Here Letter R indicates BCBS FEP prefix. For more information, contact your Network Provider Consultant or call 406-437-6100. TT$%b"Dg!h^`]-ce?i8xRiu1IrD-%oR#yt;JBOJ#"TXwD0L Fw,]xS_CU3zf]06_T} PNGCqWV^UET6X~`U 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 example: A2A12345678 Here " A2A" is BCBS alpha numeric prefix. Title: The most important and easy way to identify BCBS member is his BCBS member ID alpha prefix. We offer a wide choice of individual plans to fit your health needs and budget. Most PDF readers are a free download. 1229 0 obj <> endobj 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. Choose My Signature. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider. 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. hb``` eaXm.; `Umap@LDPpN jM*,BDu|m_(2*u x y-a`b` #; In addition, some sites may require you to agree to their terms of use and privacy policy. T. he Summary of Benefits and Coverage (SBC) document will help you choose a health. Prefix Group Address Group Name TPA Name & Address Claims Filing Claims & Benefit Contact Name Phone . For Example: ABC, AQT, TXX, TEA, A2B, 2AB, 2A2, PAS, ZGP, XXU etc. BCBS Railroad member IDs starts with a letter R. nKvo2>)*Y=}4i,+s[yL*2#kN@r115};|`R[5/iZ BCBS alpha numeric prefix digits are usually in between the prefix e.g. 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. Coverage For: Individual + Family. 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. 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. endstream endobj startxref To get information about such member IDs, you can contact BCBS prefix directory phone number i.e. Checking eligibility and/or benefit information and/or the fact that a service has been prior authorized is not a guarantee of payment. Third, it can help you make more informed decisions to choose right insurance plan and benefits. It means that BCBS members IDs prefix will must have alphabets and they may or may not have numbers. This step will help you determine if prior authorization may be required for a specific member and service. To identify correct blue cross blue shield department, they use three characters BCBS prefix in the start of each BCBS member plan ID. If you have any questions, call the number on the members ID card. 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. To identify the plan that holds the members benefits, please call the Out-of-State Blues Plan Subscriber #: 1-800-676-BLUE (2583). Wheelchairs - Mobility Assistive Equipment (Manual & Power) & Scooters - Wheelchair Purchase only -Motorized) Wheelchair: E1050, E1060, E1070, E1083, E1084, E1085 . 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. PREFIXES . AIM Specialty Health (AIM) is an independent company that has contracted with BCBSIL to provide utilization management services for members with coverage through BCBSIL. Here are links to some recent communications that were posted to notify you of important changes: Government Programs Prior Authorization Summary and Code Lists Note: Current three-character, alpha-only prefixes will not be affected by this change. 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. BCBS FEP Prefix BCBS Federal Employee Program is identified by the letter R followed by the number. 0 The prior authorization information in this notice does not apply to requests for HMO members. Northwest Arizona Employee Benefit Trust (NAEBT) Group # 037461 . Commercial Communications Decide on what kind of signature to create. The prefix may also route claim status inquiries and remit searches. TPA Name & Address. 8772287268 Mail Administrator P.O. We recently received a query from a provider that how I can identify that patient is BCBS health insurance member. 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. 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. Does BCBS Cover Wegovy for Weight Loss? So, all BCBS plans, including Anthem prefix and Non-Anthem plans announced that member IDs will also be Alpha Numeric from 2018 onwards. by calling 1-844-377-1278 (BCN) or 1-800-728-8008 (Blue Cross) or by logging oncology and in to the AIM ProviderPortal. We have a track record of providing quality medical billing services to multiple healthcare organizations and specialty providers across USA. 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 For Federal Employee Program (FEP) precertification requirements, please see the separate FEP precertification list. Curious to know what are national Accounts? 