bcbs prefix list 2021 pdf

Prefix Group Address Group Name TPA Name & Address Claims Filing Claims & Benefit Contact Name Phone . BCBS National accounts are employer groups that have outlets/offices in multiple states but they offer limited coverage to their employees. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. Also, these BCBS prefixes helps providers and medical billers to reach the correct claims department for claims and benefits inquiry. PDF 2021 Commercial Prior Authorization Requirements Summary The policy number is usually provided to the policyholder, who is the individual or entity that holds the insurance policy. There are three variants; a typed, drawn or uploaded signature. For Example: ABC, AQT, TXX, TEA, A2B, 2AB, 2A2, PAS, ZGP, XXU etc. First Care, Inc. are independent licensees of the Blue Cross and Blue Shield Association. 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 Always use the BCBS prefix on the members current ID card followed by the member id number. What is the difference between BCBS alpha prefix and BCBS alpha numeric prefix? These BCBS prefix may include alpha and numerical characters. 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. 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. 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. PAH. %%EOF To get information about such member IDs, you can contact BCBS prefix directory phone number i.e. BCBS FEP Its indicated with letter R followed by the id number. 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. These plans provide health insurance coverage for railroad employees, retirees, and their eligible dependents. First, it saves you time and hassle by allowing you to quickly identify correct BCBS insurance home plan without having to call customer service. Address: 11070 Katy Fwy, Houston, TX 77043, 2023 Xceed Billing Solution.com - All Rights Reserved, Blue Cross Blue Shield BCBS Prefix List Lookup. PDF Blue Cross and BCN utilization management medical drug list - BCBSM Plan Type: PPO . 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. 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. %PDF-1.6 % BCBS Railroad member IDs starts with a letter R. BCBS Alpha Numeric Prefix - It's a three letter Alpha numeric prefix followed by id number. endstream endobj startxref These prefixes may include alpha and numerical characters. Most PDF readers are a free download. %%EOF 1268 0 obj <>stream Note for Front Desk and Providers: When Blue Cross Blue Shield members comes to your facility or office, make sure to ask them for their active BCBS plan member ID card. b(f{YH^tn}u62\}TgT>ENWJB=J #=a$oXIq(n,tU+D'j}L(t#,w?!^oZUQR, 7a. Member identification numbers beginning with R belong to Federal Employee Program (FEP) and will not have a three-character prefix when filing. For 2021, there were no changes to overall care categories, but some of the codes within certain categories may have been updated. hb```I! This can be especially helpful if youre in a rush or need to access your BCBS prefix home plan information quickly. We make sure to update the information on daily basis, however, if you find some kind of inaccurate information, feel free to contact us. ", 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). 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. Prefix ZGP identifies Blue Cross Blue Shield of Texas PPO Product. BCBS Prefix can be classified as follows: BCBS Alpha Prefix - It's a three letter alpha prefix followed by id number. 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. So, to answer this query, we have mentioned below few important points to consider. hbbd```b``A$ Yes, Policy number same as member ID number and also known as subscriber ID number. By doing it may cause delay in processing or handling the claim. BlueCard Program Alpha Prefixes | Blue Cross and Blue Shield - BCBSTX Amerihealth Caritas Directory Healthcare, Health Insurance in United States of America, Place of Service Codes List Medical Billing. Here are links to some recent communications that were posted to notify you of important changes: Government Programs Prior Authorization Summary and Code Lists 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. =&m$ z90P&\:?$IRIj"c5l\"aD(@?Yuk>{8lkelu3X*FpT=6Rv;9'*4O-o|ELLG?-Yec,cqh(e96e4^QyD8H}'o(3 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. Let's start with you. The most important and easy way to identify BCBS member is his BCBS member ID alpha prefix. 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;$~gn-Sd"mjdTY2R*I:w8w3;fpCfQH& If you have any questions or need help submitting a prior authorization, please call 816-395-3989 for assistance. for medical policies and prior authorization requests . Third, it can help you make more informed decisions to choose right insurance plan and benefits. 0 hb``` eaXm.; `Umap@LDPpN jM*,BDu|m_(2*u x y-a`b` #; Some members ID cards may not have an alpha prefix. 365 0 obj <> endobj Regence Prefix List Form - Fill Out and Sign Printable PDF Template Commercial Communications 0 Complete patient information, on the other hand, allows your claims to process without delays. hbbd```b``@$Df/i #D2lE``vd@ "@,iZ R R2H{v# k It allows you to quickly and easily identify your insurance home plan, saving you time and hassle. PDF Traditional Coverage - BCBSIL Note: BCBS FEP (Federal Employee Program) ID starts with the alphabet R follow by the insured ID number (For Example: R987654321). PDF HMO Networks - Blue Cross and Blue Shield of Illinois 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). How To Identify Blue Cross Blue Shield Member? Member ID cards with no prefix Some member ID cards may not have a prefix. For example: ABC12345678 Here " ABC" is BCBS alpha prefix. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. 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. Group Name. by calling 1-844-377-1278 (BCN) or 1-800-728-8008 (Blue Cross) or by logging oncology and in to the AIM ProviderPortal. 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. 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. PDF 2022 Commercial PA Code Lists December Updates - BCBSIL 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. Have a look at our BCBS alpha prefix and BCBS alpha numeric prefix directory below. Medical providers - Arkansas Blue Cross and Blue Shield 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. 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. Note: Current three-character, alpha-only prefixes will not be affected by this change. Benefits and eligibility should be verified for all members prior to rendering services. 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: BCBS prefix is a three character prefixes followed by the id number except for the following products and programs. q8-_?UT"X e+1?#7DMKHY]?R,-e;PE\mL I have completed my Bachelor of Business Administration in Healthcare Management from University of Texas. Prior-Authorization And Pre-Authorization | Anthem.com 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. BCBS is one of the biggest insurance companies in USA and serving more than 106 million people. Also, pre-authorization information and medical policy for out of state plans may be found on the Blue Cross Blue Shield of Texas provider website section under Standards and Requirements, and then select "Medical Policy and Precertification/Preauthorization for Out of Area Members. Most PDF readers are a free download. There are two types of BCBS prefixes which are mentioned below: Plan Specific prefix are assigned by BCBS to each plan. We always make sure to keep BCBS prefix list and BCBS provider phone numbers directory up to date. Right after completing my degree in 2011, I started my job career as an Accounts Receivable in a medical billing company. %PDF-1.6 % (Note: For changes to come later this year, refer to this notice, posted Dec. 28, 2020: Commercial Prior Authorization Code Changes, Effective April 1, 2021. BCBS 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. 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. Title: Prefix UTS assigned to University of Texas. 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.

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