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Medical providers - Arkansas Blue Cross and Blue Shield New BCBS Alpha Numeric Prefixes | My Payer Directory Note: Current three-character, alpha-only prefixes will not be affected by this change. Blue Shield (BS) of California. hb``` eaXm.; `Umap@LDPpN jM*,BDu|m_(2*u x y-a`b` #; PDF 2021 Commercial Prior Authorization Requirements Summary In addition, some sites may require you to agree to their terms of use and privacy policy. Stand-alone dental products, vision and pharmacy when delivered through an intermediary model. PDF HMO Networks - Blue Cross and Blue Shield of Illinois Prior-Authorization And Pre-Authorization | Anthem.com 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. Prior Authorization Health insurance can be complicatedespecially when it comes to prior authorization (also referred to as pre-approval, pre-authorization and pre-certification). %PDF-1.6 % Please DO NOT randomly select a three-character prefix. It means that BCBS members IDs prefixes will must have alphabets. Born in Texas, USA. 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. 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. And to manage such a big network, they divided it into different departments state wise or employer specific. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider. Working or retired, we'll help you every step of the way to find the right plan. 800-676-2583. BCBS Prefix List Z2A to Z9Z - Alpha Numeric Lookup 2022 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. 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. 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. Most PDF readers are a free download. The prefix routes eligibility/benefits inquiries and claims to the appropriate BCBS Plan or system for timely processing. We make it easy for you to offer the healthcare coverage that delivers for your business. PAH. PDF Blue Cross and BCN utilization management medical drug list - BCBSM These plans provide health insurance coverage for railroad employees, retirees, and their eligible dependents. 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 . Not assigned prefix. 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) . BCBS National accounts are employer groups that have outlets/offices in multiple states but they offer limited coverage to their employees. External link You are leaving this website/app (site). Learn more about timely filing limits and CO 29 Denial Code. Box 7930 Philadelphia, PA 19101-7930 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. We update BCBS prefix list data on daily basis to provide latest BCBS prefix home plan information. For Example: ABC, AQT, TXX, TEA, A2B, 2AB, 2A2, PAS, ZGP, XXU etc. Blue KC Commercial Prior Authorization and Notification List Member ID cards with no prefix Some member ID cards may not have a prefix. 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. Prefix ZGP identifies Blue Cross Blue Shield of Texas PPO Product. 0t9~pE_ >if}~t~iM 'yn8Pgi |hxQD_Y. Amerihealth Caritas Directory Healthcare, Health Insurance in United States of America, Place of Service Codes List Medical Billing, Empire Blue-Cross Blue-Shield of New York, Anthem Blue-Cross Blue-Shield of Kentucky, Maryland/District of Columbia/Northern Virginia, Highmark Blue-Cross Blue-Shield of Pennsylvania, Anthem Blue-Cross Blue-Shield of Connecticut, Anthem Blue-Cross Blue-Shield of Colorado, Anthem Blue-Cross Blue-Shield of New Hampshire, Anthem Blue-Cross Blue-Shield of Missouri, Blue-Cross Blue-Shield of Western New York, Independence Blue-Cross of Philadelphia and Southeastern Pennsylvania, Anthem Blue-Cross Blue-Shield of Virginia, Excellus Blue-Cross Blue-Shield of New York, Anthem Blue-Cross Blue-Shield of Wisconsin, Highmark Blue-Cross Blue-Shield of West Virginia, Horizon Blue-Cross Blue-Shield of New Jersey, Highmark Blue-Cross Blue-Shield of Delaware. A follow-up article with additional information on transition of member care was posted Dec. 4, 2020. 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. For Federal Employee Program (FEP) precertification requirements, please see the separate FEP precertification list. All prefixes are unique. BCBS Alpha Prefix Lookup 2023 ). nKvo2>)*Y=}4i,+s[yL*2#kN@r115};|`R[5/iZ 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 15456 0 obj <>stream eah xp`}L s1zIq%A9Zc~(Iz~HQu;AT#2$ Wp`Hlpp6NQIV0hg`,g H20[20* ": for medical policies and prior authorization requests . The prior authorization information in this notice does not apply to requests for HMO members. If you have any questions or need help submitting a prior authorization, please call 816-395-3989 for assistance. Choose My Signature. Blue Cross and Blue Shield of Illinois, P.O. BCBS Railroad member IDs are assigned to members who served in railroad organizations. So the next time you need to identify accurate BCBS prefix home plan, remember to use the BCBS prefix list lookup finder. The SBC shows you how you and the plan would share t. he cost for covered health care services. 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. 8772287268 Mail Administrator P.O. American Health Group (AHG) Call 1-800-847-7605 . In the District of Columbia and . 