As one of the state's largest health insurers, Regence BlueCross BlueShield of Oregon is committed to addressing current and emerging health needs for the nearly one million Oregonians we serve. Learn how to identify our members coverage, easily submit claims and receive payment for services and supplies. Coordination of Benefits, Medicare crossover and other party liability or subrogation. Learn about electronic funds transfer, remittance advice and claim attachments. 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. WELLMARK BCBS OF IOWA. First- and second-level appeals are part of an internal review process, while independent reviews are part of an external review process. For services outside this area, please contact customer service directly at 1 (800) 365-3155 as your claim will require special handling. Our award-winning Customer Service team is made of compassionate people who care. You can appeal a decision online; in writing using email, mail or fax; or verbally. Customer Service will help you with the process. Learn more. Call customer service and web support at 800-607-0546 between 8 a.m. and 6 p.m., Monday through Friday, Pacific Time. Though it is not required, you may want to include the UMP Appeals and Grievance form (for medical services) or the Washington State Rx Services Complaint and Appeal Form (for prescription drugs) with your appeal. Some of the limits and restrictions to prescription drug coverage will apply when UMP pays second to another plan. Premera Blue Cross Blue Shield of Alaska - FEP PO Box 33932 Seattle, WA 98133-0932 Phone: 800-562-1011 6:00 AM - 5:00 PM AST Fax: 877-239-3390 (Claims and Customer Service) Fax: 877-202-3149 (Member Appeals only) Fax: 866-948-8823 (FEP Care Management - prior auth/pre-service requests) Email Members: Log in or register - MyBlue Customer eService Find helpful phone, fax and email information for assistance. the instructions to determine where to send claims or correspondence. You may send a complaint to us in writing or by calling Customer Service. When you use a network provider or network pharmacy, you dont need to submit a claimthe provider or pharmacy will do it for you. Dissatisfaction with service provided by the health plan. Step 1: Start your internet browser, and then go to the official regence bluecross blueshield of oregon address website. 24/7 anonymous hotline: 1 (800) 323-1693 Medicare Part C & D: 1 (800) 633-4227 Online reporting form Ethics & compliance hotline If we must request additional information, the processing of your claim may be delayed. REGENCE BS OF UTAH. We are now processing credentialing applications submitted on or before March 6, 2023. 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. Regence BlueShield in accordance with the terms of your Provider contract with Regence. Italiano | If the decision was after the 60-day timeframe, please include the reason you delayed filing the appeal. You can download the appeal form and submit your written appeal by fax or mail: Mail:WSRxS Regence BlueCross BlueShield of Oregon providers located in Clark County, Washington: Within 24 months after payment of the claim or notice that the claim was denied or within 30 months for claims subject to coordination of benefits. Regence BlueCross BlueShield of Utah is an independent licensee of the Blue Cross and Blue Shield Association. 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. See your certificate of coverage for more information on how to file a claim for specific services and supplies. Your budget. In keeping with our values as a tax paying nonprofit, 85% of every premium dollar goes to pay our members' medical claims and expenses. Visit the Regence provider website, regence.com to learn more about: Contact Us View information about who to contact for questions and issues. 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. Don't have your card? In every state and every community, BCBS companies are making a difference not just for our members, but For the Health of America. 3 0 obj Other specialized services (home hospice, organ/tissue transplants, and clinical trials). Claims must be submitted within 12 months of the date of service. Were empathetic, reliable and tenacious, too. 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. MAXIMUS will review the file and ensure that our decision is accurate. UMP may cover some supplies through the medical benefit and other supplies under the prescription drug benefit. 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. You have other insurance that pays first and UMP is secondary. In every state and every community, BCBS companies are making a difference not just for our members, but For the Health of America. Chronic Obstructive Pulmonary Disease. Management - prior auth/pre-service requests), Members: Log in or register - MyBlue Customer eService, Retail Pharmacy Program PO Box 52057 Phoenix, AZ 85072, Retail Pharmacy Program PO Box 52080 Phoenix, AZ 85072, Phone:800-552-0733Fax: 801-333-6523 (Mark claims: Attn New Claims)Email: Log in or register - MyBlue Customer eService, Regence BlueShield - FEPPO Box 857Lewiston, ID 83501, Regence BlueShield - FEPPO Box 1388Lewiston, ID 83501Customer Service. 