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. 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. In the District of Columbia and . 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. Enter a location and search by doctor or hospital name, health condition, or specialty. BCBS Railroad member IDs starts with a letter R. endstream endobj 366 0 obj <>>>/Filter/Standard/Length 128/O(`iYJhD[>R`Xq)/P -1324/R 4/StmF/StdCF/StrF/StdCF/U(ETWBQcf )/V 4>> endobj 367 0 obj <>/Metadata 16 0 R/PageLayout/OneColumn/Pages 363 0 R/StructTreeRoot 28 0 R/Type/Catalog>> endobj 368 0 obj <>/Font<>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 369 0 obj <>stream 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. bcbs prefix list PDF,Doc ,Images [PDF] Common Prefix Portal List PBC Premera Blue Cross Three Character Prefixes. And to manage such a big network, they divided it into different departments state wise or employer specific. These prefixes may include alpha and numerical characters. hbbd```b``"`r9LLN`DR,>6l30&U$60D2HO rH+H f`bdV8J document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Xceed Billing Solutions is amedical billing company for outsourcing medical billing services. 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. for medical policies and prior authorization requests . eviCore healthcare (eviCore) is an independent specialty medical benefits management company that provides utilization management services for BCBSIL. 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. 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. TPA Name & Address. Suite S . PDF BCBSAZ/TPA Co-Administered Group Plans - AZBlue It is used to identify and track the healthcare coverage and benefits for that specific member. Coverage Period: 01/01/2021 - 12/31/2021 . 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. 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. 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& endstream endobj startxref PDF HMO Networks - Blue Cross and Blue Shield of Illinois The prefix may also route claim status inquiries and remit searches. %%EOF $=0j]xkM#[f4YgI|in Z(0zF1-9gk!D @WeUUn/R%$'c|J6:z}\}8ZNd+SL5-h"\wE$w{3\zO>,Vta$a`D7rHmr$bwZm7yYO)&^E<2@9#&UDOz Baltimore, MD 21237 . 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. 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 . e@'SZD/KCbv*pKq~ 2021 Prior Authorization Requirement Summaries, Code Lists and Related Most PDF readers are a free download. BCBS Prefix List - Alpha Lookup by State 2022 - Finder Blue KC Commercial Prior Authorization and Notification List Have a look at our BCBS alpha prefix and BCBS alpha numeric prefix directory below. BlueCard Program Alpha Prefixes | Blue Cross and Blue Shield - BCBSTX Here Letter R indicates BCBS FEP prefix. 2021 Commercial Outpatient Behavioral Health Prior Authorization Code List This list is a new addition on our website for 2021. In case, you need any additional information related to BCBS prefix then feel free to reach out to us. Working or retired, we'll help you every step of the way to find the right plan. 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. Contact us to learn how we can improve your revenue cycle. PDF Blue Cross and BCN utilization management medical drug list - BCBSM But dont worry because our BCBS prefix finder include alpha numeric prefix information as well. Its critical to check member eligibility and benefits through the Availity Provider Portal or your preferred vendor portal prior to every scheduled appointment. There are two types of BCBS prefixes which are mentioned below: Plan Specific prefix are assigned by BCBS to each plan. 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. %PDF-1.6 % PDF Member account and prefix updates: Provider FAQs 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. 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. q8-_?UT"X e+1?#7DMKHY]?R,-e;PE\mL 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 =&m$ z90P&\:?$IRIj"c5l\"aD(@?Yuk>{8lkelu3X*FpT=6Rv;9'*4O-o|ELLG?-Yec,cqh(e96e4^QyD8H}'o(3 %{!]/Ox^ A[BXe S#(Df Right after completing my degree in 2011, I started my job career as an Accounts Receivable in a medical billing company. BCBS of Illinois (IL) PAK. These BCBS prefix may include alpha and numerical characters. For Example: ABC, AQT, TXX, TEA, A2B, 2AB, 2A2, PAS, ZGP, XXU etc. Independence Blue Cross* Quick Reference Guide . Complete patient information, on the other hand, allows your claims to process without delays. 