Fw,]xS_CU3zf]06_T} PNGCqWV^UET6X~`U PDF Blue Cross and BCN utilization management medical drug list - BCBSM Normally, account specific prefix associates to the employer group name. K8Y . For accurate and quick claims processing, it is necessary to get complete patient insurance information. What is the difference between BCBS alpha prefix and BCBS alpha numeric prefix? BCBS alpha prefix only contains alphabets and each alpha prefix represents different BCBS home plan. 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 Search for doctors near you and in your network. Customer Service: 1-800-409-9462 HCSC-PORT. 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. hbbd```b``A$ The prefix may also route claim status inquiries and remit searches. 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 1268 0 obj <>stream What If BCBS Member ID doesnt have Prefix mentioned on Card? Northwest Arizona Employee Benefit Trust (NAEBT) Group # 037461 . Does BCBS Cover Wegovy for Weight Loss? hb``` eaXm.; `Umap@LDPpN jM*,BDu|m_(2*u x y-a`b` #; The policy number is a unique identifier which may cover multiple members under the same policy, such as a family or a group. Suite S . You may also be interested to read about denial code 27 reason and solutions. BCBS Alpha Prefix are not only important to identify BCBS health insurance member but they are also very important for electronic submission of claims to the correct BCBS plan. 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. 1 of 7. Third, it can help you make more informed decisions to choose right insurance plan and benefits. PPO 837P Prefixes are also applicable, . %{!]/Ox^ A[BXe S#(Df BCBS prefix lookup directory is a valuable resource for anyone who is looking for right Blue Cross Blue Shield home plan. $=0j]xkM#[f4YgI|in Z(0zF1-9gk!D @WeUUn/R%$'c|J6:z}\}8ZNd+SL5-h"\wE$w{3\zO>,Vta$a`D7rHmr$bwZm7yYO)&^E<2@9#&UDOz 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. First, it saves you time and hassle by allowing you to quickly identify correct BCBS insurance home plan without having to call customer service. First Care, Inc. are independent licensees of the Blue Cross and Blue Shield Association. Box 805107, Chicago, Illinois 60680-4112. One option is Adobe Reader which has a built-in reader. BlueCard Program Alpha Prefixes | Blue Cross and Blue Shield - BCBSTX 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 prefix routes eligibility/benefits inquiries and claims to the appropriate BCBS Plan or system for timely processing. 365 0 obj <> endobj Commercial Communications BCBS Prefix List AAA to AZZ - Alpha Lookup by State 2022 Why does BCBSAZ update member accounts and . Some members ID cards may not have an alpha prefix. It means that BCBS members IDs prefix will must have alphabets and they may or may not have numbers. CareFirst IDs have plan codes 080/580 and 190/690. 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. PREFIXES . For Federal Employee Program (FEP) precertification requirements, please see the separate FEP precertification list. Identifying BlueCard members - Regence Prior authorization to confirm medical necessity is required for certain services and benefit plans as part of our commitment to help ensure all Blue Cross and Blue Shield of Illinois (BCBSIL) members get the right care, at the right time, in the right setting. 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. "Y24Oz>V ?I L r%dl=vHd z/;/X #k> Gq Box 14114 Lexington, KY 40512 Federal Employee Program (FEP) R prefix DC/Metropolitan Area 2024884900 MD 8008545256 DC/Metropolitan Area Mail Administrator P.O . View Medicare information Radiology utilization for Arkansas Blue Cross FEP Amerihealth Caritas Directory Healthcare, Health Insurance in United States of America, Place of Service Codes List Medical Billing. We always make sure to keep BCBS prefix list and BCBS provider phone numbers directory up to date. One option is Adobe Reader which has a built-in reader. PDF Blue Cross and Blue Shield of Minnesota and Blue Plus Commercial Prior 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. It is used to identify and track the healthcare coverage and benefits for that specific member. BCBS Alpha prefix lookup contains all the Blue Cross Blue Shield alpha prefix along with their home plan and website. If you have any questions, call the number on the members ID card. 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. 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. 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 BCBS Alpha Numeric prefix are three characters at the start of each BCBS insurance member ID. %%EOF q8-_?UT"X e+1?#7DMKHY]?R,-e;PE\mL %%EOF So, to accomplish our goal, we have listed down the complete BCBS alpha prefix list so that you can easily identify correct BCBS plan. The three-character prefix identifies the Blue Cross and Blue Shield Plan to which the member belongs. for medical policies and prior authorization requests. Not assigned prefix. PDF Independence Blue Cross Quick Reference Guide - Magellan Provider To view this file, you may need to install a PDF reader program. Coverage For: Individual + Family. 0 BCBS Alpha Numeric Prefix Its a three letter Alpha numeric prefix followed by id number. 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.
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