So, all BCBS plans, including Anthem prefix and Non-Anthem plans announced that member IDs will also be Alpha Numeric from 2018 onwards. hb```I! document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Xceed Billing Solutions is amedical billing company for outsourcing medical billing services. Our Health Choice plans are available to Arizonans who qualify for Medicaid. endstream endobj 15364 0 obj <>>>/EncryptMetadata false/Filter/Standard/Length 128/O(a;uY[7y\\ Y)/P -1036/R 4/StmF/StdCF/StrF/StdCF/U(ZgYX: )/V 4>> endobj 15365 0 obj <>/Metadata 280 0 R/PageLayout/OneColumn/Pages 15351 0 R/StructTreeRoot 2939 0 R/Type/Catalog>> endobj 15366 0 obj <>/Font<>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 15367 0 obj <>stream 15363 0 obj <> endobj A follow-up article with additional information on transition of member care was posted Dec. 4, 2020. 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. Here Letter R indicates BCBS FEP prefix. %%EOF Prefix Group Address Group Name TPA Name & Address Claims Filing Claims & Benefit Contact Name Phone . hbbd```b``A$ 2021 Commercial Specialty Pharmacy Prior Authorization Drug List This list was updated with 14 new codes effective Jan. 1, 2021. Learn more about timely filing limits and CO 29 Denial Code. Decide on what kind of signature to create. %PDF-1.6 % 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. In addition, some sites may require you to agree to their terms of use and privacy policy. 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. Curious to know what are national Accounts? Box 805107, Chicago, Illinois 60680-4112. 741 0 obj <> endobj BCBS alpha numeric prefix contains alphabets as well as digits ranging from 1 to 9. Wheelchairs - Mobility Assistive Equipment (Manual & Power) & Scooters - Wheelchair Purchase only -Motorized) Wheelchair: E1050, E1060, E1070, E1083, E1084, E1085 . Medicare Working or retired, we'll help you every step of the way to find the right plan. So, to answer this query, we have mentioned below few important points to consider. What is a member ID prefix? eah xp`}L s1zIq%A9Zc~(Iz~HQu;AT#2$ Wp`Hlpp6NQIV0hg`,g H20[20* ": We update BCBS prefix list data on daily basis to provide latest BCBS prefix home plan information. Amerihealth Caritas Directory Healthcare, Health Insurance in United States of America, Place of Service Codes List Medical Billing. %PDF-1.6 % BCBS Railroad refers to Blue Cross Blue Shield health insurance plans that are specifically designed for members who are affiliated with railroad organizations in the United States. To identify correct department, they use 3 characters Prefix in the BCBS members plan ID. Medicaid The three-character prefixes listed do not represent an exhaustive listing of prefixes. Most Blue Cross Blue Shield (BCBS) member IDs begin with a three-character prefix. Note: Current three-character, alpha-only prefixes will not be affected by this change. BCBS alpha prefix only contains alphabets and each alpha prefix represents different BCBS home plan. 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 Each BCBS alpha numeric prefix represents different BCBS home plan. 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. eO\v; tU9kN@]fh:~q:Fye{Q)ihJ HP/VD/_oy\ H ~fa4L?!ekF(\0>o Also, these BCBS prefixes helps providers and medical billers to reach the correct claims department for claims and benefits inquiry. endstream endobj startxref Have a look at our BCBS alpha prefix and BCBS alpha numeric prefix directory below. Suite S . 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. 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. 800-676-2583. BCBS FEP Prefix BCBS Federal Employee Program is identified by the letter R followed by the number. Always use the BCBS prefix on the members current ID card followed by the member id number. BCBS alpha numeric prefix digits are usually in between the prefix e.g. The policy number is a unique identifier which may cover multiple members under the same policy, such as a family or a group. BCBS is one of the biggest insurance companies in USA and serving more than 106 million people. BCBS Prefix will not only have numbers and the digits 0 and 1. BCBS Alpha Prefix Its a three letter alpha prefix followed by id number. 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. BCBS Prefix will not only have numbers and the digits 0 and 1. endstream endobj startxref BCBSIL makes no endorsement, representations or warranties regarding any products or services provided by third party vendors such as eviCore, AIM or Availity. 1268 0 obj <>stream Services that require precertification As of January 1, 2022, this list applies to all Independence Blue Cross HMO, PPO, and POS products, including Flex products. For more information, contact your Network Provider Consultant or call 406-437-6100. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. We recently received a query from a provider that how I can identify that patient is BCBS health insurance member. What is Medical Billing and Medical Billing process steps in USA? This new site may be offered by a vendor or an independent third party. 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. For Example: ABC, A2B, 2AB, 2A2 etc. AIM Specialty Health (AIM) is an independent company that has contracted with BCBSIL to provide utilization management services for members with coverage through BCBSIL. b(f{YH^tn}u62\}TgT>ENWJB=J #=a$oXIq(n,tU+D'j}L(t#,w?!^oZUQR, 7a. Independence Blue Cross (BC) of Philadelphia (Phi) and the Southeastern Pennsylvania (PA) PAI. We always make sure to keep BCBS prefix list and BCBS provider phone numbers directory up to date. Prefix ZGP identifies Blue Cross Blue Shield of Texas PPO Product. %%EOF One option is Adobe Reader which has a built-in reader. 