404 0 obj <>stream PDF Network Prefix List - CareFirst Provider Address: 11070 Katy Fwy, Houston, TX 77043, 2023 Xceed Billing Solution.com - All Rights Reserved, Blue Cross Blue Shield BCBS Prefix List Lookup. %PDF-1.6 % 365 0 obj <> endobj PDF 2022 Commercial PA Code Lists December Updates - BCBSIL %PDF-1.6 % 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. It means that BCBS members IDs prefixes will must have alphabets. BCBS Prefix will not only have numbers and the digits 0 and 1. Prior-Authorization And Pre-Authorization | Anthem.com BCBS alpha numeric prefix contains alphabets as well as digits ranging from 1 to 9. "Y24Oz>V ?I L r%dl=vHd z/;/X #k> Gq 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. Most Blue Cross Blue Shield (BCBS) member IDs begin with a three-character prefix. PDF Independence Blue Cross Quick Reference Guide - Magellan Provider PDF Provider Quick Reference Guide - CareFirst To get information about such member IDs, you can contact BCBS prefix directory phone number i.e. 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. The site may also contain non-Medicare related information. q8-_?UT"X e+1?#7DMKHY]?R,-e;PE\mL NBT . Check any internal documents you may have and update any references of "alpha prefix" to "prefix". 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 Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. 0t9~pE_ >if}~t~iM 'yn8Pgi |hxQD_Y. We recently received a query from a provider that how I can identify that patient is BCBS health insurance member. ", 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). 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 BCBS Prefix will not only have numbers and the . Medicaid It is used to identify and track the healthcare coverage and benefits for that specific member. 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 . We make sure to update the information on daily basis, however, if you find some kind of inaccurate information, feel free to contact us. In that case claim may be denied as Submit the claim to the correct address / Member ID not found. 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. 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. Second Character G assigned to the BCBS Plan as well. The policy number is a unique identifier which may cover multiple members under the same policy, such as a family or a group. 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. What is Medical Billing and Medical Billing process steps in USA? BCBS member ID have maximum 17 characters but most of the member IDs have 12 characters. 800-676-2583. Account Specific Prefix are assigned by BCBS to national accounts. hbbd```b``A$ 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. BCBS prefix lookup directory is a valuable resource for anyone who is looking for right Blue Cross Blue Shield home plan. This indicates that the claims are excluded from the BlueCard Program. 15363 0 obj <> endobj 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. Does policy number same as member ID number? If you have any questions, call the number on the members ID card. One option is Adobe Reader which has a built-in reader. =&m$ z90P&\:?$IRIj"c5l\"aD(@?Yuk>{8lkelu3X*FpT=6Rv;9'*4O-o|ELLG?-Yec,cqh(e96e4^QyD8H}'o(3 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. 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. Coverage For: Individual + Family. BCBS Alpha Numeric Prefix - It's a three letter Alpha numeric prefix followed by id number. T. he Summary of Benefits and Coverage (SBC) document will help you choose a health. 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. 1 of 7. Always make sure to submit claims to insurance company on time to avoid timely filing denial. BCBS of Illinois (IL) PAK. The prefix may also route claim status inquiries and remit searches. We update BCBS prefix list data on daily basis to provide latest BCBS prefix home plan information. We have a track record of providing quality medical billing services to multiple healthcare organizations and specialty providers across USA. (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. This new site may be offered by a vendor or an independent third party. K8Z : Page 2 . 0 Final Instructions about BCBS Prefix Lookup, United Healthcare Claims Address Information. Why does BCBSAZ update member accounts and . What is the difference between BCBS alpha prefix and BCBS alpha numeric prefix? BlueCard Program Alpha Prefixes | Blue Cross and Blue Shield - BCBSTX 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. BCBS Alpha Numeric prefix are three characters at the start of each BCBS insurance member ID. I have completed my Bachelor of Business Administration in Healthcare Management from University of Texas. So, to accomplish our goal, we have listed down the complete BCBS alpha prefix list so that you can easily identify correct BCBS plan. What is a member ID prefix? PDF Updated November 2021 - BCBSIL PAH. So the next time you need to identify accurate BCBS prefix home plan, remember to use the BCBS prefix list lookup finder. 