% Note: If you submit your claim by mail, be sure to make copies of your documents for your records. 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. We will notify you if we need more time to respond. This is the customer service number for questions about your health insurance coverage, benefits or treatment. Don't have a Regence account yet? Claims edits If you do not submit your claims through Availity Essentials, follow this process to submit your claims to us electronically. You can submit a claim online through your Regence account, or you can fax or mail your claim to Regence. If you have questions about submitting a claim for services outside the U.S., call UMP Customer Service.. Claims determinations The plan will notify you of action taken on a claim within 30 days of the plan receiving it. Premera Blue Cross Get Marvin Thomas's email address (m*****@regence.com) and phone number (253581..) at RocketReach. Send to Regence Blue Shield in accordance with the terms of your provider contract with Regence. stream Send your claim or correspondence to the Blue Cross Blue Shield plan in the state where the ambulance picked up the patient.Example: An ambulance picks up the patient in Oregon and transports her to a care facility in Washington. These forms explain what information should be included with your appeal and list the address and fax number of where to send your appeal. Instructions: 1. People with a hearing or speech disability can contact us using TTY: 711. Regence BlueShield of Idaho is an independent licensee of the Blue Cross and Blue Shield Association. Follow the steps below to submit your claim online. Appeal form (PDF): Use this form to make your written appeal. Step 4: After you have completed the login details correctly . Your life. When we make a decision about what services we will cover or how well pay for them, we let you know. You can also download the appeal form and submit your written appeal by email, fax, or mail:Email: UMPMemberAppeals@regence.comFax: 1 (877) 663-7526, Mail:UMP Appeals and GrievancesRegence BlueShieldPO Box 91015Seattle, WA 98111-9115. See Occupational injury or illness (workers' compensation) claims in your certificate of coverage. Library Access our Administrative Manual and keep up to date with news. Box 999Appleton, WI 54912-0999Fax: 1 (855) 668-8550. You are about to leave regence.com and enter another website that is not affiliated with or licensed by the Blue Cross Blue Shield Association. Premera Blue Cross Blue Shield of Alaska FEP PO Box 33932 Seattle, WA 98133-0932, Phone:800-562-1011 Italiano | To obtain information on the aggregate number of grievances, appeals and exceptions filed with the plan contact Customer Service. For any appeals that are denied, we will forward the case file to MAXIMUS Federal Services for an automatic second review. Step 3: Next, enter your Username/Password in the appropriate fields. Select the area of the map that matches the color of the county where the service was performed. Please use the comment section for additional information. Lastly mail the completed claim form to the address provided. Be on the lookout for future communications with more information about this exciting enhancement for submitting claim appeals through Availity. Coordination of benefits (COB) happens when you have health coverage through two or more groups (such as your employer and your spouses employer), and these two group health plans both pay a portion of your health care claims. Phoenix, AZ 85072, Retail Pharmacy Program If you have other medical or prescription coverage, Washington State Rx Services Complaint and Appeal Form, WSRxS Multiple Pharmacy Coverage Inquiry Form (Drug Coordination of Benefits). When the plan is the primary payer (pays first), UMP pays its normal benefit as described in the certificate of coverage. You may send a complaint to us in writing or by calling Customer Service. Please reference your agents name if applicable. We respond to pharmacy requests within 72 hours for standard requests and 24 hours for expedited requests. You can submit a marketing complaint to us by calling the phone number on the back of your member ID card or by calling 1-800-MEDICARE (1-800-633-4227). Seattle, WA 98121, Support Phone Number: 1.888.427.0470 (toll free), Mon-Fri, 7:00 a.m. to 5:00 p.m. (PT), 1.800.AVAILITY (1.800.282.4548) (toll free), Run transactions to obtain member benefit, eligibility and claims information, Access eContracting to view and sign agreement documents, Our online newsletter (6 issues per year). %&xv}`kfg`O>=toy,y_bI)45T\ei@{65z9|i8NhI;nTSp~b5[iN_ pn+JsX;fz|4]R 8ZTJ.