Individuals & Families We offer a wide choice of individual plans to fit your health needs and budget. Make sure to make copies of the front and back of member ID card. Member identification numbers beginning with R belong to Federal Employee Program (FEP) and will not have a three-character prefix when filing. 404 0 obj <>stream Address: 11070 Katy Fwy, Houston, TX 77043, 2023 Xceed Billing Solution.com - All Rights Reserved, Blue Cross Blue Shield BCBS Prefix List Lookup. 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. Amerihealth Caritas Directory Healthcare, Health Insurance in United States of America, Place of Service Codes List Medical Billing. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Xceed Billing Solutions is amedical billing company for outsourcing medical billing services. 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. Stand-alone dental products, vision and pharmacy when delivered through an intermediary model. BCBS Prefix will not only have numbers and the digits 0 and 1. Most Blue Cross Blue Shield (BCBS) member IDs begin with a three-character prefix. Blue Shield (BS) of California. The notice also refers to a medical policy for more information to help clarify when and how prior authorization requirements may apply. TT$%b"Dg!h^`]-ce?i8xRiu1IrD-%oR#yt;JBOJ#"TXwD0L Fw,]xS_CU3zf]06_T} PNGCqWV^UET6X~`U endstream endobj 742 0 obj <. BCBSIL makes no endorsement, representations or warranties regarding any products or services provided by third party vendors such as eviCore, AIM or Availity. Blue Cross and Blue Shield of Illinois, P.O. Please look for instructions or a phone number on the back of the member ID card. Use this guide to see prior approval information for members with ID card prefixes: AEE, AXC, EXX, XCB, XCQ, XCR View guides [pdf] Medicare plans Learn more about providing care for Medicare members. We update BCBS prefix list data on daily basis to provide latest BCBS prefix home plan information. Three-Character Prefixes. We recently received a query from a provider that how I can identify that patient is BCBS health insurance member. Prior Authorization for Some Commercial Members Will Transition from eviCore to AIM, Effective Jan. 1, 2021 This notice was posted Oct. 1, 2020, to alert you of a utilization management vendor change. Now, with more than 15 years of experience as a medical biller and revenue cycle manager, I am on a mission to serve the medical billing industry with my vast knowledge and years of expertise. b(f{YH^tn}u62\}TgT>ENWJB=J #=a$oXIq(n,tU+D'j}L(t#,w?!^oZUQR, 7a. Check any internal documents you may have and update any references of "alpha prefix" to "prefix". for medical policies and prior authorization requests . 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. Customer Service: 1-800-409-9462 HCSC-PORT. First Character P is symbolizing that member plan/product type is BCBS PPO. Most PDF readers are a free download. 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. AZBlue - Blue Cross Blue Shield of Arizona - Health Insurance Plans A healthier Arizona is what we're all about. 01/01/2021 . 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. endstream endobj 15364 0 obj <>>>/EncryptMetadata false/Filter/Standard/Length 128/O(a;uY[7y\\ Y)/P -1036/R 4/StmF/StdCF/StrF/StdCF/U(ZgYX: )/V 4>> endobj 15365 0 obj <>/Metadata 280 0 R/PageLayout/OneColumn/Pages 15351 0 R/StructTreeRoot 2939 0 R/Type/Catalog>> endobj 15366 0 obj <>/Font<>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 15367 0 obj <>stream Complete patient information, on the other hand, allows your claims to process without delays. 0 BCBS alpha numeric prefix digits are usually in between the prefix e.g. 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 Medicare Working or retired, we'll help you every step of the way to find the right plan. NBT . BCBS Alpha Prefix list is useful for both providers and BCBS enrolled members/patients. 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. Not assigned prefix. 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. 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. Lo-+J52(h' PAGE : Amkor Technology, Inc. Group # 039176 : AmeriBen . By knowing the details of BCBS home plan, including BCBS insurance plan benefits, coverage options, and costs, you can make better decisions about your healthcare needs. 777 0 obj <>stream Most PDF readers are a free download. 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. But dont worry because our BCBS prefix finder include alpha numeric prefix information as well. %{!]