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. Note: BCBS FEP (Federal Employee Program) ID starts with the alphabet R follow by the insured ID number (For Example: R987654321). Box 805107, Chicago, Illinois 60680-4112. BCBS FEP Its indicated with letter R followed by the id number. 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. 01/01/2021 . 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. Individuals & Families We offer a wide choice of individual plans to fit your health needs and budget. How To Identify Blue Cross Blue Shield Member? For Example: ABC, AQT, TXX, TEA, A2B, 2AB, 2A2, PAS, ZGP, XXU etc. 0|kEMi_a*-Yfj#uqEcA/6 .M.6YNw4cyo>lESMC\)H~L 1B> BCBS Alpha prefix lookup contains all the Blue Cross Blue Shield alpha prefix along with their home plan and website. PDF Traditional Coverage - BCBSIL A follow-up article with additional information on transition of member care was posted Dec. 4, 2020. Suite S . These plans provide health insurance coverage for railroad employees, retirees, and their eligible dependents. The first two characters of such BCBS prefix spots member plan and the third character is to identify the type of product in which the BCBS member is enrolled. 777 0 obj <>stream What If BCBS Member ID doesnt have Prefix mentioned on Card? Blue Cross and Blue Shield of Illinois, P.O. Commercial Prior Authorization Summary and Code Lists PDF 2021 Commercial Prior Authorization Requirements Summary 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. Here Letter R indicates BCBS FEP prefix. hbbd``b`f3$ bE FM Dmb"@ $$@z$u ad#B cG BCBS Alpha Prefix List from PAA to PZZ Updated 2023 These prefixes may include alpha and numerical characters. 0 Last updated: 07/01/2022. eviCore healthcare (eviCore) is an independent specialty medical benefits management company that provides utilization management services for BCBSIL. Stand-alone dental products, vision and pharmacy when delivered through an intermediary model. Normally, account specific prefix associates to the employer group name. This new site may be offered by a vendor or an independent third party. PDF BCBSAZ/TPA Co-Administered Group Plans - AZBlue Lets dig into it! 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 prefix is a three character prefixes followed by the id number except for the following products and programs. We have the right plan for you to keep you and your family covered. Learn more about timely filing limits and CO 29 Denial Code. a'm 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. 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. To identify the plan that holds the members benefits, please call the Out-of-State Blues Plan Subscriber #: 1-800-676-BLUE (2583). Coverage Period: 01/01/2021 - 12/31/2021 . The three-character prefixes listed do not represent an exhaustive listing of prefixes. BCBS Prefix will not only have numbers and the digits 0 and 1. 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 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. endstream endobj startxref You can also contact us for specialty medical billing services. BCBS Alpha prefix are the three characters at the start of each BCBS insurance member ID. BCBS Alpha Numeric Prefix Its a three letter Alpha numeric prefix followed by id number. 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. Also, these BCBS prefixes helps providers and medical billers to reach the correct claims department for claims and benefits inquiry. Box 14114 Lexington, KY 40512 Federal Employee Program (FEP) R prefix DC/Metropolitan Area 2024884900 MD 8008545256 DC/Metropolitan Area Mail Administrator P.O . For accurate and quick claims processing, it is necessary to get complete patient insurance information. No, the BCBS policy number is not typically the same as the BCBS member ID number. 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 8772287268 Mail Administrator P.O. 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. K8Y . 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 Codes may chan ge, and this list may be updated throughout the year. Member ID cards with no prefix Some member ID cards may not have a prefix. PDF CSS-E121 Blue Cross Select Silver 01012021 - bcbsal.org AIM Specialty Health (AIM) is an independent company that has contracted with BCBSIL to provide utilization management services for members with coverage through BCBSIL. Box 7930 Philadelphia, PA 19101-7930 . To view this file, you may need to install a PDF reader program. 