Curious to know what are national Accounts? 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. For Federal Employee Program (FEP) precertification requirements, please see the separate FEP precertification list. 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. Some members ID cards may not have an alpha prefix. %%EOF Below in our BCBS prefix lookup directory, you can lookup all the BCBS prefix appropriate home plans and their contact information. No, the BCBS policy number is not typically the same as the BCBS member ID number. ", 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). PAH. Each BCBS alpha numeric prefix represents different BCBS home plan. So, to accomplish our goal, we have listed down the complete BCBS alpha prefix list so that you can easily identify correct BCBS plan. eO\v; tU9kN@]fh:~q:Fye{Q)ihJ HP/VD/_oy\ H ~fa4L?!ekF(\0>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 PDF Updated November 2021 - BCBSIL Blue Shield (BS) of California. 1268 0 obj <>stream Why does BCBSAZ update member accounts and . PDF Blue Cross and Blue Shield of Minnesota and Blue Plus Commercial Prior 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. endstream endobj startxref document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Xceed Billing Solutions is amedical billing company for outsourcing medical billing services. 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: Hi, Im Kim Keck! This new site may be offered by a vendor or an independent third party. Learn more about timely filing limits and CO 29 Denial Code. 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. Three-Character Prefixes. By doing it may cause delay in processing or handling the claim. 15363 0 obj <> endobj The most important and easy way to identify BCBS member is his BCBS member ID alpha prefix. 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 1 of 7. hbbd``b`f3$ bE FM Dmb"@ $$@z$u ad#B cG In that case claim may be denied as Submit the claim to the correct address / Member ID not found. ). Search for doctors near you and in your network. So, to answer this query, we have mentioned below few important points to consider. Always make sure to submit claims to insurance company on time to avoid timely filing denial. 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. Please DO NOT randomly select a three-character prefix. And to manage such a big network, they divided it into different departments state wise or employer specific. Medical providers - Arkansas Blue Cross and Blue Shield Does BCBS policy number same as BCBS member ID number? PREFIXES . BCBS FEP Its indicated with letter R followed by the id number. endstream endobj 742 0 obj <. For Example: ABC, AQT, TXX, TEA, A2B, 2AB, 2A2, PAS, ZGP, XXU etc. 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. 777 0 obj <>stream To identify correct department, they use 3 characters Prefix in the BCBS members plan ID. Title: Commercial Prior Authorization Summary and Code Lists 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. Here Letter R indicates BCBS FEP prefix. BCBS Railroad member IDs are assigned to members who served in railroad organizations. To get information about such member IDs, you can contact BCBS prefix directory phone number i.e. 1254 0 obj <>/Filter/FlateDecode/ID[]/Index[1229 40]/Info 1228 0 R/Length 122/Prev 219460/Root 1230 0 R/Size 1269/Type/XRef/W[1 3 1]>>stream Please look for instructions or a phone number on the back of the member ID card. %PDF-1.6 % $=0j]xkM#[f4YgI|in Z(0zF1-9gk!D @WeUUn/R%$'c|J6:z}\}8ZNd+SL5-h"\wE$w{3\zO>,Vta$a`D7rHmr$bwZm7yYO)&^E<2@9#&UDOz First Character Z assigned to the BCBS Plan. 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. 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. . Box 805107, Chicago, Illinois 60680-4112. 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. Always use the BCBS prefix on the members current ID card followed by the member id number. Few times, BCBS plan members doesnt have prefix mentioned on their BCBS Insurance card. The site may also contain non-Medicare related information. 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. Customer Service: 1-800-409-9462 HCSC-PORT. Most PDF readers are a free download. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider. 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. Also, these BCBS prefixes helps providers and medical billers to reach the correct claims department for claims and benefits inquiry. 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. Independence Blue Cross* Quick Reference Guide . Availity provides administrative services to BCBSIL. Medicaid NBT . We update BCBS prefix list data on daily basis to provide latest BCBS prefix home plan information. Save my name, email, and website in this browser for the next time I comment. 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. 0 hb``` eaXm.; `Umap@LDPpN jM*,BDu|m_(2*u x y-a`b` #; PDF Provider Quick Reference Guide - CareFirst 8772287268 Mail Administrator P.O. K8Z : Page 2 . BlueCard Program Alpha Prefixes | Blue Cross and Blue Shield - BCBSTX PDF Traditional Coverage - BCBSIL External link You are leaving this website/app (site). Check any internal documents you may have and update any references of "alpha prefix" to "prefix". Born in Texas, USA. 0 hbbd```b``@$Df/i #D2lE``vd@ "@,iZ R R2H{v# k T. he Summary of Benefits and Coverage (SBC) document will help you choose a health. Most Blue Cross Blue Shield (BCBS) member IDs begin with a three-character prefix. 