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. by calling 1-844-377-1278 (BCN) or 1-800-728-8008 (Blue Cross) or by logging oncology and in to the AIM ProviderPortal. 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. 1 of 7. There are two types of BCBS prefixes which are mentioned below: Plan Specific prefix are assigned by BCBS to each plan. BCBS Alpha Numeric Prefix - It's a three letter Alpha numeric prefix followed by id number. Title: 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. Check any internal documents you may have and update any references of "alpha prefix" to "prefix". Yes, Policy number same as member ID number and also known as subscriber ID number. 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. To identify correct blue cross blue shield department, they use three characters BCBS prefix in the start of each BCBS member plan ID. First, it saves you time and hassle by allowing you to quickly identify correct BCBS insurance home plan without having to call customer service. 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. AZBlue - Blue Cross Blue Shield of Arizona - Health Insurance Plans A healthier Arizona is what we're all about. ;MTK 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. 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: Final Remarks about BCBS Prefix Lookup Directory. 0 BCBS prefix are easy to identify using our BCBS prefix lookup because theyre part of every BCBS member ID and we included all of them here in the BCBS prefix list. 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. First Character Z assigned to the BCBS Plan. Three-Character Prefixes. By doing it may cause delay in processing or handling the claim. plan. How To Identify Blue Cross Blue Shield Member? %{!]/Ox^ A[BXe S#(Df Blue Shield (BS) of California. First Care, Inc. are independent licensees of the Blue Cross and Blue Shield Association. 404 0 obj <>stream BCBS of Illinois (IL) PAK. Carefirst BCBS of Maryland the (MD), District of Columbia (DC) and the Northern Virginia (VA) In addition, some sites may require you to agree to their terms of use and privacy policy. Born in Texas, USA. BCBS FEP Its indicated with letter R followed by the id number. PAH. Here are links to some recent communications that were posted to notify you of important changes: Government Programs Prior Authorization Summary and Code Lists 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 site may also contain non-Medicare related information. Availity provides administrative services to BCBSIL. So, to accomplish our goal, we have listed down the complete BCBS alpha prefix list so that you can easily identify correct BCBS plan. Due to the exceeding number of BCBS insurance members, Alpha-Only Prefix member IDs exhausted. 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. K8Y . 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. nKvo2>)*Y=}4i,+s[yL*2#kN@r115};|`R[5/iZ It is used to identify and track the healthcare coverage and benefits for that specific member. 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. 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. =&m$ z90P&\:?$IRIj"c5l\"aD(@?Yuk>{8lkelu3X*FpT=6Rv;9'*4O-o|ELLG?-Yec,cqh(e96e4^QyD8H}'o(3 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. 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. The prior authorization information in this notice does not apply to requests for HMO members. %%EOF Benefits Administration Corporation, Inc. (BACI) 9411 Philadelphia RD. 01/01/2021 . You can also contact us for specialty medical billing services. Prior authorization requirements are specific to each patients policy type and the procedure(s) being rendered. Individuals & Families We offer a wide choice of individual plans to fit your health needs and budget. For accurate and quick claims processing, it is necessary to get complete patient insurance information. 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. BCBS Alpha Prefix List BCBS National accounts are employer groups that have outlets/offices in multiple states but they offer limited coverage to their employees. It means that BCBS members IDs prefixes will must have alphabets. 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. If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly. What is the difference between BCBS alpha prefix and BCBS alpha numeric prefix? I have completed my Bachelor of Business Administration in Healthcare Management from University of Texas. One option is Adobe Reader which has a built-in reader. 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. 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 . A2Z, G2A, J4K etc. %%EOF Prior authorization to confirm medical necessity is required for certain services and benefit plans as part of our commitment to help ensure all Blue Cross and Blue Shield of Illinois (BCBSIL) members get the right care, at the right time, in the right setting. %PDF-1.6 % 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. 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 In some case provider or billing company may file the claim to an incorrect address without checking the correct BCBS address. hbbd``b`f3$ bE FM Dmb"@ $$@z$u ad#B cG Search for doctors near you and in your network. Box 14114 Lexington, KY 40512 Federal Employee Program (FEP) R prefix DC/Metropolitan Area 2024884900 MD 8008545256 DC/Metropolitan Area Mail Administrator P.O . What If BCBS Member ID doesnt have Prefix mentioned on Card? endstream endobj 742 0 obj <. Its important to remember that benefit plans differ in their benefits, and details such as prior authorization requirements are subject to change. 