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. Plan Type: PPO . Do not create one or use the BCBS prefix from another member ID card. To identify correct department, they use 3 characters Prefix in the BCBS members plan ID. The policy number is usually provided to the policyholder, who is the individual or entity that holds the insurance policy. PDF Blue Cross and BCN utilization management medical drug list - BCBSM For Example: XYZ123456789. %{!]/Ox^ A[BXe S#(Df Prefix Group Address Group Name TPA Name & Address Claims Filing Claims & Benefit Contact Name Phone . 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. Prior Authorization List for Blue Shield Effective April 1, 2023 Customer Service: 1-800-409-9462 HCSC-PORT. BCBS is one of the largest medical insurance company by total members of more than 45 million. PREFIXES . There are three variants; a typed, drawn or uploaded signature. These BCBS prefix may include alpha and numerical characters. endstream endobj 1230 0 obj <. 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: 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;$~gn-Sd"mjdTY2R*I:w8w3;fpCfQH& bcbs prefix list PDF,Doc ,Images [PDF] Common Prefix Portal List PBC Premera Blue Cross Three Character Prefixes. The most important and easy way to identify BCBS member is his BCBS member ID alpha prefix. New BCBS Alpha Numeric Prefixes | My Payer Directory American Health Group (AHG) Call 1-800-847-7605 . For Federal Employee Program (FEP) precertification requirements, please see the separate FEP precertification list. %%EOF 0 Secondly, it ensures that you have the most up-to-date information about each and every BCBS prefix home plan because we update the BCBS prefix list on daily basis. For providers and medical billers who are performing medical billing services, BCBS alpha prefix are helpful to identify the correct payer ID and address for claims submission. First Character Z assigned to the BCBS Plan. In addition, some sites may require you to agree to their terms of use and privacy policy. 'MNiXG]dRBC; 0'Va~9&c}Ag$Pge;\UY,$MtN Final Remarks about BCBS Prefix Lookup Directory. Correct BCBS home plan can easily be identified using our BCBS prefix lookup directory. BCBS Prefix List Lookup 2023 - Latest Blue Cross Blue Shield Directory by calling 1-844-377-1278 (BCN) or 1-800-728-8008 (Blue Cross) or by logging oncology and in to the AIM ProviderPortal. Enter a location and search by doctor or hospital name, health condition, or specialty. Independence Blue Cross* Quick Reference Guide . b(f{YH^tn}u62\}TgT>ENWJB=J #=a$oXIq(n,tU+D'j}L(t#,w?!^oZUQR, 7a. These BCBS prefix may include alpha and numerical characters. Call 1-800-388-3193 . 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. Note: Current three-character, alpha-only prefixes will not be affected by this change. Prior Authorization Health insurance can be complicatedespecially when it comes to prior authorization (also referred to as pre-approval, pre-authorization and pre-certification). The three-character prefix identifies the Blue Cross and Blue Shield Plan to which the member belongs. The prior authorization information in this notice does not apply to requests for HMO members. endstream endobj startxref nKvo2>)*Y=}4i,+s[yL*2#kN@r115};|`R[5/iZ for medical policies and prior authorization requests. hbbd```b``"`r9LLN`DR,>6l30&U$60D2HO rH+H f`bdV8J Prefix UTS assigned to University of Texas. BCBS Alpha Prefix list is useful for both providers and BCBS enrolled members/patients. BCBSIL makes no endorsement, representations or warranties regarding any products or services provided by third party vendors such as eviCore, AIM or Availity. Few times, BCBS plan members doesnt have prefix mentioned on their BCBS Insurance card. Prior authorization requirements are specific to each patients policy type and the procedure(s) being rendered. The purpose of this list is to assist WA and AK providers to determine plan [PDF] CareFirst Third Party Administrator (TPA)/Network Lease Accounts Prefix. Medicare Working or retired, we'll help you every step of the way to find the right plan. Identifying BlueCard members - Regence Due to the exceeding number of BCBS insurance members, Alpha-Only Prefix member IDs exhausted. 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. Search for doctors near you and in your network. PDF 2021 Three Character Prefix
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