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 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. To view this file, you may need to install a PDF reader program. Independence Blue Cross (BC) of Philadelphia (Phi) and the Southeastern Pennsylvania (PA) PAI. hbbd```b``A$ for medical policies and prior authorization requests . It clarifies a utilization management vendor change for specific members. 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. Correct BCBS home plan can easily be identified using our BCBS prefix lookup directory. 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. First Character Z assigned to the BCBS Plan. eO\v; tU9kN@]fh:~q:Fye{Q)ihJ HP/VD/_oy\ H ~fa4L?!ekF(\0>o Prefix ZGP identifies Blue Cross Blue Shield of Texas PPO Product. 404 0 obj <>stream endstream endobj 742 0 obj <. Coverage Period: 01/01/2021 - 12/31/2021 . Lets dig into it! 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. BlueCard. 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 . Some members ID cards may not have an alpha prefix. 01/01/2021 . Box 14114 Lexington, KY 40512 Federal Employee Program (FEP) R prefix DC/Metropolitan Area 2024884900 MD 8008545256 DC/Metropolitan Area Mail Administrator P.O . But dont worry because our BCBS prefix finder include alpha numeric prefix information as well. BCBS Prefix will not only have numbers and the . =&m$ z90P&\:?$IRIj"c5l\"aD(@?Yuk>{8lkelu3X*FpT=6Rv;9'*4O-o|ELLG?-Yec,cqh(e96e4^QyD8H}'o(3 By doing it may cause delay in processing or handling the claim. Prior Authorization for Some Commercial Members Will Transition from eviCore to AIM, Effective Jan. 1, 2021 This notice was posted Oct. 1, 2020, to alert you of a utilization management vendor change. Amerihealth Caritas Directory Healthcare, Health Insurance in United States of America, Place of Service Codes List Medical Billing. "Y24Oz>V ?I L r%dl=vHd z/;/X #k> Gq There are three variants; a typed, drawn or uploaded signature. 0 Below in our BCBS prefix lookup directory, you can lookup all the BCBS prefix appropriate home plans and their contact information. ). Box 14115 Lexington, KY 40512 Mail Administrator P.O. So the next time you need to identify accurate BCBS prefix home plan, remember to use the BCBS prefix list lookup finder. 777 0 obj <>stream In that case claim may be denied as Submit the claim to the correct address / Member ID not found. So, to answer this query, we have mentioned below few important points to consider. `xn_F-y(MQ&O!y1?-uZ=t'=E$r2$IA)gYWp&g` For accurate and quick claims processing, it is necessary to get complete patient insurance information. Account Specific Prefix are assigned by BCBS to national accounts. 0|kEMi_a*-Yfj#uqEcA/6 .M.6YNw4cyo>lESMC\)H~L 1B> 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. Few times, BCBS plan members doesnt have prefix mentioned on their BCBS Insurance card. BCBS Alpha prefix lookup contains all the Blue Cross Blue Shield alpha prefix along with their home plan and website. Not assigned prefix. %%EOF The SBC shows you how you and the plan would share t. he cost for covered health care services. This can be especially helpful if youre in a rush or need to access your BCBS prefix home plan information quickly. First Care, Inc. are independent licensees of the Blue Cross and Blue Shield Association. BCBS National accounts are employer groups that have outlets/offices in multiple states but they offer limited coverage to their employees. 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. The three-character prefix identifies the Blue Cross and Blue Shield Plan to which the member belongs. Please look for claim filing instructions on the back of the ID card. We always make sure to keep BCBS prefix list and BCBS provider phone numbers directory up to date. BCBS FEP Its indicated with letter R followed by the id number. endstream endobj startxref Prior Authorization Health insurance can be complicatedespecially when it comes to prior authorization (also referred to as pre-approval, pre-authorization and pre-certification). Do not create one or use the BCBS prefix from another member ID card. Medicaid It allows you to quickly and easily identify your insurance home plan, saving you time and hassle. 0t9~pE_ >if}~t~iM 'yn8Pgi |hxQD_Y. . 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 document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Xceed Billing Solutions is amedical billing company for outsourcing medical billing services. Member identification numbers beginning with R belong to Federal Employee Program (FEP) and will not have a three-character prefix when filing. 1 of 7. First, it saves you time and hassle by allowing you to quickly identify correct BCBS insurance home plan without having to call customer service. 