bcbs prefix list PDF,Doc ,Images [PDF] Common Prefix Portal List PBC Premera Blue Cross Three Character Prefixes. hbbd```b``@$Df/i #D2lE``vd@ "@,iZ R R2H{v# k 777 0 obj <>stream 1268 0 obj <>stream Xceed Billing Solutions motive is to create ease for providers, medical billers, patients and everyone who is involved in revenue cycle process. So, to accomplish our goal, we have listed down the complete BCBS alpha prefix list so that you can easily identify correct BCBS plan. Commercial Communications 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. 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. BCBS Prefix will not only have numbers and the . Hi, Im Kim Keck! For Federal Employee Program (FEP) precertification requirements, please see the separate FEP precertification list. BCBS alpha numeric prefix contains alphabets as well as digits ranging from 1 to 9. Make sure to make copies of the front and back of member ID card. Have a look at our BCBS alpha prefix and BCBS alpha numeric prefix directory below. 0|kEMi_a*-Yfj#uqEcA/6 .M.6YNw4cyo>lESMC\)H~L 1B> What is Medical Billing and Medical Billing process steps in USA? nKvo2>)*Y=}4i,+s[yL*2#kN@r115};|`R[5/iZ TPA Name & Address. Prior Authorization Health insurance can be complicatedespecially when it comes to prior authorization (also referred to as pre-approval, pre-authorization and pre-certification). Box 805107, Chicago, Illinois 60680-4112. hbbd```b``A$ eO\v; tU9kN@]fh:~q:Fye{Q)ihJ HP/VD/_oy\ H ~fa4L?!ekF(\0>o therapy) BCBS Railroad member IDs starts with a letter R. But dont worry because our BCBS prefix finder include alpha numeric prefix information as well. endstream endobj startxref Does policy number same as member ID number? Always make sure to submit claims to insurance company on time to avoid timely filing denial. First Character Z assigned to the BCBS Plan. %%EOF document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Xceed Billing Solutions is amedical billing company for outsourcing medical billing services. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. Complete patient information, on the other hand, allows your claims to process without delays. Member identification numbers beginning with R belong to Federal Employee Program (FEP) and will not have a three-character prefix when filing. 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) . 0 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 . We recently received a query from a provider that how I can identify that patient is BCBS health insurance member. 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: Here Letter R indicates BCBS FEP prefix. Does BCBS Cover Wegovy for Weight Loss? 0 BCBS Alpha Prefix List Benefits Administration Corporation, Inc. (BACI) 9411 Philadelphia RD. BCBS Alpha Numeric Prefix Its a three letter Alpha numeric prefix followed by id number. 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 `xn_F-y(MQ&O!y1?-uZ=t'=E$r2$IA)gYWp&g` We always make sure to keep BCBS prefix list and BCBS provider phone numbers directory up to date. Curious to know what are national Accounts? Our Health Choice plans are available to Arizonans who qualify for Medicaid. One option is Adobe Reader which has a built-in reader. Note: BCBS FEP (Federal Employee Program) ID starts with the alphabet R follow by the insured ID number (For Example: R987654321). By using this directory, you can ensure that you have the most up-to-date information about BCBS home plans and make more informed decisions about choosing right insurance plan. 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 Prefix should be included along with ID number, exactly as it appears on the member ID card when filing the claims to insurance company. Blue Shield (BS) of California. Most Blue Cross Blue Shield (BCBS) member IDs begin with a three-character prefix. 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). 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. 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. 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. Medicaid 0 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. I have completed my Bachelor of Business Administration in Healthcare Management from University of Texas. BCBS FEP Its indicated with letter R followed by the id number. The most important and easy way to identify BCBS member is his BCBS member ID alpha prefix. BCBS prefix are easy to identify using our BCBS prefix lookup because theyre part of every BCBS member ID and we included all of them here in the BCBS prefix list. BCBS alpha prefix only contains alphabets and each alpha prefix represents different BCBS home plan. Independence Blue Cross (BC) of Philadelphia (Phi) and the Southeastern Pennsylvania (PA) PAI. BCBS alpha numeric prefix digits are usually in between the prefix e.g. In some case provider or billing company may file the claim to an incorrect address without checking the correct BCBS address. a'm Baltimore, MD 21237 . %%EOF We make sure to update the information on daily basis, however, if you find some kind of inaccurate information, feel free to contact us. . BCBS Prefix List 2021 - Alpha Numeric State Lookup BCBS Company; Z2A-Prefix Unallocated/Not Assigned: Z2B: Indiana: Anthem Blue-Cross Blue-Shield of Indiana: Z2C-Prefix Unallocated/Not Assigned: Z2D-Prefix Unallocated/Not Assigned: Z2E-Prefix Unallocated/Not Assigned: Z2F: Minnesota: Have a look at our BCBS alpha prefix and BCBS alpha numeric prefix directory below. 