Independence Blue Cross* Quick Reference Guide . 1268 0 obj <>stream Check any internal documents you may have and update any references of "alpha prefix" to "prefix". The SBC shows you how you and the plan would share t. he cost for covered health care services. Box 7930 Philadelphia, PA 19101-7930 Secondly, it ensures that you have the most up-to-date information about each and every BCBS prefix home plan because we update the BCBS prefix list on daily basis. for medical policies and prior authorization requests. To get information about such member IDs, you can contact BCBS prefix directory phone number i.e. First Character Z assigned to the BCBS Plan. PDF Independence Blue Cross Quick Reference Guide - Magellan Provider 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. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider. endstream endobj 742 0 obj <. Account Specific Prefix are assigned by BCBS to national accounts. . Its critical to check member eligibility and benefits through the Availity Provider Portal or your preferred vendor portal prior to every scheduled appointment. This step will help you determine if prior authorization may be required for a specific member and service. 800-676-2583. You may also be interested to read about denial code 27 reason and solutions. For Example: ABC, AQT, TXX, TEA, A2B, 2AB, 2A2, PAS, ZGP, XXU etc. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. An incorrect or missing three-character prefix may cause possible delays in the processing of your claims. Physicians and other health care providers are encouraged to use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment. 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. Please look for instructions or a phone number on the back of the member ID card. 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. PAJ. hb``` eaXm.; `Umap@LDPpN jM*,BDu|m_(2*u x y-a`b` #; PPO 837P Prefixes are also applicable, . A follow-up article with additional information on transition of member care was posted Dec. 4, 2020. These prefixes may include alpha and numerical characters. BCBS alpha numeric prefix digits are usually in between the prefix e.g. Member identification numbers beginning with R belong to Federal Employee Program (FEP) and will not have a three-character prefix when filing. Codes may chan ge, and this list may be updated throughout the year. What is the difference between BCBS alpha prefix and BCBS alpha numeric prefix? TPA Name & Address. 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. BCBS member ID card will have a suitcase logo at the bottom of card which will also help you to identify patient plan like HMO, PPO, POS etc. BCBS Alpha Prefix list is useful for both providers and BCBS enrolled members/patients. 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. PDF 2021 Commercial Prior Authorization Requirements Summary K8Y . ", 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). $=0j]xkM#[f4YgI|in Z(0zF1-9gk!D @WeUUn/R%$'c|J6:z}\}8ZNd+SL5-h"\wE$w{3\zO>,Vta$a`D7rHmr$bwZm7yYO)&^E<2@9#&UDOz So, to accomplish our goal, we have listed down the complete BCBS alpha prefix list so that you can easily identify correct BCBS plan. Prefix Group Address Group Name TPA Name & Address Claims Filing Claims & Benefit Contact Name Phone . Blue Cross and Blue Shield of Illinois, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue . Right after completing my degree in 2011, I started my job career as an Accounts Receivable in a medical billing company. Medicare Working or retired, we'll help you every step of the way to find the right plan. hbbd```b``@$Df/i #D2lE``vd@ "@,iZ R R2H{v# k 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. The most important and easy way to identify BCBS member is his BCBS member ID alpha prefix. View Medicare information Radiology utilization for Arkansas Blue Cross FEP We update BCBS prefix list data on daily basis to provide latest BCBS prefix home plan information. PDF BCBSAZ/TPA Co-Administered Group Plans - AZBlue PDF Provider Quick Reference Guide - CareFirst BCBS Prefix can be classified as follows: BCBS Alpha Prefix - It's a three letter alpha prefix followed by id number. Always make sure to submit claims to insurance company on time to avoid timely filing denial. 0|kEMi_a*-Yfj#uqEcA/6 .M.6YNw4cyo>lESMC\)H~L 1B> 365 0 obj <> endobj External link You are leaving this website/app (site). bcbs prefix list PDF,Doc ,Images [PDF] Common Prefix Portal List PBC Premera Blue Cross Three Character Prefixes. This new site may be offered by a vendor or an independent third party. Baltimore, MD 21237 . Medical providers - Arkansas Blue Cross and Blue Shield q8-_?UT"X e+1?#7DMKHY]?R,-e;PE\mL Final Instructions about BCBS Prefix Lookup, United Healthcare Claims Address Information. For 2021, there were no changes to overall care categories, but some of the codes within certain categories may have been updated. Narrow Network: Provider participation is by invitation. Correct BCBS home plan can easily be identified using our BCBS prefix lookup directory. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Xceed Billing Solutions is amedical billing company for outsourcing medical billing services. We recently received a query from a provider that how I can identify that patient is BCBS health insurance member. Our Health Choice plans are available to Arizonans who qualify for Medicaid. eah xp`}L s1zIq%A9Zc~(Iz~HQu;AT#2$ Wp`Hlpp6NQIV0hg`,g H20[20* ": Yes, Policy number same as member ID number and also known as subscriber ID number. Blue Cross Select Silver. What is Medical Billing and Medical Billing process steps in USA? There are several benefits of using our BCBS Prefix Lookup tool. plan. a'm You may see cards with four-character prefixes, e.g., HMSA Blue Cross Blue Shield of Hawaii uses four-character prefixes. 