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. 389 0 obj <>/Encrypt 366 0 R/Filter/FlateDecode/ID[<8909369792D16D43815F0147FF33489A><8FFDC42F54ADC847B845BC8E43A10252>]/Index[365 40]/Info 364 0 R/Length 117/Prev 191516/Root 367 0 R/Size 405/Type/XRef/W[1 3 1]>>stream %%EOF a'm %PDF-1.6 % Its important to remember that benefit plans differ in their benefits, and details such as prior authorization requirements are subject to change. 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. Final Remarks about BCBS Prefix Lookup Directory. 2021, for some of our commercial non-HMO members, such as those listed below: - PPO - Blue Choice Preferred PPO(SM) - Blue Choice PPO(SM) - Blue Options(SM)/Blue Choice Options(SM) - Blue High Performance Network(SM) [Blue HPN(SM)] This is not an exhaustive listing of all codes. We update BCBS prefix list data on daily basis to provide latest BCBS prefix home plan information. Hi, Im Kim Keck! Suite S . Final Instructions about BCBS Prefix Lookup, United Healthcare Claims Address Information. Box 7930 Philadelphia, PA 19101-7930 What is Medical Billing and Medical Billing process steps in USA? You may also be interested to read about denial code 27 reason and solutions. These BCBS prefix may include alpha and numerical characters. American Health Group (AHG) Call 1-800-847-7605 . I have completed my Bachelor of Business Administration in Healthcare Management from University of Texas. ?} AN AZBlue - Blue Cross Blue Shield of Arizona - Health Insurance Plans A healthier Arizona is what we're all about. Codes may chan ge, and this list may be updated throughout the year. 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 . Member ID cards with no prefix Some member ID cards may not have a prefix. One option is Adobe Reader which has a built-in reader. 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. The site may also contain non-Medicare related information. External link You are leaving this website/app (site). Does policy number same as member ID number? %PDF-1.6 % Customer Service: 1-800-409-9462 HCSC-PORT. If you have any questions or need help submitting a prior authorization, please call 816-395-3989 for assistance. View Medicare information Radiology utilization for Arkansas Blue Cross FEP Secondly, it ensures that you have the most up-to-date information about each and every BCBS prefix home plan because we update the BCBS prefix list on daily basis. BCBS Alpha Numeric prefix are three characters at the start of each BCBS insurance member ID. bcbs prefix list PDF,Doc ,Images [PDF] Common Prefix Portal List PBC Premera Blue Cross Three Character Prefixes. for medical policies and prior authorization requests. 'MNiXG]dRBC; 0'Va~9&c}Ag$Pge;\UY,$MtN 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. eah xp`}L s1zIq%A9Zc~(Iz~HQu;AT#2$ Wp`Hlpp6NQIV0hg`,g H20[20* ": 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. In the District of Columbia and . Contact us to learn how we can improve your revenue cycle. Blue Shield (BS) of California. Baltimore, MD 21237 . 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 Have a look at our BCBS alpha prefix and BCBS alpha numeric prefix directory below. First Character P is symbolizing that member plan/product type is BCBS PPO. Three-Character Prefixes. 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: Save my name, email, and website in this browser for the next time I comment. Medicare Working or retired, we'll help you every step of the way to find the right plan. BCBS Alpha prefix are the three characters at the start of each BCBS insurance member ID. b(f{YH^tn}u62\}TgT>ENWJB=J #=a$oXIq(n,tU+D'j}L(t#,w?!^oZUQR, 7a. These BCBS prefix may include alpha and numerical characters. Blue Cross Select Silver. Also, these BCBS prefixes helps providers and medical billers to reach the correct claims department for claims and benefits inquiry. NBT . 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 ", 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). 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) . %%EOF Prefix UTS assigned to University of Texas. What is the difference between BCBS alpha prefix and BCBS alpha numeric prefix? therapy) How To Identify Blue Cross Blue Shield Member? Always use the BCBS prefix on the members current ID card followed by the member id number. 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). 