/Ox^ A[BXe S#(Df Prior authorization requirements are specific to each patients policy type and the procedure(s) being rendered. Its critical to check member eligibility and benefits through the Availity Provider Portal or your preferred vendor portal prior to every scheduled appointment. PPO 837P Prefixes are also applicable, . 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. Search for doctors near you and in your network. Second Character G assigned to the BCBS Plan as well. Final Instructions about BCBS Prefix Lookup, United Healthcare Claims Address Information. for medical policies and prior authorization requests. Carefirst BCBS of Maryland the (MD), District of Columbia (DC) and the Northern Virginia (VA) Prior Authorization Health insurance can be complicatedespecially when it comes to prior authorization (also referred to as pre-approval, pre-authorization and pre-certification). Save my name, email, and website in this browser for the next time I comment. 2021 Commercial Outpatient Behavioral Health Prior Authorization Code List This list is a new addition on our website for 2021. The three-character prefixes listed do not represent an exhaustive listing of prefixes. The policy number is usually provided to the policyholder, who is the individual or entity that holds the insurance policy. 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: An incorrect or missing three-character prefix may cause possible delays in the processing of your claims. eO\v; tU9kN@]fh:~q:Fye{Q)ihJ HP/VD/_oy\ H ~fa4L?!ekF(\0>o The three-character prefix at the beginning of the members identification number is the key element used to identify and correctly route out-of-state claims to the appropriate BCBS Plan. The three-character prefix identifies the Blue Cross and Blue Shield Plan to which the member belongs. 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. If you have any questions or need help submitting a prior authorization, please call 816-395-3989 for assistance. To view this file, you may need to install a PDF reader program. nKvo2>)*Y=}4i,+s[yL*2#kN@r115};|`R[5/iZ In some case provider or billing company may file the claim to an incorrect address without checking the correct BCBS address. Group Name. 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. Wheelchairs - Mobility Assistive Equipment (Manual & Power) & Scooters - Wheelchair Purchase only -Motorized) Wheelchair: E1050, E1060, E1070, E1083, E1084, E1085 . One option is Adobe Reader which has a built-in reader. In addition, some sites may require you to agree to their terms of use and privacy policy. What is Medical Billing and Medical Billing process steps in USA? You can also contact us for specialty medical billing services. plan. a'm This new site may be offered by a vendor or an independent third party. 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. Here Letter R indicates BCBS FEP prefix. 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. Independence Blue Cross (BC) of Philadelphia (Phi) and the Southeastern Pennsylvania (PA) PAI. 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. There are several benefits of using our BCBS Prefix Lookup tool. Always make sure to submit claims to insurance company on time to avoid timely filing denial. The prefix may also route claim status inquiries and remit searches. American Health Group (AHG) Call 1-800-847-7605 . Suite S . TPA Name & Address. BCBS Prefix will not only have numbers and the . 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. endstream endobj startxref It is used to identify and track the healthcare coverage and benefits for that specific member. Third, it can help you make more informed decisions to choose right insurance plan and benefits. The policy number is a unique identifier which may cover multiple members under the same policy, such as a family or a group. 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. endstream endobj 1230 0 obj <. K8Z : Page 2 . Xceed Billing Solutions motive is to create ease for providers, medical billers, patients and everyone who is involved in revenue cycle process. 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. Box 7930 Philadelphia, PA 19101-7930 endstream endobj startxref It means that BCBS members IDs prefix will must have alphabets and they may or may not have numbers. 1 of 7. 1229 0 obj <> endobj PAJ. We have a track record of providing quality medical billing services to multiple healthcare organizations and specialty providers across USA. 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) . by calling 1-844-377-1278 (BCN) or 1-800-728-8008 (Blue Cross) or by logging oncology and in to the AIM ProviderPortal. 0 Call 1-800-388-3193 . It clarifies a utilization management vendor change for specific members. 