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. There are several benefits of using our BCBS Prefix Lookup tool. 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. So the next time you need to identify accurate BCBS prefix home plan, remember to use the BCBS prefix list lookup finder. It means that BCBS members IDs prefixes will must have alphabets. "Y24Oz>V ?I L r%dl=vHd z/;/X #k> Gq 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). 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. %%EOF BCBS National accounts are employer groups that have outlets/offices in multiple states but they offer limited coverage to their employees. What is Medical Billing and Medical Billing process steps in USA? TT$%b"Dg!h^`]-ce?i8xRiu1IrD-%oR#yt;JBOJ#"TXwD0L Fw,]xS_CU3zf]06_T} PNGCqWV^UET6X~`U PAGE : Amkor Technology, Inc. Group # 039176 : AmeriBen . eviCore healthcare (eviCore) is an independent specialty medical benefits management company that provides utilization management services for BCBSIL. 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 . You can also contact us for specialty medical billing services. Choose My Signature. Narrow Network: Provider participation is by invitation. ?} AN An incorrect or missing three-character prefix may cause possible delays in the processing of your claims. Plan Type: PPO . BCBS alpha numeric prefix contains alphabets as well as digits ranging from 1 to 9. BCBS Railroad member IDs starts with a letter R. 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. Individuals & Families We offer a wide choice of individual plans to fit your health needs and budget. PDF HMO Networks - Blue Cross and Blue Shield of Illinois BCBS prefix is a three character prefixes followed by the id number except for the following products and programs. 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& Let's start with you. Complete patient information, on the other hand, allows your claims to process without delays. These prefixes may include alpha and numerical characters. PDF CSS-E121 Blue Cross Select Silver 01012021 - bcbsal.org Most PDF readers are a free download. 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. PDF 2022 Commercial PA Code Lists December Updates - BCBSIL Our Health Choice plans are available to Arizonans who qualify for Medicaid. Note: Current three-character, alpha-only prefixes will not be affected by this change. 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. For Example: XYZ123456789. Box 14115 Lexington, KY 40512 Mail Administrator P.O. Make sure to make copies of the front and back of member ID card. Benefits and eligibility should be verified for all members prior to rendering 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 . First Care, Inc. are independent licensees of the Blue Cross and Blue Shield Association. BCBS is one of the largest medical insurance company by total members of more than 45 million. %PDF-1.5 % For Example: ABC, A2B, 2AB, 2A2 etc. 365 0 obj <> endobj Call 1-800-388-3193 . The prefix routes eligibility/benefits inquiries and claims to the appropriate BCBS Plan or system for timely processing. 15456 0 obj <>stream This new site may be offered by a vendor or an independent third party. TPA Name & Address. CareFirst IDs have plan codes 080/580 and 190/690. Northwest Arizona Employee Benefit Trust (NAEBT) Group # 037461 . Last updated: 07/01/2022. AZBlue - Blue Cross Blue Shield of Arizona - Health Insurance Plans The prefix may also route claim status inquiries and remit searches. How To Identify Blue Cross Blue Shield Member? 0 Commercial Communications BCBS Alpha Numeric prefix are three characters at the start of each BCBS insurance member ID. BCBS prefix lookup directory is a valuable resource for anyone who is looking for right Blue Cross Blue Shield home plan. 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 . First, it saves you time and hassle by allowing you to quickly identify correct BCBS insurance home plan without having to call customer service. This can be especially helpful if youre in a rush or need to access your BCBS prefix home plan information quickly. Checking eligibility and/or benefit information and/or the fact that a service has been prior authorized is not a guarantee of payment. 0 There are two types of BCBS prefixes which are mentioned below: Plan Specific prefix are assigned by BCBS to each plan. Note: BCBS FEP (Federal Employee Program) ID starts with the alphabet R follow by the insured ID number (For Example: R987654321). PDF Blue Cross and BCN utilization management medical drug list - BCBSM BCBS Alpha Prefix List 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 . 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. AZBlue - Blue Cross Blue Shield of Arizona - Health Insurance Plans A healthier Arizona is what we're all about. BCBSIL makes no endorsement, representations or warranties regarding any products or services provided by third party vendors such as eviCore, AIM or Availity. The three-character prefix identifies the Blue Cross and Blue Shield Plan to which the member belongs. BCBS of Illinois (IL) PAK. In case, you need any additional information related to BCBS prefix then feel free to reach out to us. endstream endobj startxref 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. What is Medical Billing and Medical Billing process steps in USA? 