Most PDF readers are a free download. The main benefits of BSBC are that it provides travel assistance and covers personal liability, accidents, and other pertaining baggage. Information current and approximate as of December 31, 2018. 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. 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, HMO Medical Service Agreement Highlight and Process Summary, 3rd Trimester Pregnancy IPA Transfer Policy, 3rd Trimester Pregnancy IPA Transfer Procedure, Ancillary Hospital Institution Care Transition Exceptions Policy, Ancillary Hospital Institution Care Transition Exceptions Procedure, Contract Management Firms Confidentiality Agreement Policy, Contract Management Firms Confidentiality Agreement Procedure, Corrective Action for Failed Utilization Management Audit of Participating IPAs Policy, Corrective Action for Failed Utilization Management Audit of Participating IPAs Procedure, Collaborative Improvement Coaching for HMO Quality Improvement Projects Policy, Collaborative Improvement Coaching for HMO Quality Improvement Projects Procedure, IPA Availability andAccessibility Requirements forImmediate Care Services Policy, IPA Availability andAccessibility Requirements forImmediate Care Services Procedure, IPA Guidelines for Member Complaints, Inquiries, Appeals and Grievances Policy, IPA Guidelines for Member Complaints, Inquiries, Appeals and Grievances Procedure, IPA Process for Establishing Out of Area for Emergency Services Policy, IPA Process for Establishing Out of Area for Emergency Services Procedure, IPAs Request for Member Transfer Procedure, Member Access to Behavioral Health Services Policy, Member Access to Behavioral Health Services Procedure, Member Notification Process when a Provider Leaves the IPA Policy, Member Notification Process when a Provider Leaves the IPA Procedure, Oversight of Contracted Infertility Vendor Policy, Oversight of Contracted Infertility Vendor Procedure, Primary Care Physician (PCP) Affiliation with Multiple IPAs Policy, Primary Care Physician (PCP) Affiliation with Multiple IPAs Procedure, Utilization Management and Case ManagementAdherence Audit of Participating IPAs Policy, Utilization Management and Case ManagementAdherence Audit of Participating IPAs Procedure, Accountable Care Organization (ACO) Dual Claimed Physician Policy and Procedure, BCBSIL Marketing Communications HLA Policy Procedure, Blue Cross Blue Shield of Illinois Quality of Complaints & Occurrences Process Policy, Blue Cross Blue Shield of Illinois Quality of Complaints & Occurrences Process Procedure, Provider Handling of Member Inquiries Complaints and Appeals, Provider Urgent/Expedited Clinical Appeal Process, Recovery of Provider Overpayments due BCBSIL, MA HMO Detailed Explanation ofNon-coverage, MA HMO Notice of Dismissal of Organization Determination Request, MA HMO UM Approval In Network ProviderLetter, MA HMO UM Approval Out of Network ProviderLetter, MA HMO Sample Provider Appeal Language for Explanation ofPayment, MA HMO Sample Waiver of LiabilityStatement, MA HMO Transition to Transplant ManagementForm, HMO Provider Credentialing Pre-application. Illinois. 2nd Character G Plan Specific (letter assigned to the BCBS Plan), 3rd Character P PPO Product (letter assigned by the BCBS Plan to identify product type elected by the member). %&'()*456789:CDEFGHIJSTUVWXYZcdefghijstuvwxyz Lets dig into it! BCBS FEP Prefix BCBS Federal Employee Program is identified by the letter R followed by the number. IPA Guidelines for Member Complaints, Inquiries, Appeals and Grievances Procedure. T2*uug)T%D._M/5WIdB;zg@W01>X_b( vkWXth$OYD8x$Ygt{" BB> M. members covered. Check Claims Claim Explanation Codes Request a Claim Adjustment View Fee Schedules . The policies and regulations provided by the organization convey great statements and activities into the proper placement. We recently received a query from a provider that how I can identify that patient is BCBS health insurance member. BCBS Alpha Prefix List of "Z"-series. 10 0 obj BCBS National accounts are employer groups that have outlets/offices in multiple states but they offer limited coverage to their employees. If you would like to change your settings or withdraw consent at any time, the link to do so is in our privacy policy accessible from our home page.. J7Wr}pY+Gqpgx ck 4=!omPyC]6bRw@;-:.L^]UMw6xAjAA8 et '/&s0k?Nb~$;,KAz1J X#!