800-676-2583. BCBS Alpha Numeric Prefix - It's a three letter Alpha numeric prefix followed by id number. For example: ABC12345678 Here " ABC" is BCBS alpha prefix. You may also want to know: United Healthcare Claims Address Information. Always make sure to submit claims to insurance company on time to avoid timely filing denial. BCBS member ID have maximum 17 characters but most of the member IDs have 12 characters. Search for doctors near you and in your network. Group Name. PAH. Make sure to make copies of the front and back of member ID card. Please DO NOT randomly select a three-character prefix. Check any internal documents you may have and update any references of "alpha prefix" to "prefix". Call 1-800-388-3193 . One option is Adobe Reader which has a built-in reader. Commercial Prior Authorization Summary and Code Lists 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. Note: BCBS FEP (Federal Employee Program) ID starts with the alphabet R follow by the insured ID number (For Example: R987654321). What is a member ID prefix? q8-_?UT"X e+1?#7DMKHY]?R,-e;PE\mL These plans provide health insurance coverage for railroad employees, retirees, and their eligible dependents. %{!]/Ox^ A[BXe S#(Df 365 0 obj <> endobj BCBS Prefix will not only have numbers and the digits 0 and 1. ;MTK BCBS is one of the largest medical insurance company by total members of more than 45 million. BCBS Alpha Prefix List Box 805107, Chicago, Illinois 60680-4112. Right after completing my degree in 2011, I started my job career as an Accounts Receivable in a medical billing company. A follow-up article with additional information on transition of member care was posted Dec. 4, 2020. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. An incorrect or missing three-character prefix may cause possible delays in the processing of your claims. This new site may be offered by a vendor or an independent third party. (Note: For changes to come later this year, refer to this notice, posted Dec. 31, 2020: New Prior Authorization Requirements for Advocate Aurora Health Members Will Take Effect April 1, 2021.). There are two types of BCBS prefixes which are mentioned below: Plan Specific prefix are assigned by BCBS to each plan. 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. Yes, Policy number same as member ID number and also known as subscriber ID number. There are several benefits of using our BCBS Prefix Lookup tool. In case, you need any additional information related to BCBS prefix then feel free to reach out to us. 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 In some case provider or billing company may file the claim to an incorrect address without checking the correct BCBS address. 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 notice also refers to a medical policy for more information to help clarify when and how prior authorization requirements may apply. Please look for instructions or a phone number on the back of the member ID card. BCBS prefix lookup directory is a valuable resource for anyone who is looking for right Blue Cross Blue Shield home plan. The site may also contain non-Medicare related information. This indicates that the claims are excluded from the BlueCard Program. Due to the exceeding number of BCBS insurance members, Alpha-Only Prefix member IDs exhausted. 0 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. 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. You can also contact us for specialty medical billing services. The policy number is usually provided to the policyholder, who is the individual or entity that holds the insurance policy. 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. We make sure to update the information on daily basis, however, if you find some kind of inaccurate information, feel free to contact us. 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. 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 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. 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. For Example: ABC, AQT, TXX, TEA, A2B, 2AB, 2A2, PAS, ZGP, XXU etc. BCBSIL makes no endorsement, representations or warranties regarding any products or services provided by third party vendors such as eviCore, AIM or Availity. 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. 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. If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly. %PDF-1.6 % PPO 837P Prefixes are also applicable, . To identify correct department, they use 3 characters Prefix in the BCBS members plan ID. Does BCBS policy number same as BCBS member ID number? BCBS Alpha Numeric Prefix Its a three letter Alpha numeric prefix followed by id number. The policy number is a unique identifier which may cover multiple members under the same policy, such as a family or a group.
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