For Example: ABC, AQT, TXX, TEA, A2B, 2AB, 2A2, PAS, ZGP, XXU etc. $=0j]xkM#[f4YgI|in Z(0zF1-9gk!D @WeUUn/R%$'c|J6:z}\}8ZNd+SL5-h"\wE$w{3\zO>,Vta$a`D7rHmr$bwZm7yYO)&^E<2@9#&UDOz 15388 0 obj <>/Encrypt 15364 0 R/Filter/FlateDecode/ID[]/Index[15363 94]/Info 15362 0 R/Length 122/Prev 932133/Root 15365 0 R/Size 15457/Type/XRef/W[1 3 1]>>stream The three-character prefix identifies the Blue Cross and Blue Shield Plan to which the member belongs. K8Y . PDF Updated November 2021 - BCBSIL I have completed my Bachelor of Business Administration in Healthcare Management from University of Texas. Working or retired, we'll help you every step of the way to find the right plan. hbbd``b`f3$ bE FM Dmb"@ $$@z$u ad#B cG Contact us to learn how we can improve your revenue cycle. An incorrect or missing three-character prefix may cause possible delays in the processing of your claims. BCBS is one of the biggest insurance companies in USA and serving more than 106 million people. 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. PDF Traditional Coverage - BCBSIL Title: PREFIXES . Northwest Arizona Employee Benefit Trust (NAEBT) Group # 037461 . A2Z, G2A, J4K etc. Box 7930 Philadelphia, PA 19101-7930 It clarifies a utilization management vendor change for specific members. PDF BCBSAZ/TPA Co-Administered Group Plans - AZBlue BCBS Alpha Numeric prefix are three characters at the start of each BCBS insurance member ID. Few times, BCBS plan members doesnt have prefix mentioned on their BCBS Insurance card. In addition, some sites may require you to agree to their terms of use and privacy policy. 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. For accurate and quick claims processing, it is necessary to get complete patient insurance information. (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. TPA Name & Address. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. BCBS National accounts are employer groups that have outlets/offices in multiple states but they offer limited coverage to their employees. One option is Adobe Reader which has a built-in reader. Enter a location and search by doctor or hospital name, health condition, or specialty. 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. 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. Suite S . Wheelchairs - Mobility Assistive Equipment (Manual & Power) & Scooters - Wheelchair Purchase only -Motorized) Wheelchair: E1050, E1060, E1070, E1083, E1084, E1085 . 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. BCBS FEP Its indicated with letter R followed by the id number. Services that require precertification - IBX One option is Adobe Reader which has a built-in reader. BCBS Alpha prefix lookup contains all the Blue Cross Blue Shield alpha prefix along with their home plan and website. It allows you to quickly and easily identify your insurance home plan, saving you time and hassle. BCBS Alpha Prefix list is useful for both providers and BCBS enrolled members/patients. Prefix Group Address Group Name TPA Name & Address Claims Filing Claims & Benefit Contact Name Phone . Unraveling the Truth, United Healthcare Claims Address, Payer ID, Fax and Phone Number, BCBS Prefix List 2023 Alpha Prefix and Alpha Number Prefix Lookup, BCBS Alpha Numeric Prefix from L2A to L9Z (Updated 2023), BCBS Provider Phone Number for Claims and Eligibility Verification, Benefits and Eligibility Verification Services. Benefits and eligibility should be verified for all members prior to rendering services. Do not create one or use the BCBS prefix from another member ID card. There are several benefits of using our BCBS Prefix Lookup tool. CareFirst IDs have plan codes 080/580 and 190/690. PDF Member account and prefix updates: Provider FAQs 800-676-2583. BCBS prefix is a three character prefixes followed by the id number except for the following products and programs. eah xp`}L s1zIq%A9Zc~(Iz~HQu;AT#2$ Wp`Hlpp6NQIV0hg`,g H20[20* ": Blue KC Commercial Prior Authorization and Notification List Added to list, with AIM effective 04/01/2021 22802 Joint, Spine Surgery Post Fusion 7-12 Vert Seg SUR712.036 AIM Guidelines Lumbar Spinal Fusion Retire from BCBS PA effective 1/1/22; continue to request PA through AIM if applicable; Added to list, with AIM effective 04/01/2021 22804 Joint, Spine Surgery Post Fusion 13/> Vert Seg SUR712.036 AIM . Medicare Working or retired, we'll help you every step of the way to find the right plan. 2021 Commercial Outpatient Behavioral Health Prior Authorization Code List This list is a new addition on our website for 2021. Commercial Communications 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). For Example: ABC, A2B, 2AB, 2A2 etc. 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. 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. 8772287268 Mail Administrator P.O. endstream endobj 742 0 obj <. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. But dont worry because our BCBS prefix finder include alpha numeric prefix information as well. By doing it may cause delay in processing or handling the claim. You may also want to know: United Healthcare Claims Address Information. 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 To view this file, you may need to install a PDF reader program. What is Medical Billing and Medical Billing process steps in USA? 