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 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. Professional Services are performed by a doctor or other healthcare professional. Cancel Proceed User name or email To see if you qualify for Extra Help, call: 1-800-633-4227. Franais | 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. Coordination of Benefits or Other Party Liability . Please do not submit attachments (e.g., X-rays, periodontal chartings) with your pretreatment estimate or initial claims submission. Follow the prompts to submit your claim online. 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. But there are some circumstances where you will need to submit a claim. A list of reciprocal partners as well as membership benefits can be found at lifeflight.org. Find the correct address listed under the type of service received (see explanation). Espaol | Information current and approximate as of December 31, 2018. Click on it. Learn more about billing and how to submit claims to us for payment, including claims for BlueCross and BlueShield Federal Employee Program (BCBS FEP) members. Ask your provider. Lastly mail the completed claim form to the address provided. Learn more about our customized editing rules, including clinical edits, bundling edits, and outpatient code editor. 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. Appropriate staff members who were not involved in the earlier decision will review the appeal. . Your provider should supply clinically relevant information, such as medical records for services denied based on medical necessity or for other clinical reasons. If you have . The member can appeal, or a representative the member chooses, including an attorney or, in some cases, a doctor. Excluded pharmacies are pharmacies that have been excluded due to fraud, waste, or abuse. Deutsch | 1 0 obj When we make a decision about what services we will cover or how well pay for them, we let you know. Consult theFEP local plan directory to find addresses and telephone numbers complies with applicable Federal and Washington state civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, gender identity, or sexual orientation. 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. Complete the Prescription Drug Claim Form and send it with your pharmacy receipts to: Pharmacy Manual ClaimsP.O. Contact informationMedicare Advantage/Medicare Part D Appeals and GrievancesPO Box 1827, MS B32AGMedford, OR 97501, FAX_Medicare_Appeals_and_Grievances@regence.com, 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. You may need to submit a claim to UMP for payment if: UMP does not cover nor coordinate benefits with workers' compensation claims. This is the customer service number for questions about your health insurance coverage, benefits or treatment. Learn how our innovative solutions can help your employees live healthier, while helping you manage your costs. Complete and mail or fax a WSRxS Multiple Pharmacy Coverage Inquiry Form (Drug Coordination of Benefits) to Washington State Rx Services. Address: 200 SW Market St Portland, OR, 97201-5715 United States See other locations Phone: Website: www.regence.com Employees (this site): Actual Employees (all sites): Actual Revenue: Modelled Year Started: Incorporated: ESG ranking: ESG industry average: What is D&B's ESG Ranking? For member appeals that qualify for a faster decision, there is an expedited appeal process. %&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,. Premera Blue Cross Blue Shield of Alaska FEP PO Box 33932 Seattle, WA 98133-0932, Phone:800-562-1011 We stay on top of issues until theyre resolved. PO Box 91102Seattle, WA 98111-9202. 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). 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 Din kehji k'eyeedgo, t' shdi k anidaalwoi bi bsh bee hane ninaaltsoos bee atah nilinigii bined bik. View the toolkit Claims submission You must submit first-level and second-level appeals no more than 180 days after receiving the previous decision. For any appeals that are denied, we will forward the case file to MAXIMUS Federal Services for an automatic second review. 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. Read the "Guidelines for prescription drugs UMP covers" section of your certificate of coverage for details. Sign in to your Regence account. Please reference your agents name if applicable. You will also receive a decision on your appeal within 30 calendar days. | To obtain information on the aggregate number of grievances, appeals and exceptions filed with the plan contact Customer Service. Management - prior auth/pre-service requests), Email: Members: Log in/register at MyBlue Customer eService, Regence BlueShield - FEPPO Box 21709Seattle, WA 98111. You receive services from an out-of-network provider. Instructions are included on how to complete and submit the form. 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. When the plan is the primary payer (pays first), UMP pays its normal benefit as described in the certificate of coverage. Note:TovieworprintaPDFdocument,youneed AdobeReader. Oregon Regence BCBS of Oregon P. O. Regence BlueShield serves select counties in the state of Washington and is an independent licensee of the Blue Cross and Blue Shield Association. Open 24 hours a day, 7 days a week. Many issues may be resolved with a phone call. Regence Blue Shield of Idaho - FEPPO Box 30270Salt Lake City, UT 84131-0207. *If you are asking for a formulary or tiering exception, your prescribing physician must provide a statement to support your request. If you have questions about submitting a claim for services outside the U.S., call UMP Customer Service. Medical records from your provider, if applicable. The quality of care you received from a provider or facility. Care Management Programs. 