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. Learn about the many ways we are contributing to the well-being of our local Illinois communities in the latest Corporate Social Responsibility Report. Note: Checking eligibility and benefits is key, butwe also have other resources to help you prepare. BCBS FEP Prefix - BCBS Federal Employee Program is identified by the letter "R" followed by the number. . PUJyf\P )} 9\7R8lSJ|y:mYY p!+uUxSACJQ;,#3X_xR We are also the largest provider of health benefits in Illinois, serving more than 8.1 million members in all 102 counties across the state. 7 0 obj 800-676-2583. ]c\RbKSTQ C''Q6.6QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ 0*" Step 1 Confirm if Prior Authorization is Required. <> Blue Cross serves over 110 million members across the country, including Washington, DC and Puerto Rico. To view this file, you may need to install a PDF reader program. Claims that are submitted after . <> 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. stream T2*uug)T%D._M/5WIdB;zg@W01>X_b( vkWXth$OYD8x$Ygt{" BB> For example: A2A12345678. 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. endobj One option is Adobe Reader which has a built-in reader. There are several benefits of using our BCBS Prefix Lookup tool. Health Care DeliveryPolicy and Procedures, Blue Cross Community Health Plans ProviderManual, Medicaid Provider Orientation(Professional), Medicaid Prior Authorization RequestForm, Medicaid Provider Orientation (Professional), Blue Cross Community OptionsSMBehavioral Health Benefit Grid. Born in Texas, USA. The alpha prefix is always three letters followed by the member's ID number which can be from 6 up to 14 characters total. 9 0 obj 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. In addition, some sites may require you to agree to their terms of use and privacy policy. Learn more. In certain situations, the baggage gets lost or goes on delaying for the baggage from the airport by claiming to the insurance company and policies for losing the baggage. BCBS prefix lookup directory is a valuable resource for anyone who is looking for right Blue Cross Blue Shield home plan. The main benefits of having insurance plans and coverages are not only getting monotonous services but also enjoying the perfect scheduling of other facilities, i.e., international travel and coverages. In this way, the BCBS holds on compensating the costs and indulges with the maximum support of the customers. Note: BCBS FEP (Federal Employee Program) ID starts with the alphabet R follow by the insured ID number (For Example: R987654321). BCBS is the biggest private insurance company in the United States after federal insurance and there are hundreds of BCBS plans according to state and geographical areas. } !1AQa"q2#BR$3br LAB. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. For example, baggage and other items will get lost if you fall sick before or during the trip. Blue cross blue shield itself is a federation of 35 separate health insurance in the United States. The first two alphabets of the prefix denote the plan and the third alphabet prefix denotes the type of product the insured choose for coverage. The following prefix list comes with filling up the health care claims and analyses the correct address of the BSCs sections. The site may also contain non-Medicare related information. Regardless of any prior authorization or benefit determination, the final decision regarding any treatment or service is between the patient and the health care provider. New to Blue Access for 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. Language Assistance (opens in a new window) and Non-Discrimination Notice . Renew Illinois Individual, Family & Medicaid Health Insurance, Blue Cross Community MMAI (Medicare-Medicaid Plan), Making Your Health Insurance Work For You, Prescription Drug Changes and Pharmacy Information, Machine Readable Files for Transparency in Coverage, Learn About Colon Cancer Screening Options. endobj It covers the plans and analyses the services with the complete access of the employees. _( ~ G+[~:d#y8J5)-*]4hLFk-P3sI77O. Lets dig into it! Anthem Blue-Cross Blue-Shield of Ohio. Blue Cross Blue Shield companies provide a best-in-class, comprehensive suite of international products and services for people who live, work and travel internationally, giving them confidence that quality care can be accessed wherever and . Returning Shopper? However it has several policies for its customers. If possible, make copies of the member's ID card (front and . Today you will find The BCBS Alpha Prefix List from UAA to UZZ. You may also be interested to read about denial code 27 reason and solutions. giV7Lxp^^YM(_{27e;//3_`|eC9EliUDD.3fJ0]6DT{,dMZRPRWN2C7?HL4fvy|\b%^SKwIOh)xo${A%t7A3_h}AL IPA Guidelines for Member Complaints, Inquiries, Appeals and Grievances Procedure. BCBS Prefix List 2021 - Alpha. By doing it may cause delay in processing or handling the claim. And to manage such a big network, they divided it into different departments state wise or employer specific. 5 0 obj What If BCBS Member ID doesnt have Prefix mentioned on Card? !(!0*21/*.-4;K@48G9-.BYBGNPTUT3? 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). In some case provider or billing company may file the claim to an incorrect address without checking the correct BCBS address. 