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. Final Instructions about BCBS Prefix Lookup, United Healthcare Claims Address Information. BCBS Alpha Numeric Prefix Its a three letter Alpha numeric prefix followed by id number. endstream endobj 1230 0 obj <. Independence Blue Cross (BC) of Philadelphia (Phi) and the Southeastern Pennsylvania (PA) PAI. ", 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). Save my name, email, and website in this browser for the next time I comment. 404 0 obj <>stream The most important and easy way to identify BCBS member is his BCBS member ID alpha prefix. Baltimore, MD 21237 . 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. The SBC shows you how you and the plan would share t. he cost for covered health care services. For more information, contact your Network Provider Consultant or call 406-437-6100. Blue Shield (BS) of California. PDF 2021 Commercial Prior Authorization Requirements Summary PDF CSS-E121 Blue Cross Select Silver 01012021 - bcbsal.org To get information about such member IDs, you can contact BCBS prefix directory phone number i.e. 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 . PDF Blue Cross and BCN utilization management medical drug list - BCBSM Coverage Period: 01/01/2021 - 12/31/2021 . 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. For example: ABC12345678 Here " ABC" is BCBS alpha prefix. This can be especially helpful if youre in a rush or need to access your BCBS prefix home plan information quickly. 1268 0 obj <>stream For Example: XYZ123456789. Identifying BlueCard members - Regence Medical providers - Arkansas Blue Cross and Blue Shield A follow-up article with additional information on transition of member care was posted Dec. 4, 2020. This step will help you determine if prior authorization may be required for a specific member and service. In some case provider or billing company may file the claim to an incorrect address without checking the correct BCBS address. ?} AN Correct BCBS home plan can easily be identified using our BCBS prefix lookup directory. 0 bcbs prefix list PDF,Doc ,Images - pdfprof.com %%EOF Choose My Signature. =&m$ z90P&\:?$IRIj"c5l\"aD(@?Yuk>{8lkelu3X*FpT=6Rv;9'*4O-o|ELLG?-Yec,cqh(e96e4^QyD8H}'o(3 Does BCBS Cover Wegovy for Weight Loss? BlueCard. 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) . Check any internal documents you may have and update any references of "alpha prefix" to "prefix". 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. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Xceed Billing Solutions is amedical billing company for outsourcing medical billing services. Benefits Administration Corporation, Inc. (BACI) 9411 Philadelphia RD. Xceed Billing Solutions motive is to create ease for providers, medical billers, patients and everyone who is involved in revenue cycle process. Please look for claim filing instructions on the back of the ID card. BCBS prefix lookup directory is a valuable resource for anyone who is looking for right Blue Cross Blue Shield home plan. What If BCBS Member ID doesnt have Prefix mentioned on Card? 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. BlueCard Program Alpha Prefixes | Blue Cross and Blue Shield - BCBSTX 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. Search for doctors near you and in your network. Most PDF readers are a free download. PDF Blue Cross and Blue Shield of Minnesota and Blue Plus Commercial Prior These BCBS prefix may include alpha and numerical characters. New BCBS Alpha Numeric Prefixes | My Payer Directory PDF 2021 Three Character Prefix 2021 Prior Authorization Requirement Summaries, Code Lists and Related endstream endobj startxref Third, it can help you make more informed decisions to choose right insurance plan and benefits. AZBlue - Blue Cross Blue Shield of Arizona - Health Insurance Plans A healthier Arizona is what we're all about. In that case claim may be denied as Submit the claim to the correct address / Member ID not found. First Character Z assigned to the BCBS Plan. 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. 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. Normally, account specific prefix associates to the employer 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. 0 a'm 777 0 obj <>stream In addition, some sites may require you to agree to their terms of use and privacy policy. K8Z : Page 2 . 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: Commercial Prior Authorization Summary and Code Lists BCBS Prefix List 2023 - Alpha Prefix and Alpha Number Prefix Lookup And to manage such a big network, they divided it into different departments state wise or employer specific. ;MTK 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. What is Medical Billing and Medical Billing process steps in USA? It means that BCBS members IDs prefix will must have alphabets and they may or may not have numbers. We recently received a query from a provider that how I can identify that patient is BCBS health insurance member. Note: BCBS FEP (Federal Employee Program) ID starts with the alphabet R follow by the insured ID number (For Example: R987654321). All prefixes are unique. (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.). Member ID cards with no prefix Some member ID cards may not have a prefix. BCBS Alpha Numeric Prefix - It's a three letter Alpha numeric prefix followed by id number. BCBS member ID have maximum 17 characters but most of the member IDs have 12 characters. You may see cards with four-character prefixes, e.g., HMSA Blue Cross Blue Shield of Hawaii uses four-character prefixes. Availity provides administrative services to BCBSIL. 