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. Stand-alone dental products, vision and pharmacy when delivered through an intermediary model. What is the difference between BCBS alpha prefix and BCBS alpha numeric prefix? Xceed Billing Solutions motive is to create ease for providers, medical billers, patients and everyone who is involved in revenue cycle process. Follow the step-by-step instructions below to design your premiere blue cross amp the regency group three character prefixes: Select the document you want to sign and click Upload. Lets dig into it! BCBS Alpha Prefix Its a three letter alpha prefix followed by id number. Contact us to learn how we can improve your revenue cycle. To identify correct blue cross blue shield department, they use three characters BCBS prefix in the start of each BCBS member plan ID. Blue KC Commercial Prior Authorization and Notification List Identifying BlueCard members - Regence Does BCBS Cover Wegovy for Weight Loss? PDF Network Prefix List - CareFirst Provider Member identification numbers beginning with R belong to Federal Employee Program (FEP) and will not have a three-character prefix when filing. There are three variants; a typed, drawn or uploaded signature. Prefix Group Address Group Name TPA Name & Address Claims Filing Claims & Benefit Contact Name Phone . 2021 Commercial Outpatient Behavioral Health Prior Authorization Code List This list is a new addition on our website for 2021. a'm We have the right plan for you to keep you and your family covered. 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. A2Z, G2A, J4K etc. BCBS Alpha prefix are the three characters at the start of each BCBS insurance member ID. 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. 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. 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, 2021 Commercial Prior Authorization Requirements Summary, 2021 Commercial Outpatient Medical Surgical Prior Authorization Code List, 2021 Commercial Specialty Pharmacy Prior Authorization Drug List, 2021 Commercial Outpatient Behavioral Health Prior Authorization Code List, New Prior Authorization Requirements for Some Custom Account Members Will Take Effect Jan. 1, 2021, 2021 Medicaid Prior Authorization Requirements Summary, 2021 Medicaid Prior Authorization Code List, 2021 MA PPO Prior Authorization Requirements Summary, 2021 MA PPO Prior Authorization Code List, BCBSIL Provider Network Consultant (PNC) team, Update: Utilization Management Change for Advocate Aurora Health Members, Effective Jan. 1, 2021 This News and Updates was posted Dec.15, 2020, and updated Dec. 31, 2020 to reflect a corrected phone number. Independence Blue Cross (BC) of Philadelphia (Phi) and the Southeastern Pennsylvania (PA) PAI. 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. You may see cards with four-character prefixes, e.g., HMSA Blue Cross Blue Shield of Hawaii uses four-character prefixes. q8-_?UT"X e+1?#7DMKHY]?R,-e;PE\mL If you have any questions, call the number on the members ID card. BCBS Prefix List Z2A to Z9Z - Alpha Numeric Lookup 2022 This step will help you determine if prior authorization may be required for a specific member and service. BCBS Alpha Prefix Lookup 2023 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. Medicare Working or retired, we'll help you every step of the way to find the right 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. BCBS Prefix will not only have numbers and the digits 0 and 1. BCBS Prefix List 2023 - Alpha Prefix and Alpha Number Prefix Lookup 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. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. Not assigned prefix. PDF 2021 Three Character Prefix 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. 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: Right after completing my degree in 2011, I started my job career as an Accounts Receivable in a medical billing company. Amerihealth Caritas Directory Healthcare, Health Insurance in United States of America, Place of Service Codes List Medical Billing. Codes may chan ge, and this list may be updated throughout the year. Blue Cross and Blue Shield of Illinois, P.O. 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 will not only have numbers and the . BCBS Prefix will not only have numbers and the digits 0 and 1. But dont worry because our BCBS prefix finder include alpha numeric prefix information as well. Summaries and code lists are posted as a reference to help you determine when prior authorization may be required for non-HMO government programs members. Working or retired, we'll help you every step of the way to find the right plan. 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. For example: A2A12345678 Here " A2A" is BCBS alpha numeric prefix. BCBS Alpha Numeric Prefix - It's a three letter Alpha numeric prefix followed by id number. plan. If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly. In the District of Columbia and . 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. What If BCBS Member ID doesnt have Prefix mentioned on Card? Due to the exceeding number of BCBS insurance members, Alpha-Only Prefix member IDs exhausted. Prior Authorization Health insurance can be complicatedespecially when it comes to prior authorization (also referred to as pre-approval, pre-authorization and pre-certification). nKvo2>)*Y=}4i,+s[yL*2#kN@r115};|`R[5/iZ Third, it can help you make more informed decisions to choose right insurance plan and benefits. 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
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