#fdP]^RP|z~-3KT\n:)O68m+zm96th+/5O6=%7;s"(CTF fZTreF`Tzq`a=6>GGW[tXudM+W6`m~yuCCu xd!XDmSdoQ/= y?ck r1rMc.c0>'1|\a{ enTc |GBl]|mCxr,. PO Box 1271 MS C7APortland, OR 97207-1271 This form is to be used only for services in Oregon and Clark County, WA. TRS: 711Business hours: Monday through Friday 8 a.m. to 4:30 p.m. (Pacific). Join us! The Regence Operations Trainer I would have two years' experience in operational areas to include customer service, claims, membership and/or delivering training in a matrixed environment or . Blue Cross Blue Shield Association (BCBS, BCBSA) is a federation, or supraorganization, of, in 2022, 34 independent and locally operated BCBSA companies that provide health insurance in the United States to more than 115 million people. Contact Us | Blue Cross Blue Shield BCBS Customer Service Call the toll-free number on the back of your member ID card for BCBS customer service. A decision to deny, modify, reduce, or terminate payment, coverage, certification, or provision of health care services or benefits, including the admission to, or continued stay in, a health care facility. Completion of the credentialing process takes 30-60 days. endobj See Complaints about quality of care in your certificate of coverage to learn more. You should wait until the primary plan has paid to submit a secondary claim to UMP, unless the primary plan's processing of the claim is delayed. 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. Open 24 hours a day, 7 days a week. Email: Send email through your WSRxS account at ump.regence.com/sebb/benefits/prescriptionsNote: This email is not secure. Blue Cross and Blue Shield of Montana will process the claim. When UMP pays second, you must still pay your deductible before UMP pays benefits. If you have questions about eligibility and enrollment:Employees:Contact your payroll or benefits office.SEBB Continuation Coverage members:Call the SEBB ProgramPhone: 1 (800) 200-1004 Box 1106Lewiston, ID 83501-1106. We will ask your permission if we need more time to respond. If UMP is secondary, you must include a copy of your primary plan's Explanation of Benefits, which lists the services covered and how much the other plan paid. To request or check the status of a redetermination (appeal). Step 2: Next, locate the "Login" button at the top-right corner. <>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Send your claim or correspondence to the Blue Cross Blue Shield plan in the state from which the durable medical equipment was sent.Example: You live in Seattle and order parts for a wheelchair from a company in Montana. About Regence BlueCross BlueShield of Oregon. We're ready. The Centers for Medicare & Medicaid Services values your feedback and will use it to continue to improve the quality of the Medicare program. Congestive Heart Failure. Identify BlueCard members, verify eligibility and submit claims for out-of-area patients. To see if you qualify for Extra Help, call: 1-800-633-4227. 1-800-962-2731. In every state and every community, BCBS companies are making a difference not just for our members, but For the Health of America. Sign in to your Regence account. For more information about dual coverage, read the If you have other medical coverage (or UMP High Deductible "If you have other HDHP coverage") section in your plans certificate of coverage. MAXIMUS Federal Services is a contracted provider hired by the Center for Medicare and Medicaid Services (also known as CMS) and has no affiliation with us. 2 0 obj But there are some circumstances where you will need to submit a claim. Ask your provider. If your primary plan uses a different mail-order pharmacy, you will have to use your primary plans mail order pharmacy and then submit a claim to Washington State Rx Services. Manage your claimsGet your prescription claims history, view your benefits and claims information, and more by logging in to your Washington State Rx Services Account. Coordination of Benefits, Medicare crossover and other party liability or subrogation. Contact us as soon as possible because time limits apply. Is this your business? Cancel Proceed User name or email Complete and mail or fax a Multiple Coverage Inquiry Form to Regence: Regence BlueShieldAttn: UMP ClaimsPO Box 91015MS BU386Seattle, WA 98111-9115. Learn more. The plan will not pay claims for prescription drugs submitted more than 12 months after purchase or prescription drugs purchased from an excluded pharmacy. You have the right to file a grievance, or complaint, about us or one of our plan providers for matters other than payment or coverage disputes. You can also get information and assistance on how to submit a written appeal by calling the Customer Service number on the back of your member ID card. Claims and clinical appeals address: PO Box 21702 Eagan, MN 55121 Care management Phone: 844-996-0329 Fax: 888-302-9325 2023 holiday closures January 2 May 29 July 4 September 4 November 23 November 24 December 25 6:00 AM - 5:00 PM ASTFax: 877-239-3390 (Claims and Customer Service)Fax: 877-202-3149 (Member Appeals only)Fax: 866-948-8823 (FEP Care PO BOX 21267 SEATTLE, WA 98111 800-845-0377. Media Contact: Audrey Glasby Regence BlueCross BlueShield of Utah Regence . 