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. Lets dig into it! For example: ABC12345678 Here " ABC" is BCBS alpha prefix. Coverage For: Individual + Family. 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. Its important to remember that benefit plans differ in their benefits, and details such as prior authorization requirements are subject to change. BCBS Alpha Numeric Prefix - It's a three letter Alpha numeric prefix followed by id number. The policy number is usually provided to the policyholder, who is the individual or entity that holds the insurance policy. You can also contact us for specialty medical billing services. It allows you to quickly and easily identify your insurance home plan, saving you time and hassle. 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. BCBS Alpha Prefix Its a three letter alpha prefix followed by id number. Call 1-800-388-3193 . 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 The three-character prefix identifies the Blue Cross and Blue Shield Plan to which the member belongs. Individuals & Families We offer a wide choice of individual plans to fit your health needs and budget. 2021 Commercial Specialty Pharmacy Prior Authorization Drug List This list was updated with 14 new codes effective Jan. 1, 2021. eah xp`}L s1zIq%A9Zc~(Iz~HQu;AT#2$ Wp`Hlpp6NQIV0hg`,g H20[20* ": Its critical to check member eligibility and benefits through the Availity Provider Portal or your preferred vendor portal prior to every scheduled appointment. This new site may be offered by a vendor or an independent third party. To view this file, you may need to install a PDF reader program. First Character P is symbolizing that member plan/product type is BCBS PPO. Blue Cross Select Silver. These BCBS prefix may include alpha and numerical characters. The prefix may also route claim status inquiries and remit searches. AIM Specialty Health (AIM) is an independent company that has contracted with BCBSIL to provide utilization management services for members with coverage through BCBSIL. In that case claim may be denied as Submit the claim to the correct address / Member ID not found. 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. Coverage Period: 01/01/2021 - 12/31/2021 . External link You are leaving this website/app (site). Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. 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. 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. Please look for instructions or a phone number on the back of the member ID card. 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;$~gn-Sd"mjdTY2R*I:w8w3;fpCfQH& q8-_?UT"X e+1?#7DMKHY]?R,-e;PE\mL Enter a location and search by doctor or hospital name, health condition, or specialty. To identify the plan that holds the members benefits, please call the Out-of-State Blues Plan Subscriber #: 1-800-676-BLUE (2583). BCBS National accounts are employer groups that have outlets/offices in multiple states but they offer limited coverage to their employees. A2Z, G2A, J4K etc. We have a track record of providing quality medical billing services to multiple healthcare organizations and specialty providers across USA. What If BCBS Member ID doesnt have Prefix mentioned on Card? Save my name, email, and website in this browser for the next time I comment. For Example: XYZ123456789. What is a member ID prefix? One option is Adobe Reader which has a built-in reader. 'MNiXG]dRBC; 0'Va~9&c}Ag$Pge;\UY,$MtN Carefirst BCBS of Maryland the (MD), District of Columbia (DC) and the Northern Virginia (VA) Most PDF readers are a free download. BCBS Railroad member IDs are assigned to members who served in railroad organizations. The site may also contain non-Medicare related information. 741 0 obj <> endobj 2021 Commercial Prior Authorization Requirements Summary (Updated December 2020) This document provides an overview of services/care categories for which prior authorization may be required for some commercial, non-HMO Blue Cross and Blue Shield of Illinois (BCBSIL) members. Decide on what kind of signature to create. Unraveling the Truth, United Healthcare Claims Address, Payer ID, Fax and Phone Number, BCBS Prefix List 2023 Alpha Prefix and Alpha Number Prefix Lookup, BCBS Alpha Numeric Prefix from L2A to L9Z (Updated 2023), BCBS Provider Phone Number for Claims and Eligibility Verification, Benefits and Eligibility Verification Services. Three-Character Prefixes. b(f{YH^tn}u62\}TgT>ENWJB=J #=a$oXIq(n,tU+D'j}L(t#,w?!