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Get 5 free searches. You must continue to use network pharmacies until you are disenrolled from our plan to receive prescription drug coverage under our formulary. Regence BlueShield in accordance with the terms of your Provider contract with Regence. Professional Services are performed by a doctor or other healthcare professional. Regence BlueShield serves select counties in the state of Washington and is an Independent Licensee of the Blue Cross and Blue Shield Association. endobj REGENCE BS OF WASHINGTON. Circumstances beyond the plans control. Find helpful phone, fax and email information for assistance. Select the area of the map that matches the color of the county where the service was performed. You receive services from an out-of-network provider. That way, we can verify your account and start helping you as quickly as possible. The second high-deductible health plan cannot include an HSA. Oregon - Blue Cross and Blue Shield's Federal Employee Program Send your claim or correspondence to the Blue Cross Blue Shield plan in the state where the ambulance picked up the patient.Example: An ambulance picks up the patient in Oregon and transports her to a care facility in Washington. PO BOX 25956 SALT LAKE CITY, UT 84125 800-662-0876. An appeal is an oral or written request submitted by you or your authorized representative to Regence BlueShield or Washington State Rx Services to reconsider: You or someone you authorize to represent you may request an appeal. Members: Log in/register at MyBlue Customer eService, Regence Blue Cross Blue Shield of Oregon - FEPPO Box 31105Salt Lake City, UT 84131, Regence Blue Cross Blue Shield of Oregon - FEPPO Box 1269Portland, OR 97207. Premera Blue Cross Blue Shield of Alaska - FEP PO Box 33932 Seattle, WA 98133-0932 Phone: 800-562-1011 6:00 AM - 5:00 PM AST Fax: 877-239-3390 (Claims and Customer Service) Fax: 877-202-3149 (Member Appeals only) Fax: 866-948-8823 (FEP Care Management - prior auth/pre-service requests) Email Members: Log in or register - MyBlue Customer eService TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m EST., Monday through Friday. 2 0 obj Contact us as soon as possible because time limits apply. Any enrollee may appeal a decision made by the School Employees Benefits Board (SEBB) Program regarding SEBB eligibility, enrollment, premium payments, or premium surcharges (if applicable) to the SEBB Appeals Unit. When UMP pays second to another plan that covers the member, UMP will pay only an amount needed to bring the total benefit up to the amount UMP would have paid if the member did not have another plan. Premera Blue Cross Appropriate staff members who were not involved in the earlier decision will review the appeal. Send your claim or correspondence to the Blue Cross Blue Shield plan in the state where the laboratory work was sent for testing.Example: The lab service you used is in Arizona but the sample was sent to Nevada for analysis. In keeping with our values as a tax paying nonprofit, 85% of every premium dollar goes to pay our members' medical claims and expenses. You must submit the claim to Regence as a medical claim. Congestive Heart Failure. Regence BlueShield of Idaho offers health and dental coverage to 142,000 members throughout the state. You can also get information and assistance on how to submit a written appeal by calling the Customer Service number on the back of your member ID card. If you do not submit your claims through Availity Essentials, follow this process to submit your claims to us electronically. Learn about dental billing information to help ensure your dental claims are processed quickly and correctly. TTY users should call, 1-800-325-0778; or your Medicaid Office. Improving Health State-by-State, For the Health of America. An appeal for services related to the Centers of Excellence Program must be submitted within 180 days after you receive notice of the denial to Premera.Submit appeals to: Mail:Premera Blue Cross Regence bluecross blueshield of oregon address You can download the appeal form and submit your written appeal by fax or mail: Mail:WSRxS Youll receive notice of the action on your complaint within 30 calendar days of our receiving it. PO Box 1271 MS C7APortland, OR 97207-1271 This form is to be used only for services in Oregon and Clark County, WA. Claims determinationsThe plan will notify you of action taken on a claim within 30 days of the plan receiving it. You are about to leave regence.com and enter