8 0 obj endobj Here " ABC" is BCBS alpha prefix. The site may also contain non-Medicare related information. x\moFn"pI \Mc7 t,\GizffwN(LP4Kuda)\rxD870x(c%BE6q\4i5 #orUcA"QLoHCfG*QRx(aI*uS(IFf,3D*RY3dyGB{Zt|g&Dq~? We and our partners use cookies to Store and/or access information on a device. We and our partners use data for Personalised ads and content, ad and content measurement, audience insights and product development. Check Claims Claim Explanation Codes Request a Claim Adjustment View Fee Schedules . All claims must be submitted to Blue Cross Blue Shield. 4/1/2022. The Blue Cross helps to deal with the coverage of finding out medical costs and other emergencies. To viewrequirements summaries andprocedure code lists, refer to theSupport Materials (Commercial)andSupport Materials (Government Programs)pages. As you transition to Medicare, we hope you'll Stay with Blue and get Medicare coverage from a company you trust. Here " A2A" is BCBS alpha numeric prefix. 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. One option is Adobe Reader which has a built-in reader. Prior authorization isrequiredfor some members/services/drugsbefore services are rendered to confirm medical necessity as defined by the members health benefit plan. XCE. Blue Cross Blue Shield Federal Phone Number. Michigan. Calls will be returned the next . In that situation, health insurance makes the right baggage and passport coverage decisions. BCBS prefix is a three character prefixes followed by the id number except for the following products and programs. Does blue cross blue shield cover shingles vaccine? For more than 85 years, weve provided our members with comprehensive, affordable health plans, making Illinois a healthier place to live, work and play. <> BCBS prefix list EAA-EZZ. A Google Certified Publishing Partner. 2/1/2023. Correct BCBS home plan can easily be identified using our BCBS prefix lookup directory. Have a look at our BCBS alpha prefix and BCBS alpha numeric prefix directory below. One option is Adobe Reader which has a built-in reader. Our trusted community experts can give you the one-on-one help you need to shop for health insurance. 17 0 obj We are also the largest provider of health benefits in Illinois, serving more than 8.1 million members in all 102 counties across the state. from the date of service. Curious to know what are national Accounts? endobj Create an account. Most PDF readers are a free download. Search your plan's drug list, find a pharmacy, and more. Here we have listed down all the Blue Cross Shield Prefix along with BCBS home plan name and website for BCBS member IDs ranging from W2A to W9Z. To identify correct department, they use 3 characters Prefix in the BCBS members plan ID. This new site may be offered by a vendor or an independent third party. So, to accomplish our goal, we have listed down the complete BCBS alpha prefix list so that you can easily identify correct BCBS plan. These prefixes may include alpha and numerical characters. A prior authorization isnota guarantee of benefits or payment. The prefixes identify the member's BCBS prefix list plan or national account and become essential when routing claims for processing. Independence Blue Cross (BC) of Philadelphia (Phi) and the Southeastern Pennsylvania (PA) ZAB. Amerihealth Caritas Directory Healthcare, Health Insurance in United States of America, Place of Service Codes List Medical Billing. Step-by-Step Guide for Provider Finder . endobj If the provider or member doesnt get prior authorization for out-of-network services, the claim may be denied. 2021 Commercial Specialty Pharmacy Prior Authorization Drug List This list was updated with 14 new codes effective Jan. 1, 2021. Livestock Protection. From April 1 to September 30, on weekends and holidays you may be required to leave a message. BCBS Prefix will not only have numbers and the digits 0 and 1. First Character P is symbolizing that member plan/product type is BCBS PPO. You can also contact us for specialty medical billing services. In the USA, the BCBS is a very well-known health insurance statement that conveys more association and deals with numerous activities. Prior authorization requests for our Blue Cross Medicare Advantage (PPO)SM(MA PPO), Blue Cross Community Health PlansSM(BCCHPSM) and Blue Cross Community MMAI (Medicare-Medicaid Plan)SMmembers can be submitted to eviCore in two ways. I Don't Have My Member ID Card. In addition, some sites may require you to agree to their terms of use and privacy policy. Topics include everything from improving your well-being to explaining health coverage. Alpha Prefix means plan id starts with three alphabets like ABC, XYZ, etc. Sample BCBS prefix list. The insurance company also provides facilities for the senior citizens and claims to give the best facilities for them and get them admitted to the nearest hospital. Blue-Cross Blue-Shield of Illinois. BCBS Prefix List EAA-EZZ (2023) November 3, 2020 by medicalbillingrcm. 7aM- I|x,# The blue cross blue shield coverage deals with the best services for its customers and involves a better statement of the medical treatments. For accurate and quick claims processing, it is necessary to get complete patient insurance information. 