^oZUQR, 7a. This new site may be offered by a vendor or an independent third party. Services that require precertification As of January 1, 2022, this list applies to all Independence Blue Cross HMO, PPO, and POS products, including Flex products. eviCore healthcare (eviCore) is an independent specialty medical benefits management company that provides utilization management services for BCBSIL. Title: An incorrect or missing three-character prefix may cause possible delays in the processing of your claims. Search for doctors near you and in your network. %%EOF The notice also refers to a medical policy for more information to help clarify when and how prior authorization requirements may apply. 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. To identify correct blue cross blue shield department, they use three characters BCBS prefix in the start of each BCBS member plan ID. ", 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). 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. For 2021, there were no changes to overall care categories, but some of the codes within certain categories may have been updated. Note: Current three-character, alpha-only prefixes will not be affected by this change. AZBlue - Blue Cross Blue Shield of Arizona - Health Insurance Plans A healthier Arizona is what we're all about. It means that BCBS members IDs prefix will must have alphabets and they may or may not have numbers. Added to list, with AIM effective 04/01/2021 22802 Joint, Spine Surgery Post Fusion 7-12 Vert Seg SUR712.036 AIM Guidelines Lumbar Spinal Fusion Retire from BCBS PA effective 1/1/22; continue to request PA through AIM if applicable; Added to list, with AIM effective 04/01/2021 22804 Joint, Spine Surgery Post Fusion 13/> Vert Seg SUR712.036 AIM . There are three variants; a typed, drawn or uploaded signature. 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. 404 0 obj <>stream ;MTK This step will help you determine if prior authorization may be required for a specific member and service. 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. Not assigned prefix. To identify correct department, they use 3 characters Prefix in the BCBS members plan ID. 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. A follow-up article with additional information on transition of member care was posted Dec. 4, 2020. For Example: ABC, A2B, 2AB, 2A2 etc. %{!]/Ox^ A[BXe S#(Df 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. In addition, some sites may require you to agree to their terms of use and privacy policy. If you have any questions, call the number on the members ID card. (Note: For changes to come later this year, refer to this notice, posted Dec. 28, 2020: Commercial Prior Authorization Code Changes, Effective April 1, 2021. BCBS FEP Prefix BCBS Federal Employee Program is identified by the letter R followed by the number. So the next time you need to identify accurate BCBS prefix home plan, remember to use the BCBS prefix list lookup finder. This can be especially helpful if youre in a rush or need to access your BCBS prefix home plan information quickly. Below in our BCBS prefix lookup directory, you can lookup all the BCBS prefix appropriate home plans and their contact information. e@'SZD/KCbv*pKq~ by calling 1-844-377-1278 (BCN) or 1-800-728-8008 (Blue Cross) or by logging oncology and in to the AIM ProviderPortal. Why does BCBSAZ update member accounts and . The policy number is a unique identifier which may cover multiple members under the same policy, such as a family or a group. BCBS prefix is a three character prefixes followed by the id number except for the following products and programs. Suite S . "Y24Oz>V ?I L r%dl=vHd z/;/X #k> Gq Last updated: 07/01/2022. Please look for claim filing instructions on the back of the ID card. %PDF-1.6 % 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. We make it easy for you to offer the healthcare coverage that delivers for your business. ?} AN Stand-alone dental products, vision and pharmacy when delivered through an intermediary model. In the District of Columbia and . It clarifies a utilization management vendor change for specific members. %%EOF BCBS member ID have maximum 17 characters but most of the member IDs have 12 characters. Right after completing my degree in 2011, I started my job career as an Accounts Receivable in a medical billing company.
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bcbs prefix list 2021 pdf