endstream This can be especially helpful if youre in a rush or need to access your BCBS prefix home plan information quickly. Hi, Im Kim Keck! Does policy number same as member ID number? Compliance, Fraud, Waste and Abuse Program and Reporting: HCSC and its subsidiaries are founded on the basic principles of good business behavior. Remember, member benefits and review requirements will vary based on service/drug being rendered and individual/group policy elections. Information current and approximate as of December 31, 2018. BCBS prefix list EAA-EZZ. Amerihealth Caritas Directory Healthcare, Health Insurance in United States of America, Place of Service Codes List Medical Billing, Independence Blue-Cross of Philadelphia and Southeastern Pennsylvania, Maryland/District of Columbia/Northern Virginia, Anthem Blue-Cross Blue-Shield of Virginia, Excellus Blue-Cross Blue-Shield of New York, Anthem Blue-Cross Blue-Shield of Missouri, Blue-Cross Blue-Shield of Western New York, Empire Blue-Cross Blue-Shield of New York, Anthem Blue-Cross Blue-Shield of Colorado, Anthem Blue-Cross Blue-Shield of Wisconsin, Highmark Blue-Cross Blue-Shield of Pennsylvania, Horizon Blue-Cross Blue-Shield of New Jersey, Anthem Blue-Cross Blue-Shield of Connecticut, Anthem Blue-Cross Blue-Shield of Kentucky. Admin 22. _( ~ G+[~:d#y8J5)-*]4hLFk-P3sI77O. It also suggests that the members enjoy the networks participating with the hospital and other medical costs. X2A to X9Z. W2A to W9Z. BCBS Alpha Prefix List from UAA to UZZ Updated 2023. 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. % The alpha prefix is very important to the identification number. The prefix acts as a key element in confirming the members' eligibility and coverage information. Illinois. Request a new replacement member ID card, or download a temporary copy. Complete Guideline and Strategy, Tips to Create the Perfect Medical Provider Resume, Benefits and Eligibility Verification Services. Other providers are available in our network. What is 25 modifier and how to use it for insurance Payment, How to code for diagnosis and procedures related to Monkey pox, BCBS Alpha Prefix List from YAA to YZZ Updated 2023, Timely Filing Limits for all Insurances updated (2023), Blue Cross Blue Shield insurance Companies Statewise, BCBS of South Carolina (SC) / Southcarolinablues, Highmark Blue Shield (BS) of Pennsylvanaia (PA), Blue shield(BS) of Northeastern New York (NeNY). <> BCBS Alpha Numeric Prefix Its a three letter Alpha numeric prefix followed by id number. It helps to cover up the flights or any delays. For more than 85 years, we've provided our members with comprehensive, affordable health . Search for doctors, dentists, hospitals and other health care providers. Get the most from your BCBSIL pharmacy benefits. Always make sure to submit claims to insurance company on time to avoid timely filing denial. 3 0 obj Have a look at our BCBS alpha prefix and BCBS alpha numeric prefix directory below. Home plans are generally used as a member of the former application. BAB. Sample BCBS prefix list. You may also be interested to read about denial code 27 reason and solutions. <> 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. <> endobj Sometimes, a plan may require the member to request prior authorization for services. 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. PUJyf\P )} 9\7R8lSJ|y:mYY p!+uUxSACJQ;,#3X_xR Blue cross blue shield itself is a federation of 35 separate health insurance in the United States. We have a track record of providing quality medical billing services to multiple healthcare organizations and specialty providers across USA. These BCBS prefix may include alpha and numerical characters. 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. endobj 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. We cant decide Blue cross Blue shield members state just by looking first alpha prefix. The BCBSIL Commercial Provider Manual is organized into the following sections for providers participating in PPO, Blue Choice PPOSM, HMO and the Blue High Performance NetworkSM(Blue HPNSM)EPO. For Example: ABC, TXX, TEA, A2B, 2AB, 2A2, PAS, XXU etc. In the case of baggage cover, the organization holds on compensating for the loss or any kind of delay. 14 0 obj Ans. IPA Guidelines for Member Complaints, Inquiries, Appeals and Grievances Procedure. The terms of the members plan control the available benefits. Most PDF readers are a free download. 12 0 obj Medicare Advantage is an alternative to original Medicare where a private health insurance . . A prior authorization isnota guarantee of benefits or payment. In general, there arethreestepsprovidersshould follow. Online - The eviCore Web Portal is available 24x7. Xceed Billing Solutions motive is to create ease for providers, medical billers, patients and everyone who is involved in revenue cycle process. 2 0 obj BCBS member ID have maximum 17 characters but most of the member IDs have 12 characters. Note: Most out-of-network services require utilization management review. 