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 Independence Blue Cross* Quick Reference Guide . If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly. What If BCBS Member ID doesnt have Prefix mentioned on Card? =&m$ z90P&\:?$IRIj"c5l\"aD(@?Yuk>{8lkelu3X*FpT=6Rv;9'*4O-o|ELLG?-Yec,cqh(e96e4^QyD8H}'o(3 Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. For Example: ABC, AQT, TXX, TEA, A2B, 2AB, 2A2, PAS, ZGP, XXU etc. 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. BCBS FEP Its indicated with letter R followed by the id number. We make it easy for you to offer the healthcare coverage that delivers for your business. BCBS is one of the largest medical insurance company by total members of more than 45 million. %PDF-1.6 % 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. Curious to know what are national Accounts? 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: 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. For more information, contact your Network Provider Consultant or call 406-437-6100. This new site may be offered by a vendor or an independent third party. In that case claim may be denied as Submit the claim to the correct address / Member ID not found. 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). So, to answer this query, we have mentioned below few important points to consider. %PDF-1.6 % Prefix ZGP identifies Blue Cross Blue Shield of Texas PPO Product. For Example: ABC, AQT, TXX, TEA, A2B, 2AB, 2A2, PAS, ZGP, XXU etc. . By doing it may cause delay in processing or handling the claim. Coverage Period: 01/01/2021 - 12/31/2021 . Why does BCBSAZ update member accounts and . Also, these BCBS prefixes helps providers and medical billers to reach the correct claims department for claims and benefits inquiry. For example: A2A12345678 Here " A2A" is BCBS alpha numeric prefix. You may also want to know: United Healthcare Claims Address Information. Benefits and eligibility should be verified for all members prior to rendering services. Born in Texas, USA. To identify the plan that holds the members benefits, please call the Out-of-State Blues Plan Subscriber #: 1-800-676-BLUE (2583). To identify correct blue cross blue shield department, they use three characters BCBS prefix in the start of each BCBS member plan ID. 15388 0 obj <>/Encrypt 15364 0 R/Filter/FlateDecode/ID[]/Index[15363 94]/Info 15362 0 R/Length 122/Prev 932133/Root 15365 0 R/Size 15457/Type/XRef/W[1 3 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. ;MTK 0 A follow-up article with additional information on transition of member care was posted Dec. 4, 2020. I have completed my Bachelor of Business Administration in Healthcare Management from University of Texas. BCBS member ID have maximum 17 characters but most of the member IDs have 12 characters. This indicates that the claims are excluded from the BlueCard Program. 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& Box 805107, Chicago, Illinois 60680-4112. 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. We make sure to update the information on daily basis, however, if you find some kind of inaccurate information, feel free to contact us. Box 14114 Lexington, KY 40512 Federal Employee Program (FEP) R prefix DC/Metropolitan Area 2024884900 MD 8008545256 DC/Metropolitan Area Mail Administrator P.O . No, the BCBS policy number is not typically the same as the BCBS member ID number. This can be especially helpful if youre in a rush or need to access your BCBS prefix home plan information quickly. This includes our Medicaid Blue Cross Community Health PlansSM (BCCHPSM) and Blue Cross Community MMAI (Medicare-Medicaid Plan)SM and Blue Cross Medicare Advantage (PPO)SM(MA PPO) members. So, to accomplish our goal, we have listed down the complete BCBS alpha prefix list so that you can easily identify correct BCBS plan. endstream endobj startxref Contact us to learn how we can improve your revenue cycle. 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` 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 These prefixes may include alpha and numerical characters. 0t9~pE_ >if}~t~iM 'yn8Pgi |hxQD_Y. %%EOF T. he Summary of Benefits and Coverage (SBC) document will help you choose a health. Northwest Arizona Employee Benefit Trust (NAEBT) Group # 037461 . Availity provides administrative services to BCBSIL. For Example: XYZ123456789. Choose My Signature. Hi, Im Kim Keck! A2Z, G2A, J4K etc. 2021 Commercial Specialty Pharmacy Prior Authorization Drug List This list was updated with 14 new codes effective Jan. 1, 2021. %PDF-1.5 % therapy) PAH. 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.
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