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. Today you will find The BCBS Alpha Prefix List from SAA to SZZ. BCBS Insurance mainly focuses on medical treatments and providing maximum support for the financial condition. It helps to cover up the flights or any delays. As noted above, when you check eligibility and benefits, in addition to confirming if prior authorization is required, youll also be directed to the appropriate vendor, if applicable. Prefixes are also used to identify and correctly route claims to the appropriate Blue Cross Blue Shield [] There is a total of 732 alpha prefixes in the BCBS EAA-EZZ list and 39 are Not Assigned prefixes out of 732. Click on a section title to view the content. MedicalBillingRCM.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com. Tdb[+Np/1oz1_(:3^%:\tr'c!HfRY{P#~Kr>S: BCBS Alpha Prefix list is useful for both providers and BCBS enrolled members/patients. 2nd Character G Plan Specific (letter assigned to the BCBS Plan), 3rd Character P PPO Product (letter assigned by the BCBS Plan to identify product type elected by the member). We have a track record of providing quality medical billing services to multiple healthcare organizations and specialty providers across USA. $TbYmVcI^ONr#H2.G uG!`;4%x$;L[| BCBSIL contracts with Prime to provide pharmacy benefit management and other related services. You may also want to know: United Healthcare Claims Address Information. Some requests are handled by BCBSIL; others are handled by utilization management vendors. BCBS is one of the biggest insurance companies in USA and serving more than 106 million people. The following travel insurance helps to deal with all the medical costs and also covers the family expenses. 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. Correct BCBS home plan can easily be identified using our BCBS prefix lookup directory. Also its not a sequential order hence its hard to find unless we check with first 3 alpha prefix. <> Learn more about timely filing limits and CO 29 Denial Code. If you donotget prior approval via the prior authorization process for services and drugs on our prior authorization lists: When and how should prior authorization requests be submitted? endstream endobj The 34 independent BCBS companies insure more than 107 million members across all 50 states, the District of Columbia, and Puerto Rico. BCBS Alpha prefix lookup contains all the Blue Cross Blue Shield alpha prefix along with their home plan and website. 13 0 obj State Lookup. 2/1/2023. The terms of the members plan control the available benefits. <> <> Ans. We make sure to share latest data but in case you find some misinformation, please let us know so that we can help you to provide most accurate BCBS Alpha Numeric Prefix list. The Home and Host plan is also working in the Blue Cross Blue Shield plan. !D)v&GVr`&dq:1+{maO1DmP[ +|zUma-lT *5+J&E k$T46Bt^:+~/ES" These documents are located inhttp://www.hisccompliance.com. Does policy number same as member ID number? Admin 22. For Example: XYZ123456789. %&'()*456789:CDEFGHIJSTUVWXYZcdefghijstuvwxyz Blue Cross Blue Shield insurance Companies - Statewise. BCBS of Arkansas Blue Advantage Administrators. 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. Get all the coverage of Original Medicare plus prescription drugs and extra benefits, with plan premiums as low as $0/month. They always offer packages within the amounts mentioned. F1Xkt~ n_]}M,h>@iB;jVhX8M5%s9A}SHB+;zwOUR*7Y@"Z/j[xW[,5ygwxxe7cjgj;=d sXT >oTL{ $(5V7Ev-BNlJaZw7F^Uv >U$+o\!je mR[D-h?jkC: .cJ]QC,1p 9ArnWP) v5s]M*I'vv 4 0 obj It shows that these type of BCBS member IDs are different. There are two types of BCBS prefixes which are mentioned below: Plan Specific prefix are assigned by BCBS to each plan. Prior authorization requests for our Blue Cross Medicare Advantage (PPO) SM (MA PPO), Blue Cross Community Health Plans SM (BCCHP SM) and Blue Cross Community MMAI (Medicare-Medicaid Plan) SM members can be submitted to eviCore in two ways. BCBS member ID have maximum 17 characters but most of the member IDs have 12 characters. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. Make sure to make copies of the front and back of member ID card. Most PDF readers are a free download. endobj It also goes on dealing with the student plan. The prefix acts as a key element in confirming the members' eligibility and coverage information. LAA. This new site may be offered by a vendor or an independent third party. Prime Therapeutics LLC (Prime) is a pharmacy benefit management company. Find a BCBS Company by Prefix. The Blue cross blue shield company mainly provides proper health insurance coverages. We update BCBS prefix data on daily basis to provide latest BCBS prefix information. One of the biggest issues in todays generation is where medical treatments and conditions lie. Here I have shared the list of BCBS alpha prefix ranging from BAA to BZZ. The programs main benefit is that it allows one to receive and understand the health care benefits. Also, these BCBS prefixes helps providers and medical billers to reach the correct claims department for claims and benefits inquiry. If you are using electronic submission then prefix is important to submit claims successfully and received by insurance correctly. We cant decide Blue cross Blue shield members state just by looking first alpha prefix. In that case claim may be denied as Submit the claim to the correct address / Member ID not found. These blue shield companies negotiate with the doctors and the other hospitals.