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 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 . Due to the exceeding number of BCBS insurance members, Alpha-Only Prefix member IDs exhausted. 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. Regence Prefix List Form - Fill Out and Sign Printable PDF Template 2021 Commercial Outpatient Behavioral Health Prior Authorization Code List This list is a new addition on our website for 2021. 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. BCBS Alpha Prefix Its a three letter alpha prefix followed by id number. 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 . Note: Current three-character, alpha-only prefixes will not be affected by this change. 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. Here are links to some recent communications that were posted to notify you of important changes: Government Programs Prior Authorization Summary and Code Lists First Care, Inc. are independent licensees of the Blue Cross and Blue Shield Association. Box 805107, Chicago, Illinois 60680-4112. Choose My Signature. So the next time you need to identify accurate BCBS prefix home plan, remember to use the BCBS prefix list lookup finder. BCBS of Illinois (IL) PAK. Lo-+J52(h' 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. 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. AIM Specialty Health (AIM) is an independent company that has contracted with BCBSIL to provide utilization management services for members with coverage through BCBSIL. Medicaid A2Z, G2A, J4K etc. hb```I! Each BCBS alpha numeric prefix represents different BCBS home plan. To view this file, you may need to install a PDF reader program. Prefix UTS assigned to University of Texas. Second Character G assigned to the BCBS Plan as well. 01/01/2021 . Plan Type: PPO . Group Name. b(f{YH^tn}u62\}TgT>ENWJB=J #=a$oXIq(n,tU+D'j}L(t#,w?!^oZUQR, 7a. Blue Cross and Blue Shield of Illinois, aDivision of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association, PDF File is in portable document format (PDF). PDF Blue Cross and Blue Shield of Minnesota and Blue Plus Commercial Prior Blue KC Commercial Prior Authorization and Notification List If youre a medical biller or a provider and going to submit BCBS plan member claim to the insurance, make sure to submit member ID including prefix. Also, pre-authorization information and medical policy for out of state plans may be found on the Blue Cross Blue Shield of Texas provider website section under Standards and Requirements, and then select "Medical Policy and Precertification/Preauthorization for Out of Area Members. No, the BCBS policy number is not typically the same as the BCBS member ID number. Please look for claim filing instructions on the back of the ID card. Coverage For: Individual + Family. We update BCBS prefix list data on daily basis to provide latest BCBS prefix home plan information. %PDF-1.6 % Follow the step-by-step instructions below to design your premiere blue cross amp the regency group three character prefixes: Select the document you want to sign and click Upload. hbbd``b`f3$ bE FM Dmb"@ $$@z$u ad#B cG Most Blue Cross Blue Shield (BCBS) member IDs begin with a three-character prefix. 15363 0 obj <> endobj In some case provider or billing company may file the claim to an incorrect address without checking the correct BCBS address. Below in our BCBS prefix lookup directory, you can lookup all the BCBS prefix appropriate home plans and their contact information. Third, it can help you make more informed decisions to choose right insurance plan and benefits. %PDF-1.6 % There are two types of BCBS prefixes which are mentioned below: Plan Specific prefix are assigned by BCBS to each plan. 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. 0 Hi, Im Kim Keck! 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. ;MTK Here Letter R indicates BCBS FEP prefix. These BCBS prefix may include alpha and numerical characters. AZBlue - Blue Cross Blue Shield of Arizona - Health Insurance Plans A healthier Arizona is what we're all about. 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, 2021 Commercial Prior Authorization Requirements Summary, 2021 Commercial Outpatient Medical Surgical Prior Authorization Code List, 2021 Commercial Specialty Pharmacy Prior Authorization Drug List, 2021 Commercial Outpatient Behavioral Health Prior Authorization Code List, New Prior Authorization Requirements for Some Custom Account Members Will Take Effect Jan. 1, 2021, 2021 Medicaid Prior Authorization Requirements Summary, 2021 Medicaid Prior Authorization Code List, 2021 MA PPO Prior Authorization Requirements Summary, 2021 MA PPO Prior Authorization Code List, BCBSIL Provider Network Consultant (PNC) team, Update: Utilization Management Change for Advocate Aurora Health Members, Effective Jan. 1, 2021 This News and Updates was posted Dec.15, 2020, and updated Dec. 31, 2020 to reflect a corrected phone number. Few times, BCBS plan members doesnt have prefix mentioned on their BCBS Insurance card. Why does BCBSAZ update member accounts and . Services that require precertification - IBX BCBS Prefix List AAA to AZZ - Alpha Lookup by State 2022 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. 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. 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. 2021 Commercial Specialty Pharmacy Prior Authorization Drug List This list was updated with 14 new codes effective Jan. 1, 2021. BlueCard. endstream endobj startxref Correct BCBS home plan can easily be identified using our BCBS prefix lookup directory. The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. For Federal Employee Program (FEP) precertification requirements, please see the separate FEP precertification list.

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