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. %PDF-1.5 When a claim for workers compensation is accepted, all services related to that injury or illness are not covered, even if some services are denied by workers compensation. See our FAQs for more claim information and contacts. Please follow Locate a network pharmacy by using the Pharmacy Locator Tool. The members full name (the name of the employee, retiree, or dependent covered by the plan), The member ID number (starting with a W on your UMP member ID card), The name(s) of any providers involved in the issue you are appealing, A statement describing the issue and your desired outcome, A copy of the Explanation of Benefits, if applicable, or a list of the claim numbers you are appealing. The plan will notify you within the 30-day period that an extension is necessary, with a description of the information needed and why it is needed. Coding toolkit View our clinical edits and model claims editing. Learn about Regence Lewiston, ID office. Subscribe to online communications receive newsletters and important news via email. Dissatisfaction with service provided by the health plan. For more information about the appeals process, including expedited appeals for urgent or life-threatening conditions and requesting an external review by an Independent Review Organization, read the "Complaint and appeal procedures" section in your plan's certificate of coverage. <> An appeal is a request from a member, or an authorized representative, to change a decision we have made about: Other matters included in your plan's contract with us or as required by state or federal law, Someone who has insurance through an employer, and any dependents they choose to enroll. 2003 Western Ave # 600, Box 1106 Lewiston, ID 83501-1106 Fax: 1 (877) 357-3418 . Asthma. Products and networks Learn more about the products we offer and the provider networks that support them. View the toolkit Claims submission medical equipment supplier, ambulance services, applied behavior analysis services (ABA) or clinical social worker. Oral coverage decision requests1 (855) 522-8896 To request or check the status of a redetermination (appeal): 1 (866) 749-0355 Fax numbersAppeals and grievances: 1 (888) 309-8784Prescription coverage decisions: 1 (888) 335-3016 Make sure you have your Member ID card handy when you call us. Usually we will send you an Explanation of Benefits (EOB) statement or a letter explaining our decision about a pre-authorization request. Procedure and diagnosis (codes) or description of the injury or illness, d. Provider's name, address, phone number, and National Provider Identifier (NPI) or Tax ID number, e. For ambulance claims, also include the ZIP code where the member was picked up and where they were taken. Open 24 hours a day, 7 days a week. x][o%~`C?3=k7A I87ggglM"_Unx9d,*Wdx cwU74/_C&$jTD/ew|/_t_~suJo~/X7/fTjz=u?|1w_k;vZ]!w??!~pw!cw DG6JOw{v?M.>~h9{/|0 _&CrOL%be_/WWc9U~;?#*bX Fz-w~7`e_ :5ZmLme'UFSgs\\@=~!r)Q;ZDf}Z1^W8qw`v0]wcEo5tLBn-4%x\I[s$8eBM:)$2dY9s>E;& Use the appeal form below. You are about to leave regence.com and enter another website that is not affiliated with or licensed by the Blue Cross Blue Shield Association. That way, we can verify your account and start helping you as quickly as possible. If services were rendered in New York or Pennsylvania, then use the state-specific file address PDF. This 30-day period may be extended by 15 days when action cannot be taken on the claim due to: Manage your claimsSee the status of your claims, see how much you owe, find a specific claim, and more by logging in to your Regence account. You have the right to appeal, or request an independent review of, any action we take or decision we make about your coverage, benefits or services. For services outside this area, please contact customer service directly at 1 (800) 365-3155 as your claim will require special handling. If you wish to appoint someone to act on your behalf, you must complete an appointment of representative form and send it to us with your prescription coverage determination form. Learn how to identify our members coverage, easily submit claims and receive payment for services and supplies. | This form is to be used to request a deduction on a future remittance advice (voucher) in response to a recent recoupment request from Regence, or as a result of an overpayment discovered by your internal claims review process. Washington State Rx ServicesPO Box 40168Portland, OR 97240-0168. Information current and approximate as of December 31, 2018. Select a State. Were proud to stand with you during this challenging time. Other specialized services (home hospice, organ/tissue transplants, and clinical trials). for other plans. If you or your dependents are enrolled in UMP High Deductible and want to enroll in another health plan, you and your dependents can only enroll in other high-deductible health plans. If you have questions, contact Premera at 1 (855) 784-4563 (TRS: 711) Monday through Friday 7 a.m. to 5 p.m. (Pacific). When UMP pays second to another plan that covers the member, UMP will pay only an amount needed to bring the total benefit up to the amount UMP would have paid if the member did not have another plan.
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