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. BCBS Prefix can be classified as follows: BCBS Alpha Prefix - It's a three letter alpha prefix followed by id number. This indicates that the claims are excluded from the BlueCard Program. 0 Please look for instructions or a phone number on the back of the member ID card. Benefits Administration Corporation, Inc. (BACI) 9411 Philadelphia RD. 1 of 7. The following summary and related prior authorization lists were posted on the Support Materials (Commercial) page the Utilization Management section of our Provider website as of Jan. 1, 2021: Commercial Communications Infusion Site of Care Prior Authorization Drug List: New Codes Will Be Added, Effective Jan. 1, 2021 This notice was posted Dec. 28, 2020, to advise you of 14 new codes being added to our specialty pharmacy prior authorization drug list. BCBS Alpha Prefix List from PAA to PZZ Updated 2023 Prior Authorization for Some Commercial Members Will Transition from eviCore to AIM, Effective Jan. 1, 2021 This notice was posted Oct. 1, 2020, to alert you of a utilization management vendor change. Third, it can help you make more informed decisions to choose right insurance plan and benefits. Identifying BlueCard members - Regence It means that BCBS members IDs prefix will must have alphabets and they may or may not have numbers. By doing it may cause delay in processing or handling the claim. Address: 11070 Katy Fwy, Houston, TX 77043, 2023 Xceed Billing Solution.com - All Rights Reserved, Blue Cross Blue Shield BCBS Prefix List Lookup. To identify correct blue cross blue shield department, they use three characters BCBS prefix in the start of each BCBS member plan ID. Xceed Billing Solutions motive is to create ease for providers, medical billers, patients and everyone who is involved in revenue cycle process. Make sure to make copies of the front and back of member ID card. Medicaid Narrow Network: Provider participation is by invitation. The above material is for informational purposes only and is not a substitute for the independent medical judgment of a physician or other health care provider. Each BCBS alpha numeric prefix represents different BCBS home plan. So, to accomplish our goal, we have listed down the complete BCBS alpha prefix list so that you can easily identify correct BCBS plan. T. he Summary of Benefits and Coverage (SBC) document will help you choose a health. 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. Why does BCBSAZ update member accounts and . 741 0 obj <> endobj Save my name, email, and website in this browser for the next time I comment. Box 14115 Lexington, KY 40512 Mail Administrator P.O. Check any internal documents you may have and update any references of "alpha prefix" to "prefix". BlueCard. 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). 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. b(f{YH^tn}u62\}TgT>ENWJB=J #=a$oXIq(n,tU+D'j}L(t#,w?!^oZUQR, 7a. Does policy number same as member ID number? But dont worry because our BCBS prefix finder include alpha numeric prefix information as well. To get information about such member IDs, you can contact BCBS prefix directory phone number i.e. BCBS Prefix List Lookup 2023 - Latest Blue Cross Blue Shield Directory Final Remarks about BCBS Prefix Lookup Directory. Correct BCBS home plan can easily be identified using our BCBS prefix lookup directory. There are three variants; a typed, drawn or uploaded signature. Physicians and other health care providers are encouraged to use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment. 365 0 obj <> endobj %%EOF 1229 0 obj <> endobj =&m$ z90P&\:?$IRIj"c5l\"aD(@?Yuk>{8lkelu3X*FpT=6Rv;9'*4O-o|ELLG?-Yec,cqh(e96e4^QyD8H}'o(3 Curious to know what are national Accounts? Use this guide to see prior approval information for members with ID card prefixes: AEE, AXC, EXX, XCB, XCQ, XCR View guides [pdf] Medicare plans Learn more about providing care for Medicare members. Commercial Prior Authorization Summary and Code Lists BCBS Prefix List 2021 - Alpha State Lookup BCBS Company; AAA: Alabama: Blue-Cross Blue-Shield of Alabama: AAB: Michigan: Blue-Cross Blue-Shield of Michigan: AAC: Illinois: Blue-Cross Blue-Shield of Illinois: AAD: South Carolina: Blue-Cross Blue-Shield of South Carolina: AAE: Nevada: BCBS Alpha Prefix Its a three letter alpha prefix followed by id number. BCBS prefix are easy to identify using our BCBS prefix lookup because they're part of every BCBS member ID and we included all of them here in the BCBS prefix list. For example: ABC12345678 Here " ABC" is BCBS alpha prefix. eO\v; tU9kN@]fh:~q:Fye{Q)ihJ HP/VD/_oy\ H ~fa4L?!ekF(\0>o BCBS prefix are easy to identify using our BCBS prefix lookup because theyre part of every BCBS member ID and we included all of them here in the BCBS prefix list. Our Health Choice plans are available to Arizonans who qualify for Medicaid. 761 0 obj <>/Filter/FlateDecode/ID[]/Index[741 37]/Info 740 0 R/Length 98/Prev 110535/Root 742 0 R/Size 778/Type/XRef/W[1 2 1]>>stream (Note: For changes to come later this year, refer to this notice, posted Dec. 28, 2020: Commercial Prior Authorization Code Changes, Effective April 1, 2021. In case, you need any additional information related to BCBS prefix then feel free to reach out to us. What is a member ID prefix? ;MTK O}BAXv:OP)Qt9>PN,RG4uZu~?raYW+Q`|w[OD klW1Kg|'6'8=rRW00+,oD~`Ox(4DLMm,$Uy69r!$w0.<5>gJd'0?wf\2t| :\xQ cwh)}Ycb8I5vg~TQNnx^Y$M'JL+0?