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 Highmark BCBS of Pennsylvania (PA) ZAC. The calculation begins from the date of service, discharge date or last date of treatment up to 365days, including weekends. The cross also goes through the analysis of gaining health insurance and forms a series of packages. 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. BCBS is one of the biggest insurance companies in USA and serving more than 106 million people. 2021 Commercial Outpatient Behavioral Health Prior Authorization Code List This list is a new addition on our website for 2021. Address: 11070 Katy Fwy, Houston, TX 77043, 2023 Xceed Billing Solution.com - All Rights Reserved. By doing it may cause delay in processing or handling the claim. BCBS member ID prefix help medical billers, health care providers and patients to identify BCBS healthcare plan. If you have questions on a request handled by BCBSIL, contact our Medical Management department. 15 0 obj endobj External link You are leaving this website/app (site). First Character Z assigned to the BCBS Plan. Certain employer groups may require prior authorization or pre-notification through other vendors. BCBS of Kansas City. Prior authorization (sometimes called preauthorization or pre-certification) is apre-service utilization management review. These documents are located inhttp://www.hisccompliance.com. N9=*io1*sLxfLf9`El/Ou:!fUKc3'I"UIcL 0 d.|XbY!&e|&1'b[7N!B!axHgY&K8Ugxl ]j.,pj,$&GHox Want to be part of our amazing team? 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. Z2A to Z9A. endobj Always check eligibility and benefits first,via theAvailityEssentialsor your preferred web vendor, prior to rendering care and services. <> 365days . $ 382. State Lookup. Emergency services are an exception. Independence Blue Cross (BC) of Philadelphia (Phi) and the Southeastern Pennsylvania (PA) Some of our partners may process your data as a part of their legitimate business interest without asking for consent. UAC. Here you can find the BCBS prefix finder along with BCBS home plan name and website for BCBS member IDs ranging from F2A to F9Z. Prior authorization isrequiredfor some members/services/drugsbefore services are rendered to confirm medical necessity as defined by the members health benefit plan. These blue shield companies negotiate with the doctors and the other hospitals. Related forms. The perfect members of BCBS insurance get more flexibility and facilities in terms of health insurance. will be denied. Save my name, email, and website in this browser for the next time I comment. %&'()*456789:CDEFGHIJSTUVWXYZcdefghijstuvwxyz It also states the important papers for identification that would help safeguard the situation and also save the expenses. To view the purposes they believe they have legitimate interest for, or to object to this data processing use the vendor list link below. 1 0 obj 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). BCBS Prefix List EAA-EZZ (2023) November 3, 2020 by medicalbillingrcm. <> Make sure to make copies of the front and back of member ID card. Provided on the website you will find the following documents: Medicare and Government Contracts Compliance Program, Blue Cross Medicare Advantage HMO Non-Delegated Model Manual, Blue Cross Medicare Advantage PPO ProviderManual, CMS Qualified Medicare Beneficiary Program, 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). BCBS Prefix List 2021 - Alpha. Any individuals who impact HCSC's Medicare or Medicaid contract(s) are expected to abide by the Medicare and Government Contracts Compliance Program, the Code of Business Ethics and Conduct and the Medicare Compliance Policies. endobj 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. It also files on checking the incorrect address and submits the correct form of claiming the right details. 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 . Amerihealth Caritas Directory Healthcare, Health Insurance in United States of America, Place of Service Codes List Medical Billing. Information for Blue Cross and Blue Shield of Illinois (BCBSIL) members is found onour member site. Right after completing my degree in 2011, I started my job career as an Accounts Receivable in a medical billing company. BSBS insurance involves unique prefixes and follows up a unique ID number. 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. Topics include everything from improving your well-being to explaining health coverage. The health of your eyes and teeth can affect your overall health. It allows you to quickly and easily identify your insurance home plan, saving you time and hassle. Log In to the Shopping Cart, Need to Make a Payment? For Example: ABC, TXX, TEA, A2B, 2AB, 2A2, PAS, XXU etc. Blue-Cross Blue-Shield of Illinois. Prefix UTS assigned to University of Texas. 