another website that is not affiliated with or licensed by the Blue Cross Blue Shield Association. complies with applicable Federal and Washington state civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, gender identity, or sexual orientation. complies with applicable Federal and Washington state civil rights laws, Determine the county where the service was performed* (see exceptions below). You can submit feedback about your Medicare health plan or prescription drug plan directly to Medicare. Please include the following information when requesting an appeal: The plan will send confirmation when it receives your appeal. When a claim for workers compensation is accepted, all services related to that injury or illness are not covered, even if some services are denied by workers compensation. | Learn how our innovative solutions can help your employees live healthier, while helping you manage your costs. Regence: The most trusted name in health insurance Experience life with Blue With a plan powered by the most trusted name in health insurance, you'll have coverage tailored to your health. Premera Blue Cross Blue Shield of Alaska FEP PO Box 33932 Seattle, WA 98133-0932, Phone:800-562-1011 6:00 AM - 5:00 PM ASTFax: 877-239-3390 (Claims and Customer Service)Fax: 877-202-3149 (Member Appeals only)Fax: 866-948-8823 (FEP Care Claims determinationsThe plan will notify you of action taken on a claim within 30 days of the plan receiving it. But there are some circumstances where you will need to submit a claim. Step 4: After you have completed the login details correctly . Polski | Regence BlueCross BlueShield of Oregon hiring Trainer I in Medford You can appeal a decision online; in writing using email, mail or fax; or verbally. Coordination of benefits (COB) happens when you have health coverage through two or more groups (such as your employer and your spouses employer), and these two group health plans both pay a portion of your health care claims. Is this your business? Make sure you contact the right company (see below). Identify BlueCard members, verify eligibility and submit claims for out-of-area patients. Learn more about global periods, modifiers, virtual care, unlisted codes and NCCI bypass modifiers. Regence BlueCross BlueShield of Oregon is an independent licensee of the Blue Cross and Blue Shield Association. PDF State Mail to Mailing Address City, State Zip Learn about electronic funds transfer, remittance advice and claim attachments. If additional information is needed, we will send you a request. Claims payment, processing, or reimbursement for health care services or supplies. In the left-hand column, locate the state where services were rendered. **If you, or your prescribing physician, believe that waiting for a standard decision (which will be provided within 72 hours) could seriously harm your life, health or ability to regain maximum function, you can ask for an expedited decision. It was formed in 1982 from the merger of its two namesake organizations: Blue Cross was founded in 1929 and became the Blue Cross Association in 1960, while . Learn more. Dental billing - Regence Coverage decision requests can be submitted by you or your prescribing physician by calling us or faxing your request. Step 1: Start your internet browser, and then go to the official regence bluecross blueshield of oregon claims address website. If your coverage changes, call UMP Customer Service and Washington State Rx Services. See what were doing in your community to keep people safe and healthy. Regence Provider Appeal Form Special Message: Coming soon, you will be able to dispute (appeal) a claim on Availity from the claim status result page. This 30-day period may be extended by 15 days when action cannot be taken on the claim due to: Manage your claimsSee the status of your claims, see how much you owe, find a specific claim, and more by logging in to your Regence account. Make sure you submit your complaint to the right company (see below). % If you want a written response, you must request one. Your provider must submit all clinically relevant information to the plan by phone or fax. If you buy your prescription drugs at a network pharmacy, your claim will be submitted for you. The plan will notify you within the 30-day period that an extension is necessary, with a description of the information needed and why it is needed. See Occupational injury or illness (workers' compensation) claims in your certificate of coverage. Coding toolkit Oral coverage decision requests1 (855) 522-8896 To request or check the status of a redetermination (appeal): 1 (866) 749-0355 Fax numbersAppeals and grievances: 1 (888) 309-8784Prescription coverage decisions: 1 (888) 335-3016 UMP may cover some supplies through the medical benefit and other supplies under the prescription drug benefit. If MAXIMUS disagrees with our decision, we authorize or pay for the requested services within the timeframe outlined by MAXIMUS. You are about to leave regence.com and enter another website that is not affiliated with or licensed by the Blue Cross Blue Shield Association. Contact Us | Blue Cross Blue Shield The following information must appear on the provider's itemized bill for the plan to consider the claim for payment: a. Regence users: make the switch to the Availity Web Portal You have been redirected from the Regence or Asuris Northwest Health Provider Center. Attn: Member Appeals We will accept verbal expedited appeals. Get help when you need it. TTY/TDD users can call 1-877-486-2048, 24 hours a day/7 days a week. If the decision was after the 60-day timeframe, please include the reason you delayed filing the appeal. Marvin Thomas email address & phone number | Regence Bluecross Phone:800-562-1011Fax: 877-239-3390 (Claims and Customer Service)Fax: 877-202-3149 (Member Appeals)Fax: 866-948-8823 (FEP Care Management - prior auth/pre-service requests), Email: You must submit prescription drug claims within 12 months of purchase. Those documents will include the specific rules, guidelines or other similar criteria that affected the decision. We stay on top of issues until theyre resolved. Learn how to identify our members coverage, easily submit claims and receive payment for services and supplies. Claims and clinical appeals address: PO Box 21702 Eagan, MN 55121 Care management Phone: 844-996-0329 Fax: 888-302-9325 2023 holiday closures January 2 May 29 July 4 September 4 November 23 November 24 December 25 Instructions are included on how to complete and submit the form. medical equipment supplier, ambulance services, applied behavior analysis services (ABA) or clinical social worker. 3 0 obj Address: 200 SW Market St Portland, OR, 97201-5715 United States See other locations Phone: Website: www.regence.com Employees (this site): Actual Employees (all sites): Actual Revenue: Modelled Year Started: Incorporated: ESG ranking: ESG industry average: What is D&B's ESG Ranking? Claims Submission Map | FEP | Premera Blue Cross Step 3: Next, enter your Username/Password in the appropriate fields. As a nonprofit independent licensee of the Blue Cross and Blue Shield Association, Regence is part of a . Examples: medical doctor, osteopath, optometrist, chiropractor, physical therapist, audiologist, independent laboratory, nurse practitioner, durable If you have questions, contact Washington State Rx Services Customer Service at 1 (888) 361-1611 (TRS: 711) Monday through Friday 7:30 a.m. to 5:30 p.m. (Pacific). We are now processing credentialing applications submitted on or before March 6, 2023. Provider Contacts | Provider | Premera Blue Cross Notice will include explanation why an extension is needed and when the plan expects to act on the claim. Tagalog | Regence BlueShield serves select counties in the state of Washington and is an independent licensee of the Blue Cross and Blue Shield Association. Overpayment Recovery Process - Regence Allied professionals, including behavioral health, vision, chiropractic and other complementary service providers: Contact your allied provider relations representatives & consultants. You may only disenroll or switch prescription drug plans under certain circumstances. WELLMARK BCBS OF IOWA. You get a vaccine or flu shot from an out-of-network provider. If you are a member of another air ambulance's membership program that is a reciprocal partner of Life Flight Network, please make sure you report this to our billing office at (866) 883-9998. Sign in to your Regence account. Availity and Regence If an initial phone call does not resolve your complaint, you may submit your complaint over the phone or by email, fax, or mail. See how our affordable Regence plans offer coverage, access and convenienceso you can live your best. Phoenix, AZ 85072, Retail Pharmacy Program Information current and approximate as of December 31, 2018. Consult theFEP local plan directory to find addresses and telephone numbers for other plans.Note: If the laboratory work was sent to Washington for testing or analysis, refer to theWashington claims submission