&H&K8 '!q15O*e g'<2Aq$04g[ UmKU80xxR An Independent Licensee of the Blue Cross Blue Shield Association 020469 (03-01-2023) Prefix BCBS Plan Prefix BCBS Plan Prefix BCBS Plan A2T Premera Blue Cross A9P Premera Blue Cross ACF Premera Blue Cross AGL Premera Blue Cross/Shared Admin GUJ AHC Premera Blue Cross AJX Premera Blue Cross GVY ALK Premera Blue Cross Prefix UTS assigned to University of Texas. Blue Cross and Blue Shield of Illinois is proud to be the states only statewide, customer-owned health insurer. Always use the BCBS prefix on the members current ID card followed by the member id number. endobj It helps to cover up the flights or any delays. Final Remarks about BCBS Prefix Lookup Directory. Does united healthcare community plan cover chiropractic treatments? Third, it can help you make more informed decisions to choose right insurance plan and benefits. Member Prefix List Patient Roster Claims & Payments. 800-676-2583. Prefixes are also used to identify and correctly route claims to the appropriate Blue Cross Blue Shield [] 107. The following prefix list comes with filling up the health care claims and analyses the correct address of the BSCs sections. If you are using electronic submission then prefix is important to submit claims successfully and received by insurance correctly. How Long Does the Judge Approval Process for Workers Comp Settlement Take? knowledge of BCBS alpha prefix is compulsory if you are handling denials and AR follow up. As noted above, when you check eligibility and benefits, in addition to confirming if prior authorization is required, youll also be directed to the appropriate vendor, if applicable. Step-by-Step Guide for Provider Finder . For Example: ABC, TXX, TEA, A2B, 2AB, 2A2, PAS, XXU etc. Provided on the website you will find the following documents: Medicare and Government Contracts Compliance Program, Blue Cross Medicare Advantage HMO Non-Delegated Model Manual, Blue Cross Medicare Advantage PPO ProviderManual, CMS Qualified Medicare Beneficiary Program, 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). 2021 Commercial Specialty Pharmacy Prior Authorization Drug List This list was updated with 14 new codes effective Jan. 1, 2021. 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. Renew Illinois Individual, Family & Medicaid Health Insurance, Blue Cross Community MMAI (Medicare-Medicaid Plan), Making Your Health Insurance Work For You, Prescription Drug Changes and Pharmacy Information, Machine Readable Files for Transparency in Coverage, Learn About Colon Cancer Screening Options. <> :C5*|}6_D20&Z+NvN0l+TyX ^:"WJ*~'vW/;3eW0Jx] >Ou#_D4W_H5d"t~"AM)B#z_s*,f0Vy5X]KJ_ It also issues for automation extension of the travel insurance plan. In the USA, the BCBS is a very well-known health insurance statement that conveys more association and deals with numerous activities. Today you will find The BCBS Alpha Prefix List from SAA to SZZ. The following application indulges with the contraction of providing the best health care services and plans a specific role and coverages for the customers. Five most Workers Compensation Mistakes to Avoid in Maryland. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Independence Blue Cross(BC) of Philadelphia(Phi) and the Southeastern Pennsylvania(PA), Carefirst BCBS of Maryland the (MD), District of Columbia (DC) and the Northern Virginia (VA). There are two types of BCBS prefixes which are mentioned below: Plan Specific prefix are assigned by BCBS to each plan. These blue shield companies negotiate with the doctors and the other hospitals. So the next time you need to identify accurate BCBS prefix home plan, remember to use the BCBS prefix list lookup finder. In that case claim may be denied as Submit the claim to the correct address / Member ID not found. Once a prior authorization request is received and processed, the decision is communicated to the provider. Search for doctors, dentists, hospitals and other health care providers. M+. In certain situations, the baggage gets lost or goes on delaying for the baggage from the airport by claiming to the insurance company and policies for losing the baggage. Include the alpha prefix and all alpha characters preceding the alpha prefix on all correspondence and claims submitted to Blue Cross Blue Shield of Texas. Highmark BCBS of Pennsylvania (PA) ZAC. 1 0 obj We cant decide Blue cross Blue shield members state just by looking first alpha prefix. For government programs prior authorization requests handled by eviCore healthcare (eviCore): Other providers are available in our network. It allows you to quickly and easily identify your insurance home plan, saving you time and hassle. Every Blue Cross and Blue Shield plan starts with an alpha prefix so they are called in medical terms BCBS Alpha Prefix. The prefix acts as a key element in confirming the members' eligibility and coverage information. BCBS Alpha Prefix list is useful for both providers and BCBS enrolled members/patients. Blue Cross Blue Shield of Illinois: IBU: