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. Lo-+J52(h' In the District of Columbia and . %PDF-1.6 % No, the BCBS policy number is not typically the same as the BCBS member ID number. It clarifies a utilization management vendor change for specific members. BCBS Alpha Prefix List Availity provides administrative services to BCBSIL. These prefixes may include alpha and numerical characters. To get information about such member IDs, you can contact BCBS prefix directory phone number i.e. ?} AN Most Blue Cross Blue Shield (BCBS) member IDs begin with a three-character prefix. Here are links to some recent communications that were posted to notify you of important changes: Government Programs Prior Authorization Summary and Code Lists To identify correct blue cross blue shield department, they use three characters BCBS prefix in the start of each BCBS member plan ID. BCBS Alpha Prefix List from PAA to PZZ Updated 2023 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. For 2021, there were no changes to overall care categories, but some of the codes within certain categories may have been updated. $=0j]xkM#[f4YgI|in Z(0zF1-9gk!D @WeUUn/R%$'c|J6:z}\}8ZNd+SL5-h"\wE$w{3\zO>,Vta$a`D7rHmr$bwZm7yYO)&^E<2@9#&UDOz 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. hb``` eaXm.; `Umap@LDPpN jM*,BDu|m_(2*u x y-a`b` #; "Y24Oz>V ?I L r%dl=vHd z/;/X #k> Gq BCBS Alpha prefix lookup contains all the Blue Cross Blue Shield alpha prefix along with their home plan and website. 800-676-2583. You may see cards with four-character prefixes, e.g., HMSA Blue Cross Blue Shield of Hawaii uses four-character prefixes. PAGE : Amkor Technology, Inc. Group # 039176 : AmeriBen . %%EOF What is Medical Billing and Medical Billing process steps in USA? T. he Summary of Benefits and Coverage (SBC) document will help you choose a health. Working or retired, we'll help you every step of the way to find the right plan. 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. BlueCard Program Alpha Prefixes | Blue Cross and Blue Shield - BCBSTX American Health Group (AHG) Call 1-800-847-7605 . 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. Prefix Group Address Group Name TPA Name & Address Claims Filing Claims & Benefit Contact Name Phone . BCBS Prefix will not only have numbers and the . For Example: ABC, AQT, TXX, TEA, A2B, 2AB, 2A2, PAS, ZGP, XXU etc. bcbs prefix list PDF,Doc ,Images - pdfprof.com Make sure to make copies of the front and back of member ID card. Prefix UTS assigned to University of Texas. If you have any questions, call the number on the members ID card. 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. Blue Cross Select Silver. 0|kEMi_a*-Yfj#uqEcA/6 .M.6YNw4cyo>lESMC\)H~L 1B> Plan Type: PPO . BCBSIL makes no endorsement, representations or warranties regarding any products or services provided by third party vendors such as eviCore, AIM or Availity. 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. Correct BCBS home plan can easily be identified using our BCBS prefix lookup directory. 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 These plans provide health insurance coverage for railroad employees, retirees, and their eligible dependents. In case, you need any additional information related to BCBS prefix then feel free to reach out to us. PDF CSS-E121 Blue Cross Select Silver 01012021 - bcbsal.org Stand-alone dental products, vision and pharmacy when delivered through an intermediary model. Choose My Signature. BCBS member ID have maximum 17 characters but most of the member IDs have 12 characters. 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. Contact us to learn how we can improve your revenue cycle. We update BCBS prefix list data on daily basis to provide latest BCBS prefix home plan information. BCBS is one of the biggest insurance companies in USA and serving more than 106 million people. For Example: XYZ123456789. This article offers an overview of 2021 prior authorization support materials and related communications that may apply for some of our non-HMO commercial and government programs members, effective Jan. 1, 2021. =&m$ z90P&\:?$IRIj"c5l\"aD(@?Yuk>{8lkelu3X*FpT=6Rv;9'*4O-o|ELLG?-Yec,cqh(e96e4^QyD8H}'o(3 PDF Blue Cross and Blue Shield of Minnesota and Blue Plus Commercial Prior A2Z, G2A, J4K etc. 15363 0 obj <> endobj Check any internal documents you may have and update any references of "alpha prefix" to "prefix". PDF BCBSAZ/TPA Co-Administered Group Plans - AZBlue ;MTK BCBS Alpha prefix are the three characters at the start of each BCBS insurance member ID. Does policy number same as member ID number? 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 prefixes listed do not represent an exhaustive listing of prefixes. Carefirst BCBS of Maryland the (MD), District of Columbia (DC) and the Northern Virginia (VA) BCBS Prefix List AAA to AZZ - Alpha Lookup by State 2022 CareFirst IDs have plan codes 080/580 and 190/690. PDF Member account and prefix updates: Provider FAQs The SBC shows you how you and the plan would share t. he cost for covered health care services. PAH. BCBS Prefix will not only have numbers and the digits 0 and 1. Call 1-800-388-3193 . In that case claim may be denied as Submit the claim to the correct address / Member ID not found. For more information, contact your Network Provider Consultant or call 406-437-6100. External link You are leaving this website/app (site). 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. PREFIXES . You can also contact us for specialty medical billing services. BlueCard. There are two types of BCBS prefixes which are mentioned below: Plan Specific prefix are assigned by BCBS to each plan. In some case provider or billing company may file the claim to an incorrect address without checking the correct BCBS address. 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 . 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. 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. BCBS alpha numeric prefix digits are usually in between the prefix e.g. Identifying BlueCard members - Regence 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. 404 0 obj <>stream Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. 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& Commercial Communications Services that require precertification - IBX AZBlue - Blue Cross Blue Shield of Arizona - Health Insurance Plans Prior authorization requirements are specific to each patients policy type and the procedure(s) being rendered. Independence Blue Cross (BC) of Philadelphia (Phi) and the Southeastern Pennsylvania (PA) PAI. This indicates that the claims are excluded from the BlueCard Program. PPO 837P Prefixes are also applicable, . Box 805107, Chicago, Illinois 60680-4112. . 