map to determine where to send your claim for processing. Provider home - Regence Instructions: 1. Regence BlueCross BlueShield of Oregon providers located in Clark County, Washington: Within 24 months after payment of the claim or notice that the claim was denied or within 30 months for claims subject to coordination of benefits. Medical records from your provider, if applicable. For more information about dual coverage, read the If you have other medical coverage (or UMP High Deductible "If you have other HDHP coverage") section in your plans certificate of coverage. Regence BlueCross BlueShield of Utah. . Many issues may be resolved with a phone call. Premera Blue Cross Blue Shield of Alaska - FEP PO Box 33932 Seattle, WA 98133-0932 Phone: 800-562-1011 6:00 AM - 5:00 PM AST Fax: 877-239-3390 (Claims and Customer Service) Fax: 877-202-3149 (Member Appeals only) Fax: 866-948-8823 (FEP Care Management - prior auth/pre-service requests) Email Members: Log in or register - MyBlue Customer eService An appeal qualifies for the expedited process when the member or physician feels that the member's life or health would be jeopardized by not having an appeal decision within 72 hours. claim was denied or 30 months for claims subject to coordination of benefits. Regence BlueShield of Idaho | Regence If you or your dependents have other insurance, you must let UMP Customer Service and Washington State Rx Services know so claims are paid correctly. Learn more about when, and how, to submit claim attachments. Dental billing. Seattle, WA 98121, Support Phone Number: 1.888.427.0470 (toll free), Mon-Fri, 7:00 a.m. to 5:00 p.m. (PT), 1.800.AVAILITY (1.800.282.4548) (toll free), Run transactions to obtain member benefit, eligibility and claims information, Access eContracting to view and sign agreement documents, Our online newsletter (6 issues per year). 7:00 AM - 6:00 PM PSTFax: 877-239-3390 (Claims and Customer Service)Fax: 877-202-3149 (Member Appeals only)Fax: 866-948-8823 (FEP Care If your prescribing physician asks for a faster decision for you, or supports you in asking for one by stating (in writing or through a phone call to us) that he or she agrees that waiting 72 hours could seriously harm your life, health or ability to regain maximum function, we will give you a decision within 24 hours. <>>> For services outside this area, please contact customer service directly at 1 (800) 365-3155 as your claim will require special handling. You will also receive a decision on your appeal within 30 calendar days. Kreyl Ayisyen | You must submit first-level and second-level appeals no more than 180 days after receiving the previous decision. If you have . Media Contact: Audrey Glasby Regence BlueCross BlueShield of Utah Regence . When UMP pays second, you must still pay your deductible before UMP pays benefits. PO BOX 21267 SEATTLE, WA 98111 800-845-0377. Blue Cross and Blue Shield of Montana will process the claim. Your life. P | With a plan powered by the most trusted name in health insurance, youll have coverage tailored to your health. Location. Please contact the Medicare Appeals Team at 1 (866) 749-0355 or submit the appeal in writing and stating you need a fast, expedited, or hot" review, or a similar notation on the paperwork. Get Marvin Thomas's email address (m*****@regence.com) and phone number (253581..) at RocketReach. See the About UMP High Deductible Health Plan and If you have other HDHP coverage sections in the UMP High Deductible certificate of coverage for more information on secondary health plans and limitations. In addition, you cannot obtain a brand-name drug for the copayment that applies to the generic drug. If you have other medical or prescription coverage, Washington State Rx Services Complaint and Appeal Form, WSRxS Multiple Pharmacy Coverage Inquiry Form (Drug Coordination of Benefits). Were proud to stand with you during this challenging time. Username. Regence BlueCross BlueShield of Utah FAQs & Resources Complete and mail or fax a WSRxS Multiple Pharmacy Coverage Inquiry Form (Drug Coordination of Benefits) to Washington State Rx Services. Regence BlueCross BlueShield Medicare Advantage Plans in Oregon Blue Cross and Blue Shield of Nevada will process the claim. Regence BlueCross BlueShield of Utah is an independent licensee of the Blue Cross and Blue Shield Association. Regence BlueCross BlueShield of Utah PO Box 1106 Lewiston, Idaho 83501 Or Fax claim to: (888) 606-6582 FORM PD020-UT Page 2 of 3 (Eff. A list of reciprocal partners as well as membership