9 0 obj Final Remarks about BCBS Prefix Lookup Directory. An example of data being processed may be a unique identifier stored in a cookie. On the other hand, host plans indicate more services in the health care services and competition within the area. In most ways, the policy numbers and their section move forward with a unique number to get respective orders and their identification to analyze the main purposes of billing the healthcare system. When does health insurance expire after leaving job? endobj In some case provider or billing company may file the claim to an incorrect address without checking the correct BCBS address. V!E5y"w Dx])Vq_j.xwuUgq>bmh`M.hjsw Y_8NzZtAj&4B8%5"a t@BpweUI#t@SsRR)tx6a5B+sPWO^p[,U\ewdRyN@! endobj Today you will find The BCBS Alpha Prefix List from SAA to SZZ. You can: Pay a bill online or sign up for auto bill pay. . . BAA. %PDF-1.5 Blue cross coverage goes through the idea of calling out the blue cross blue shield company, which helps to provide the programs benefits. mr+*W@B 6 0 obj In the USA, the BCBS is a very well-known health insurance statement that conveys more association and deals with numerous activities. You may also want to know: United Healthcare Claims Address Information. giV7Lxp^^YM(_{27e;//3_`|eC9EliUDD.3fJ0]6DT{,dMZRPRWN2C7?HL4fvy|\b%^SKwIOh)xo${A%t7A3_h}AL To request a hard copy of Blue Advantage's provider directory, please call our Member Service Department at 1-888-234-8266, 8 a.m. to 8 p.m., seven (7) days a week. Health Equity and Social Determinants of Health (SDoH), Over the Counter Equivalent Exclusion Program, Prior Authorization and Step Therapy Programs, Consolidated Appropriations Act & Transparency in Coverage, Medical Policy/Pre-certification: Out-of-area Members, HMO Medical Service Agreement Highlight and Process Summary, 3rd Trimester Pregnancy IPA Transfer Policy, 3rd Trimester Pregnancy IPA Transfer Procedure, Ancillary Hospital Institution Care Transition Exceptions Policy, Ancillary Hospital Institution Care Transition Exceptions Procedure, Contract Management Firms Confidentiality Agreement Policy, Contract Management Firms Confidentiality Agreement Procedure, Corrective Action for Failed Utilization Management Audit of Participating IPAs Policy, Corrective Action for Failed Utilization Management Audit of Participating IPAs Procedure, Collaborative Improvement Coaching for HMO Quality Improvement Projects Policy, Collaborative Improvement Coaching for HMO Quality Improvement Projects Procedure, IPA Availability andAccessibility Requirements forImmediate Care Services Policy, IPA Availability andAccessibility Requirements forImmediate Care Services Procedure, IPA Guidelines for Member Complaints, Inquiries, Appeals and Grievances Policy, IPA Guidelines for Member Complaints, Inquiries, Appeals and Grievances Procedure, IPA Process for Establishing Out of Area for Emergency Services Policy, IPA Process for Establishing Out of Area for Emergency Services Procedure, IPAs Request for Member Transfer Procedure, Member Access to Behavioral Health Services Policy, Member Access to Behavioral Health Services Procedure, Member Notification Process when a Provider Leaves the IPA Policy, Member Notification Process when a Provider Leaves the IPA Procedure, Oversight of Contracted Infertility Vendor Policy, Oversight of Contracted Infertility Vendor Procedure, Primary Care Physician (PCP) Affiliation with Multiple IPAs Policy, Primary Care Physician (PCP) Affiliation with Multiple IPAs Procedure, Utilization Management and Case ManagementAdherence Audit of Participating IPAs Policy, Utilization Management and Case ManagementAdherence Audit of Participating IPAs Procedure, Accountable Care Organization (ACO) Dual Claimed Physician Policy and Procedure, BCBSIL Marketing Communications HLA Policy Procedure, Blue Cross Blue Shield of Illinois Quality of Complaints & Occurrences Process Policy, Blue Cross Blue Shield of Illinois Quality of Complaints & Occurrences Process Procedure, Provider Handling of Member Inquiries Complaints and Appeals, Provider Urgent/Expedited Clinical Appeal Process, Recovery of Provider Overpayments due BCBSIL, MA HMO Detailed Explanation ofNon-coverage, MA HMO Notice of Dismissal of Organization Determination Request, MA HMO UM Approval In Network ProviderLetter, MA HMO UM Approval Out of Network ProviderLetter, MA HMO Sample Provider Appeal Language for Explanation ofPayment, MA HMO Sample Waiver of LiabilityStatement, MA HMO Transition to Transplant ManagementForm, HMO Provider Credentialing Pre-application. If you are using electronic submission then prefix is important to submit claims successfully and received by insurance correctly. Health Exchange. If you have questions on a request handled by AIM or eviCore, call the appropriate vendor, as noted above. The alpha prefix is very important to the identification number. w !1AQaq"2B #3Rbr For government programs prior authorization requests handled by eviCore healthcare (eviCore): 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. Sign up for theLifeTimes newsletterto get health and benefits articles delivered to your inbox every month. 2/1/2023. Continue with Recommended Cookies.