777 0 obj <>stream Prefix UTS assigned to University of Texas. To view this file, you may need to install a PDF reader program. One option is Adobe Reader which has a built-in reader. 0t9~pE_ >if}~t~iM 'yn8Pgi |hxQD_Y. Final Remarks about BCBS Prefix Lookup Directory. It means that BCBS members IDs prefix will must have alphabets and they may or may not have numbers. Benefits Administration Corporation, Inc. (BACI) 9411 Philadelphia RD. We update BCBS prefix list data on daily basis to provide latest BCBS prefix home plan information. b(f{YH^tn}u62\}TgT>ENWJB=J #=a$oXIq(n,tU+D'j}L(t#,w?!^oZUQR, 7a. Plan Type: PPO . Some members ID cards may not have an alpha prefix. For accurate and quick claims processing, it is necessary to get complete patient insurance information. What is Medical Billing and Medical Billing process steps in USA? 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. In addition, some sites may require you to agree to their terms of use and privacy policy. 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. 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. Commercial Communications Correct BCBS home plan can easily be identified using our BCBS prefix lookup directory. 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. 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. %PDF-1.6 % These plans provide health insurance coverage for railroad employees, retirees, and their eligible dependents. 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 . BCBS FEP Its indicated with letter R followed by the id number. 365 0 obj <> endobj We recently received a query from a provider that how I can identify that patient is BCBS health insurance member. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. 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. 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. So, all BCBS plans, including Anthem prefix and Non-Anthem plans announced that member IDs will also be Alpha Numeric from 2018 onwards. Prior authorization requirements are specific to each patients policy type and the procedure(s) being rendered. BCBS alpha numeric prefix digits are usually in between the prefix e.g. The three-character prefix identifies the Blue Cross and Blue Shield Plan to which the member belongs. Box 14115 Lexington, KY 40512 Mail Administrator P.O. Please DO NOT randomly select a three-character prefix. Services that require precertification - IBX We have a track record of providing quality medical billing services to multiple healthcare organizations and specialty providers across USA. To identify correct blue cross blue shield department, they use three characters BCBS prefix in the start of each BCBS member plan ID. This new site may be offered by a vendor or an independent third party. Coverage For: Individual + Family. Blue Cross Select Silver. BCBS Prefix will not only have numbers and the digits 0 and 1. BCBS alpha prefix only contains alphabets and each alpha prefix represents different BCBS home plan. Call 1-800-388-3193 . For example: A2A12345678 Here " A2A" is BCBS alpha numeric prefix. In some case provider or billing company may file the claim to an incorrect address without checking the correct BCBS address. a'm For 2021, there were no changes to overall care categories, but some of the codes within certain categories may have been updated. 8772287268 Mail Administrator P.O. nKvo2>)*Y=}4i,+s[yL*2#kN@r115};|`R[5/iZ To get information about such member IDs, you can contact BCBS prefix directory phone number i.e. Address: 11070 Katy Fwy, Houston, TX 77043, 2023 Xceed Billing Solution.com - All Rights Reserved, Blue Cross Blue Shield BCBS Prefix List Lookup. What is the difference between BCBS alpha prefix and BCBS alpha numeric prefix? Most Blue Cross Blue Shield (BCBS) member IDs begin with a three-character prefix. 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. Also, these BCBS prefixes helps providers and medical billers to reach the correct claims department for claims and benefits inquiry. First Character Z assigned to the BCBS Plan. Medicaid hbbd```b``@$Df/i #D2lE``vd@ "@,iZ R R2H{v# k View Medicare information Radiology utilization for Arkansas Blue Cross FEP What is a member ID prefix? For Example: ABC, A2B, 2AB, 2A2 etc. hb```I! 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.
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