benefits can be found at lifeflight.org. View your credentialing status in Payer Spaces on Availity Essentials. These forms explain what information should be included with your appeal and list the address and fax number of where to send your appeal. We offer the option to subscribe to receive the following communications via email: Subscribe to receive an email when new editions of the provider newsletters are available. You may need to submit your own claim if you buy drugs at a non-network pharmacy, dont show your ID card, or have other prescription coverage that pays first and UMP is secondary. Quickly identify members and the type of coverage they have. 636 GRAND AVE DES MOINES, IA 50309 800-245-6105. Box 30805 Salt Lake City, UT 84130- 0805 *Pennsylvania BCNEPA P.O. Centers of Excellence and Washington State Prescription Services do not provide BlueCross BlueShield services and are separate companies solely responsible for their products/services. To obtain information on the aggregate number of grievances, appeals and exceptions filed with the plan contact Customer Service. Open 24 hours a day, 7 days a week. The members full name (the name of the employee, retiree, or dependent covered by the plan), The member ID number (starting with a W on your UMP member ID card), The name(s) of any providers involved in the issue you are appealing, A statement describing the issue and your desired outcome, A copy of the Explanation of Benefits, if applicable, or a list of the claim numbers you are appealing. If you have questions about eligibility and enrollment:Employees:Contact your payroll or benefits office.SEBB Continuation Coverage members:Call the SEBB ProgramPhone: 1 (800) 200-1004 CLAIM.MD | Payer Information | OR BCBS (Regence) Payer Information OR BCBS (Regence) Payer ID: 00851 This insurance is also known as: Regence Blue Cross of Oregon Blue Cross Blue Shield of OR REGENCE BLUECROSS BLUESHIELD OF OREGON REGENCE BCBS OF OREGON FEP G00851 Other ID's: 12B41, SB850 Need to submit transactions to this insurance carrier? Learn more about our customized editing rules, including clinical edits, bundling edits, and outpatient code editor. | While it's a good idea to submit a complaint as soon as possible, there isn't a deadline to do so. If you have any questions about specific aspects of this information or need clarifications, please email press@bcbsa.com . endobj 2023 Regence health plans are Independent Licensees of the Blue Cross and Blue Shield Association serving members in Idaho, Oregon, Utah and select counties of Washington. Box 1106Lewiston, ID 83501-1106 Fax: 1 (877) 357-3418 If you have questions about submitting a claim for services outside the U.S., call UMP Customer Service. Mail or fax both the claim form and the provider's claim document (or bill) to: Regence BlueShieldAttn: UMP ClaimsP.O. For questions about appeals, call the SEBB Appeals Unit at 1 (800) 351-6827. Some of the limits and restrictions to prescription drug coverage will apply when UMP pays second to another plan. Media Contact: Lou Riepl Regence BlueCross BlueShield of Utah Regence BlueShield of . Use the link below to find your local BCBS company's website. Diabetes. Para humingi ng tulong sa Tagalog, pakitawagan ang numero ng telepono ng Serbisyo sa Kostumer (Customer Service) na nakasulat sa likod ng inyong kard bilang miyembro. All from Regence, a company committed to service, community and this place we call home. State/Alpha Prefix Claims Filing Address Alabama BCBS of Alabama P.O. PDF Amendment to Regence Bluecross Blueshield of Oregon Medical Group Agreement Consult theFEP local plan directory to find addresses and telephone numbers You can submit a claim online through your Regence account, or you can fax or mail your claim to Regence. We know it is essential for you to receive payment promptly. THIS AMENDMENT, effective January 01, 2023, hereby amends the Medical Group Agreement ("Agreement" or as otherwise defined in the Agreement) and any and all amendments, addenda, attachments or exhibits thereto by and between Regence BlueCross BlueShield of Oregon (Regence or as otherwise defined in the Agreement and hereafter referred to as Complete the Prescription Drug Claim Form and send it with your pharmacy receipts to: Pharmacy Manual ClaimsP.O. In every state and every community, BCBS companies are making a difference not just for our members, but For the Health of America. Please reference your agents name if applicable. Regence BlueCross BlueShield of Oregon | OneHealthPort