Blue Cross Blue Shield of Alabama: IBV: Blue Cross Blue Shield of Massachusetts: IBW: Blue Cross . endobj 2 0 obj If possible, make copies of the member's ID card (front and . To viewrequirements summaries andprocedure code lists, refer to theSupport Materials (Commercial)andSupport Materials (Government Programs)pages. The prefixes identify the member's BCBS prefix list plan or national account and become essential when routing claims for processing. Medical Billing and Coding Information Guide. In case, you need any additional information related to BCBS prefix then feel free to reach out to us. Topics include everything from improving your well-being to explaining health coverage. They always offer packages within the amounts mentioned. &UMDU}%h UX[_kRGyzte,.-pD?^]Yt%i7=$Foy*ja(5}31$9w}eLvdA oV;_$myuVLW5v^{=GW;ig)aYff,WW(/-"*{Wf;x5qS:@-q$QJLgvCd2>OXe|lqc;Kv.&Pkuz?&jm*1qm1UqmeETH}6Iq?} Dl]mh*MNgUh9dzQ!hTk H:Azif+ ]V"U23 We make sure to share latest data but in case you find some misinformation, please let us know so that we can help you to provide most accurate BCBS Alpha Prefix List. 18 0 obj Prior authorization isrequiredfor some members/services/drugsbefore services are rendered to confirm medical necessity as defined by the members health benefit plan. Alpha Prefix means plan id starts with three alphabets like ABC, XYZ, etc. 5 0 obj XCE. 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. UAA. BSBS insurance involves unique prefixes and follows up a unique ID number. Have a look at BCBS alpha prefix and alpha numeric prefix directory below. To view this file, you may need to install a PDF reader program. These BCBS prefix may include alpha and numerical characters. Blue Cross Blue Shield Federal Phone Number. 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. If you are using electronic submission then prefix is important to submit claims successfully and received by insurance correctly. Amerihealth Caritas Directory Healthcare, Health Insurance in United States of America, Place of Service Codes List Medical Billing, Independence Blue-Cross of Philadelphia and Southeastern Pennsylvania, Maryland/District of Columbia/Northern Virginia, Anthem Blue-Cross Blue-Shield of Virginia, Excellus Blue-Cross Blue-Shield of New York, Anthem Blue-Cross Blue-Shield of Missouri, Blue-Cross Blue-Shield of Western New York, Empire Blue-Cross Blue-Shield of New York, Anthem Blue-Cross Blue-Shield of Colorado, Anthem Blue-Cross Blue-Shield of Wisconsin, Highmark Blue-Cross Blue-Shield of Pennsylvania, Horizon Blue-Cross Blue-Shield of New Jersey, Anthem Blue-Cross Blue-Shield of Connecticut, Anthem Blue-Cross Blue-Shield of Kentucky. BCBS Company. U2A to U9Z. Blue Cross Blue Shield insurance Companies - Statewise. Curious to know what are national Accounts? V2A to V9Z. October 1, 2022 by Rebecca Williams. X2A to X9Z. In addition to verifying membership/coverage status and other important details,this step returns information on prior authorization requirements and utilization management vendors, if applicable. The benefits that BCBS Insurance provides are. Stand-alone dental products, vision and pharmacy when delivered through an intermediary model. State Lookup. Online - The eviCore Web Portal is available 24x7. Step 2If prior authorization is required, have the following information ready: Step 3 Submit Your Prior Authorization Request. You may also want to know: United Healthcare Claims Address Information. Coupon "NSingh10" for 10% Off onFind-A-CodePlans. $ 382. Born in Texas, USA. 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. _( ~ G+[~:d#y8J5)-*]4hLFk-P3sI77O. Admin 22A. It means that BCBS members IDs prefix will must have alphabets and they may or may not have numbers. 17 0 obj Log In to the Shopping Cart, Need to Make a Payment? Anthem BCBS of Connecticut. Returning Shopper? Continue with Recommended Cookies. Blue cross coverage goes through the idea of calling out the blue cross blue shield company, which helps to provide the programs benefits. BCBS Alpha prefix and BCBS Alpha numeric prefix are very important to submit claims to BCBS insurance. Most PDF readers are a free download. Skip to content. Here you can find the BCBS prefix finder along with BCBS home plan name and website for BCBS member IDs ranging from F2A to F9Z. Prior authorization requests for our Blue Cross Medicare Advantage (PPO) SM (MA PPO), Blue Cross Community Health Plans SM (BCCHP SM) and Blue Cross Community MMAI (Medicare-Medicaid Plan) SM members can be submitted to eviCore in two ways. For commercialprior authorization requests handled by AIM Specialty Health(AIM): Commercial non-HMO prior authorization requests can be submitted to AIM intwo ways. PUJyf\P )} 9\7R8lSJ|y:mYY p!