\:3Y(+Sb1:_%^uur(h>mS The most important and easy way to identify BCBS member is his BCBS member ID alpha prefix. In addition, some sites may require you to agree to their terms of use and privacy policy. PAGE : Amkor Technology, Inc. Group # 039176 : AmeriBen . For Example: ABC, AQT, TXX, TEA, A2B, 2AB, 2A2, PAS, ZGP, XXU etc. First Character Z assigned to the BCBS Plan. %%EOF by calling 1-844-377-1278 (BCN) or 1-800-728-8008 (Blue Cross) or by logging oncology and in to the AIM ProviderPortal. CareFirst IDs have plan codes 080/580 and 190/690. 01/01/2021 . document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Xceed Billing Solutions is amedical billing company for outsourcing medical billing services. This new site may be offered by a vendor or an independent third party. External link You are leaving this website/app (site). Prior authorization to confirm medical necessity is required for certain services and benefit plans as part of our commitment to help ensure all Blue Cross and Blue Shield of Illinois (BCBSIL) members get the right care, at the right time, in the right setting. 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. hbbd``b`f3$ bE FM Dmb"@ $$@z$u ad#B cG BCBS member ID have maximum 17 characters but most of the member IDs have 12 characters. Note: BCBS FEP (Federal Employee Program) ID starts with the alphabet R follow by the insured ID number (For Example: R987654321). Customer Service: 1-800-409-9462 HCSC-PORT. TPA Name & Address. BCBS is one of the largest medical insurance company by total members of more than 45 million. First Care, Inc. are independent licensees of the Blue Cross and Blue Shield Association. 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. 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. 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. Commercial Communications Second Character G assigned to the BCBS Plan as well. Account Specific Prefix are assigned by BCBS to national accounts. 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. Does BCBS Cover Wegovy for Weight Loss? 15363 0 obj <> endobj The main difference between BCBS alpha prefix and BCBS alpha numeric prefix is that BCBS alpha prefix only contains alphabets whereas BCBS alpha numeric prefix consists of alphabets as well as numbers ranging from 1 to 9. To view this file, you may need to install a PDF reader program. Regence Prefix List Form - Fill Out and Sign Printable PDF Template BCBS Prefix will not only have numbers and the digits 0 and 1. BCBS is one of the biggest insurance companies in USA and serving more than 106 million people. Independence Blue Cross (BC) of Philadelphia (Phi) and the Southeastern Pennsylvania (PA) PAI. AIM Specialty Health (AIM) is an independent company that has contracted with BCBSIL to provide utilization management services for members with coverage through BCBSIL. Search for doctors near you and in your network. NBT . 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. BCBS alpha prefix only contains alphabets and each alpha prefix represents different BCBS home plan. Coverage For: Individual + Family. For 2021, there were no changes to overall care categories, but some of the codes within certain categories may have been updated. "Y24Oz>V ?I L r%dl=vHd z/;/X #k> Gq This step will help you determine if prior authorization may be required for a specific member and service. Medicare Working or retired, we'll help you every step of the way to find the right plan. Carefirst BCBS of Maryland the (MD), District of Columbia (DC) and the Northern Virginia (VA) AZBlue - Blue Cross Blue Shield of Arizona - Health Insurance Plans A healthier Arizona is what we're all about. BlueCard Program Alpha Prefixes | Blue Cross and Blue Shield - BCBSTX Most PDF readers are a free download. PDF Network Prefix List - CareFirst Provider Summaries and code lists are posted as a reference to help you determine when prior authorization may be required for non-HMO government programs members. PREFIXES . PDF BCBSAZ/TPA Co-Administered Group Plans - AZBlue View Medicare information Radiology utilization for Arkansas Blue Cross FEP There are two types of BCBS prefixes which are mentioned below: Plan Specific prefix are assigned by BCBS to each plan. Most Blue Cross Blue Shield (BCBS) member IDs begin with a three-character prefix. The notice also refers to a medical policy for more information to help clarify when and how prior authorization requirements may apply. Its critical to check member eligibility and benefits through the Availity Provider Portal or your preferred vendor portal prior to every scheduled appointment. therapy) PDF Traditional Coverage - BCBSIL Northwest Arizona Employee Benefit Trust (NAEBT) Group # 037461 . plan. If you have any questions, call the number on the members ID card. How To Identify Blue Cross Blue Shield Member? Amerihealth Caritas Directory Healthcare, Health Insurance in United States of America, Place of Service Codes List Medical Billing. BCBSIL makes no endorsement, representations or warranties regarding any products or services provided by third party vendors such as eviCore, AIM or Availity. BCBS prefix is a three character prefixes followed by the id number except for the following products and programs. A2Z, G2A, J4K etc. Prefix Group Address Group Name TPA Name & Address Claims Filing Claims & Benefit Contact Name Phone .