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. We always make sure to keep BCBS prefix list and BCBS provider phone numbers directory up to date. 0 So, all BCBS plans, including Anthem prefix and Non-Anthem plans announced that member IDs will also be Alpha Numeric from 2018 onwards. So the next time you need to identify accurate BCBS prefix home plan, remember to use the BCBS prefix list lookup finder. BCBS alpha numeric prefix contains alphabets as well as digits ranging from 1 to 9. One option is Adobe Reader which has a built-in reader. 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. Last updated: 07/01/2022. %{!]/Ox^ A[BXe S#(Df 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 Alpha Prefix list is useful for both providers and BCBS enrolled members/patients. eviCore healthcare (eviCore) is an independent specialty medical benefits management company that provides utilization management services for BCBSIL. If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly. Independence Blue Cross* Quick Reference Guide . Regence Prefix List Form - Fill Out and Sign Printable PDF Template It means that BCBS members IDs prefix will must have alphabets and they may or may not have numbers. Always use the BCBS prefix on the members current ID card followed by the member id number. 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. First Character P is symbolizing that member plan/product type is BCBS PPO. Medical providers - Arkansas Blue Cross and Blue Shield (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. Checking eligibility and/or benefit information and/or the fact that a service has been prior authorized is not a guarantee of payment. In addition, some sites may require you to agree to their terms of use and privacy policy. Decide on what kind of signature to create. 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. Normally, account specific prefix associates to the employer group name. Few times, BCBS plan members doesnt have prefix mentioned on their BCBS Insurance card. 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. 777 0 obj <>stream hbbd```b``@$Df/i #D2lE``vd@ "@,iZ R R2H{v# k To identify the plan that holds the members benefits, please call the Out-of-State Blues Plan Subscriber #: 1-800-676-BLUE (2583). BCBS prefix lookup directory is a valuable resource for anyone who is looking for right Blue Cross Blue Shield home plan. It is used to identify and track the healthcare coverage and benefits for that specific member. Three-Character Prefixes. To view this file, you may need to install a PDF reader program. BCBS Prefix List Lookup 2023 - Latest Blue Cross Blue Shield Directory I have completed my Bachelor of Business Administration in Healthcare Management from University of Texas. 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 . 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 . BCBS Prefix can be classified as follows: BCBS Alpha Prefix - It's a three letter alpha prefix followed by id number. The prefix may also route claim status inquiries and remit searches. We recently received a query from a provider that how I can identify that patient is BCBS health insurance member. PAJ. BCBS is one of the largest medical insurance company by total members of more than 45 million. Northwest Arizona Employee Benefit Trust (NAEBT) Group # 037461 . Medicare Working or retired, we'll help you every step of the way to find the right plan. %%EOF Always make sure to submit claims to insurance company on time to avoid timely filing denial. therapy) For accurate and quick claims processing, it is necessary to get complete patient insurance information. Most PDF readers are a free download. Its critical to check member eligibility and benefits through the Availity Provider Portal or your preferred vendor portal prior to every scheduled appointment. This can be especially helpful if youre in a rush or need to access your BCBS prefix home plan information quickly. Lets dig into it! BCBS of Illinois (IL) PAK. plan. Born in Texas, USA. We make sure to update the information on daily basis, however, if you find some kind of inaccurate information, feel free to contact us. There are three variants; a typed, drawn or uploaded signature. Please DO NOT randomly select a three-character prefix. 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. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Xceed Billing Solutions is amedical billing company for outsourcing medical billing services. For example: A2A12345678 Here " A2A" is BCBS alpha numeric prefix. Have a look at our BCBS alpha prefix and BCBS alpha numeric prefix directory below. Due to the exceeding number of BCBS insurance members, Alpha-Only Prefix member IDs exhausted. q8-_?UT"X e+1?#7DMKHY]?R,-e;PE\mL Individuals & Families We offer a wide choice of individual plans to fit your health needs and budget. TT$%b"Dg!h^`]-ce?i8xRiu1IrD-%oR#yt;JBOJ#"TXwD0L Fw,]xS_CU3zf]06_T} PNGCqWV^UET6X~`U AZBlue - Blue Cross Blue Shield of Arizona - Health Insurance Plans A healthier Arizona is what we're all about. In addition, some sites may require you to agree to their terms of use and privacy policy. 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. 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. 365 0 obj <> endobj These BCBS prefix may include alpha and numerical characters. The prefix routes eligibility/benefits inquiries and claims to the appropriate BCBS Plan or system for timely processing. K8Y . Final Remarks about BCBS Prefix Lookup Directory. BCBS National accounts are employer groups that have outlets/offices in multiple states but they offer limited coverage to their employees. 15456 0 obj <>stream So, to accomplish our goal, we have listed down the complete BCBS alpha prefix list so that you can easily identify correct BCBS plan. nKvo2>)*Y=}4i,+s[yL*2#kN@r115};|`R[5/iZ BCBS prefix is a three character prefixes followed by the id number except for the following products and programs. Some members ID cards may not have an alpha prefix. 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. PDF Blue Cross and BCN utilization management medical drug list - BCBSM Group Name. Its important to remember that benefit plans differ in their benefits, and details such as prior authorization requirements are subject to change.
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