+uUxSACJQ;,#3X_xR The calculation begins from the date of service, discharge date or last date of treatment up to 365days, including weekends. . These BCBS prefix may include alpha and numerical characters. Commercial Communications Remember, member benefits and review requirements will vary based on service/drug being rendered and individual/group policy elections. -x0cjH4`f4`c:A 9K+)tnapM"f2:d+-%0|[FpPDRtZd)@@0,4|(a8`0XE3Fx"K@dd`vF[VgGs.OO'wAl~B~P%sr:|7Rz Ans. <> BCBS Alpha Prefix List of "U"-series. Usually, the provider is responsible for requesting prior authorization before performing a service if the member is seeing an in-network provider. BCBS prefix lookup directory is a valuable resource for anyone who is looking for right Blue Cross Blue Shield home plan. The presence of the members in the organization deals with decisions on certain critical conditions of the customers and getting steps to solve the issues. !(!0*21/*.-4;K@48G9-.BYBGNPTUT3? These prefixes may include alpha and numerical characters. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. Independence Blue Cross (BC) of Philadelphia (Phi) and the Southeastern Pennsylvania (PA) In case, you need any additional information related to BCBS prefix then feel free to reach out to us. Do not delay the billing of a claim for any reason. BCBS FEP Its indicated with letter R followed by the id number. Always check eligibility and benefits first,via theAvailityEssentialsor your preferred web vendor, prior to rendering care and services. Prime Therapeutics LLC (Prime) is a pharmacy benefit management company. However it has several policies for its customers. endobj BAB. Learn more about Ezoic here. BCBS Prefix will not only have numbers and the digits 0 and 1. For example: A2A12345678. Blue Cross Blue Shield insurance Companies - Statewise. BCBS Insurance mainly focuses on medical treatments and providing maximum support for the financial condition. %PDF-1.5 Note: BCBS FEP (Federal Employee Program) ID starts with the alphabet R follow by the insured ID number (For Example: R987654321). Not assigned prefix: GAX: BCBS Illinois: GAY: Anthem Central Region (OH, IN, KY) GAZ: Not assigned prefix: GBA: BCBS Montana: GBB: Anthem Blue Cross California: GBC: Wellmark BCBS: GBD: In this way, the BCBS holds on compensating the costs and indulges with the maximum support of the customers. Does policy number same as member ID number? In addition, some sites may require you to agree to their terms of use and privacy policy. I Don't Have My Member ID Card. Insurance Identifier Lookup; Plan Phone Numbers; Medicare Contractors; State Medicaid Plans; Home; Medicare Advantage List; . Blue Cross Blue Shield companies provide a best-in-class, comprehensive suite of international products and services for people who live, work and travel internationally, giving them confidence that quality care can be accessed wherever and . 11 0 obj The following travel insurance helps to deal with all the medical costs and also covers the family expenses. From April 1 to September 30, on weekends and holidays you may be required to leave a message. <> First Character Z assigned to the BCBS Plan. BCBS Prefix will not only have numbers and the digits 0 and 1. Tdb[+Np/1oz1_(:3^%:\tr'c!HfRY{P#~Kr>S: 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. Business health insurance plans designed to fit any size small business and budget. 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. External link You are leaving this website/app (site). Here " ABC" is BCBS alpha prefix. F1Xkt~ n_]}M,h>@iB;jVhX8M5%s9A}SHB+;zwOUR*7Y@"Z/j[xW[,5ygwxxe7cjgj;=d sXT >oTL{ $(5V7Ev-BNlJaZw7F^Uv >U$+o\!je mR[D-h?jkC: .cJ]QC,1p 9ArnWP) v5s]M*I'vv Save my name, email, and website in this browser for the next time I comment. Anthem Blue-Cross Blue-Shield of Ohio. If you have questions on a request handled by AIM or eviCore, call the appropriate vendor, as noted above. The cross also goes through the analysis of gaining health insurance and forms a series of packages. Most of the expenses get exposed through the treatments, and for that, the coverages are built up. If the provider or member doesnt get prior authorization for out-of-network services, the claim may be denied. endobj The site may also contain non-Medicare related information. In addition, some sites may require you to agree to their terms of use and privacy policy. To identify correct department, they use 3 characters Prefix in the BCBS members plan ID. You can also contact us for specialty medical billing services. will be denied. <> 6 0 obj It also files on checking the incorrect address and submits the correct form of claiming the right details.