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. The prefix routes eligibility/benefits inquiries and claims to the appropriate BCBS Plan or system for timely processing. Learn more about timely filing limits and CO 29 Denial Code. For Federal Employee Program (FEP) precertification requirements, please see the separate FEP precertification list. BCBS Alpha Prefix Its a three letter alpha prefix followed by id number. The three-character prefixes listed do not represent an exhaustive listing of prefixes. 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. 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 Our Health Choice plans are available to Arizonans who qualify for Medicaid. Why does BCBSAZ update member accounts and . 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. Customer Service: 1-800-409-9462 HCSC-PORT. American Health Group (AHG) Call 1-800-847-7605 . Its important to remember that benefit plans differ in their benefits, and details such as prior authorization requirements are subject to change. First Care, Inc. are independent licensees of the Blue Cross and Blue Shield Association. "Y24Oz>V ?I L r%dl=vHd z/;/X #k> Gq Its critical to check member eligibility and benefits through the Availity Provider Portal or your preferred vendor portal prior to every scheduled appointment. Medicaid Most PDF readers are a free download. 2021 Commercial Specialty Pharmacy Prior Authorization Drug List This list was updated with 14 new codes effective Jan. 1, 2021. 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. endstream endobj startxref 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. PAJ. BCBS Alpha Prefix List from PAA to PZZ Updated 2023 PPO 837P Prefixes are also applicable, . AIM Specialty Health (AIM) is an independent company that has contracted with BCBSIL to provide utilization management services for members with coverage through BCBSIL. No, the BCBS policy number is not typically the same as the BCBS member ID number. TT$%b"Dg!h^`]-ce?i8xRiu1IrD-%oR#yt;JBOJ#"TXwD0L Fw,]xS_CU3zf]06_T} PNGCqWV^UET6X~`U 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. 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. Final Remarks about BCBS Prefix Lookup Directory. 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. 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. 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. 'MNiXG]dRBC; 0'Va~9&c}Ag$Pge;\UY,$MtN Always make sure to submit claims to insurance company on time to avoid timely filing denial. Some members ID cards may not have an alpha prefix. %PDF-1.6 % 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. The prior authorization information in this notice does not apply to requests for HMO members. BCBS Alpha Prefix Lookup 2023 BCBS of Illinois (IL) PAK. BCBS alpha numeric prefix contains alphabets as well as digits ranging from 1 to 9. BCBS Prefix List - Alpha Lookup by State 2022 - Finder 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. 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 . Here are links to some recent communications that were posted to notify you of important changes: Government Programs Prior Authorization Summary and Code Lists The notice also refers to a medical policy for more information to help clarify when and how prior authorization requirements may apply. 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. PDF HMO Networks - Blue Cross and Blue Shield of Illinois We offer a wide choice of individual plans to fit your health needs and budget. In the District of Columbia and . You can also contact us for specialty medical billing services. Box 14114 Lexington, KY 40512 Federal Employee Program (FEP) R prefix DC/Metropolitan Area 2024884900 MD 8008545256 DC/Metropolitan Area Mail Administrator P.O . plan. 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. Lets dig into it! Here Letter R indicates BCBS FEP prefix. %%EOF To identify correct blue cross blue shield department, they use three characters BCBS prefix in the start of each BCBS member plan ID. 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. 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. hb```I! Also, these BCBS prefixes helps providers and medical billers to reach the correct claims department for claims and benefits inquiry. q8-_?UT"X e+1?#7DMKHY]?R,-e;PE\mL Last updated: 07/01/2022. eviCore healthcare (eviCore) is an independent specialty medical benefits management company that provides utilization management services for BCBSIL. We make it easy for you to offer the healthcare coverage that delivers for your business. 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. If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly. The three-character prefix identifies the Blue Cross and Blue Shield Plan to which the member belongs. So, to accomplish our goal, we have listed down the complete BCBS alpha prefix list so that you can easily identify correct BCBS plan.

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