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. K8Z : Page 2 . 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 . 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. Plan Type: PPO . 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. There are several benefits of using our BCBS Prefix Lookup tool. 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: It allows you to quickly and easily identify your insurance home plan, saving you time and hassle. 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. We make sure to update the information on daily basis, however, if you find some kind of inaccurate information, feel free to contact us. 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. 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. 365 0 obj <> endobj To identify the plan that holds the members benefits, please call the Out-of-State Blues Plan Subscriber #: 1-800-676-BLUE (2583). Last updated: 07/01/2022. For Federal Employee Program (FEP) precertification requirements, please see the separate FEP precertification list. 1229 0 obj <> endobj Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider. The following summary and related prior authorization lists were posted on the Support Materials (Commercial) page the Utilization Management section of our Provider website as of Jan. 1, 2021: Commercial Communications BCBS Railroad member IDs are assigned to members who served in railroad organizations. 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. 0 $=0j]xkM#[f4YgI|in Z(0zF1-9gk!D @WeUUn/R%$'c|J6:z}\}8ZNd+SL5-h"\wE$w{3\zO>,Vta$a`D7rHmr$bwZm7yYO)&^E<2@9#&UDOz Group Name. BCBS prefix is a three character prefixes followed by the id number except for the following products and programs. If you have any questions, call the number on the members ID card. In case, you need any additional information related to BCBS prefix then feel free to reach out to us. Not assigned prefix. It shows that these type of BCBS member IDs are different. Does BCBS Cover Wegovy for Weight Loss? And to manage such a big network, they divided it into different departments state wise or employer specific. 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. Box 14115 Lexington, KY 40512 Mail Administrator P.O. View Medicare information Radiology utilization for Arkansas Blue Cross FEP TPA Name & Address. endstream endobj 1230 0 obj <. 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 . We have the right plan for you to keep you and your family covered. hbbd```b``"`r9LLN`DR,>6l30&U$60D2HO rH+H f`bdV8J If you have any questions or need help submitting a prior authorization, please call 816-395-3989 for assistance. Checking eligibility and/or benefit information and/or the fact that a service has been prior authorized is not a guarantee of payment. Normally, account specific prefix associates to the employer group name. ", Blue Cross and Blue Shield of Texas, aDivision of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association, PDF File is in portable document format (PDF). We make it easy for you to offer the healthcare coverage that delivers for your business. The SBC shows you how you and the plan would share t. he cost for covered health care services. 'MNiXG]dRBC; 0'Va~9&c}Ag$Pge;\UY,$MtN Some members ID cards may not have an alpha prefix. TT$%b"Dg!h^`]-ce?i8xRiu1IrD-%oR#yt;JBOJ#"TXwD0L Fw,]xS_CU3zf]06_T} PNGCqWV^UET6X~`U for medical policies and prior authorization requests . We update BCBS prefix list data on daily basis to provide latest BCBS prefix home plan information. for medical policies and prior authorization requests. therapy) The prefix routes eligibility/benefits inquiries and claims to the appropriate BCBS Plan or system for timely processing. 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 site may also contain non-Medicare related information. Below in our BCBS prefix lookup directory, you can lookup all the BCBS prefix appropriate home plans and their contact information. This new site may be offered by a vendor or an independent third party. Member ID cards with no prefix Some member ID cards may not have a prefix. Coverage For: Individual + Family. BCBS Prefix can be classified as follows: BCBS Alpha Prefix - It's a three letter alpha prefix followed by id number. ). NBT . This can be especially helpful if youre in a rush or need to access your BCBS prefix home plan information quickly. BCBS Railroad member IDs starts with a letter R. hbbd```b``@$Df/i #D2lE``vd@ "@,iZ R R2H{v# k Second Character G assigned to the BCBS Plan as well. Coverage Period: 01/01/2021 - 12/31/2021 . Complete patient information, on the other hand, allows your claims to process without delays. BCBS Alpha Numeric Prefix Its a three letter Alpha numeric prefix followed by id number. 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. BCBS member ID have maximum 17 characters but most of the member IDs have 12 characters. 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. eviCore healthcare (eviCore) is an independent specialty medical benefits management company that provides utilization management services for BCBSIL. Commercial Prior Authorization Summary and Code Lists 2021 Commercial Outpatient Behavioral Health Prior Authorization Code List This list is a new addition on our website for 2021. 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. For example: A2A12345678 Here " A2A" is BCBS alpha numeric prefix. e@'SZD/KCbv*pKq~
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