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. Stay up to date on what's happening from Salt Lake to St. George. %PDF-1.5 Media Contact: Lou Riepl Regence BlueCross BlueShield of Utah Regence BlueShield of . 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. Make sure Costco Mail Order Pharmacy or PPS has the information for both plans and knows which plan is primary. Contact us as soon as possible because time limits apply. TTY/TDD users can call 1-877-486-2048, 24 hours a day/7 days a week. REGENCE BS OF WASHINGTON. Regence: The most trusted name in health insurance Experience life with Blue With a plan powered by the most trusted name in health insurance, you'll have coverage tailored to your health. Youll receive notice of the action on your complaint within 30 calendar days of our receiving it. PO BOX 21267 SEATTLE, WA 98111 800-845-0377. Use the appeal form below. Regence BlueCross BlueShield of Oregon offers health and dental coverage to 750,000 members throughout the state. Polski | Select a State. 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. Regence users: make the switch to the Availity Web Portal You have been redirected from the Regence or Asuris Northwest Health Provider Center. All claims must be submitted to UMP within 12 months of the date of service or purchase to prevent denial of the claim. 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. Email: Send email through your WSRxS account at ump.regence.com/sebb/benefits/prescriptionsNote: This email is not secure. We offer the option to subscribe to receive the following communications via email: Subscribe to receive an email when new editions of the provider newsletters are available. An appeal is an oral or written request submitted by you or your authorized representative to Regence BlueShield or Washington State Rx Services to reconsider: You or someone you authorize to represent you may request an appeal. There are several levels of appeal, including internal and external appeal levels, which you may follow. Select the area of the map that matches the color of the county where the service was performed. Blue Cross and Blue Shield of Nevada will process the claim. Step 2: Next, locate the "Login" button at the top-right corner. PO BOX 25956 SALT LAKE CITY, UT 84125 800-662-0876. You cannot ask for a tiering exception for a drug in our Specialty Tier. Please follow If you have any questions about specific aspects of this information or need clarifications, please email press@bcbsa.com . medical equipment supplier, ambulance services, applied behavior analysis services (ABA) or clinical social worker. Claims edits If you do not submit your claims through Availity Essentials, follow this process to submit your claims to us electronically. | All from Regence, a company committed to service, community and this place we call home. There are three levels to the appeals process: first-level, second-level, and external review (independent review). You may only disenroll or switch prescription drug plans under certain circumstances. Please include the following information when requesting an appeal: The plan will send confirmation when it receives your appeal. 10/18) v2 INSTRUCTIONS FOR FILING A CLAIM IMPORTANT: Use this form for all medical, pharmacy, dental, and vision services covered by 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. View our clinical edits and model claims editing. Consult theFEP local plan directory to find addresses and telephone numbers for other plans.Note: If the equipment was sent from a DME provider in Washington, refer to thesubmission map to determine where to send your claim for processing. UMP medical plans are administered by Regence BlueShield. 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 Regence Provider Appeal Form Special Message: Coming soon, you will be able to dispute (appeal) a claim on Availity from the claim status result page. Regence BlueCross BlueShield of Utah Uniform Medical Plan (UMP) is a self-insured Preferred Provider Organization (PPO) medical plan offered through the Washington State Health Care Authority. Media Contact: Audrey Glasby Regence BlueCross BlueShield of Utah Regence . 7:00 AM - 6:00 PM PSTFax: 877-239-3390 (Claims and Customer Service)Fax: 877-202-3149 (Member Appeals only)Fax: 866-948-8823 (FEP Care If your prescribing physician asks for a faster decision for you, or supports you in asking for one by stating (in writing or through a phone call to us) that he or she agrees that waiting 72 hours could seriously harm your life, health or ability to regain maximum function, we will give you a decision within 24 hours. People with a hearing or speech disability can contact us using TTY: 711. Click on your plan, then choose theGrievances & appealscategory on the forms and documents page. Coronary Artery Disease. Library Access our Administrative Manual and keep up to date with news. Blue cross blue shield address Medicaid Address and phone number - List 1 Medicaid claim submission address - List 2 Medicare . All features have been transitioned to the Availity Provider Portal. 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.
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regence bcbs of oregon claims address