What If BCBS Member ID doesnt have Prefix mentioned on Card? If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly. 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). 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. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider. hbbd``b`f3$ bE FM Dmb"@
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Each BCBS alpha numeric prefix represents different BCBS home plan. 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 . Medicaid Born in Texas, USA. It means that BCBS members IDs prefix will must have alphabets and they may or may not have numbers. What is Medical Billing and Medical Billing process steps in USA? PDF 2021 Three Character Prefix For example: ABC12345678 Here " ABC" is BCBS alpha prefix. 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 Address: 11070 Katy Fwy, Houston, TX 77043, 2023 Xceed Billing Solution.com - All Rights Reserved, Blue Cross Blue Shield BCBS Prefix List Lookup. The three-character prefix identifies the Blue Cross and Blue Shield Plan to which the member belongs. Commercial Communications What is Medical Billing and Medical Billing process steps in USA? Box 14114 Lexington, KY 40512 Federal Employee Program (FEP) R prefix DC/Metropolitan Area 2024884900 MD 8008545256 DC/Metropolitan Area Mail Administrator P.O . 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. Xceed Billing Solutions motive is to create ease for providers, medical billers, patients and everyone who is involved in revenue cycle process. BCBS Prefix will not only have numbers and the digits 0 and 1. 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. nKvo2>)*Y=}4i,+s[yL*2#kN@r115};|`R[5/iZ 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. PDF BCBSAZ/TPA Co-Administered Group Plans - AZBlue =&m$
z90P&\:?$IRIj"c5l\"aD(@?Yuk>{8lkelu3X*FpT=6Rv;9'*4O-o|ELLG?-Yec,cqh(e96e4^QyD8H}'o(3 If youre a medical biller or a provider and going to submit BCBS plan member claim to the insurance, make sure to submit member ID including prefix. 01/01/2021 . For Example: ABC, A2B, 2AB, 2A2 etc. O}BAXv:OP)Qt9>PN,RG4uZu~?raYW+Q`|w[OD klW1Kg|'6'8=rRW00+,oD~`Ox(4DLMm,$Uy69r!$w0.<5>gJd'0?wf\2t| :\xQ cwh)}Ycb8I5vg~TQNnx^Y$M'JL+0?\:3Y(+Sb1:_%^uur(h>mS
Decide on what kind of signature to create. BCBS Alpha Prefix List For 2021, there were no changes to overall care categories, but some of the codes within certain categories may have been updated. ?} AN
A follow-up article with additional information on transition of member care was posted Dec. 4, 2020. 1 of 7. 'MNiXG]dRBC; 0'Va~9&c}Ag$Pge;\UY,$MtN 800-676-2583. 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 . 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. 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& %PDF-1.6
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The site may also contain non-Medicare related information. 2021 Prior Authorization Requirement Summaries, Code Lists and Related hb```I! Its important to remember that benefit plans differ in their benefits, and details such as prior authorization requirements are subject to change. Some members ID cards may not have an alpha prefix. PDF Updated November 2021 - BCBSIL 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. First Character P is symbolizing that member plan/product type is BCBS PPO. First Care, Inc. are independent licensees of the Blue Cross and Blue Shield Association. BCBS Prefix List 2023 - Alpha Prefix and Alpha Number Prefix Lookup %%EOF
BCBS Prefix will not only have numbers and the . bcbs prefix list PDF,Doc ,Images - pdfprof.com New BCBS Alpha Numeric Prefixes | My Payer Directory 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 PDF Member account and prefix updates: Provider FAQs Please look for instructions or a phone number on the back of the member ID card. Note: BCBS FEP (Federal Employee Program) ID starts with the alphabet R follow by the insured ID number (For Example: R987654321). Box 7930 Philadelphia, PA 19101-7930 PDF CSS-E121 Blue Cross Select Silver 01012021 - bcbsal.org Blue KC Commercial Prior Authorization and Notification List CareFirst IDs have plan codes 080/580 and 190/690. Box 805107, Chicago, Illinois 60680-4112. 0
An incorrect or missing three-character prefix may cause possible delays in the processing of your claims. If you have any questions or need help submitting a prior authorization, please call 816-395-3989 for assistance. The most important and easy way to identify BCBS member is his BCBS member ID alpha prefix. Normally, account specific prefix associates to the employer group name. There are three variants; a typed, drawn or uploaded signature. 389 0 obj
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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. Northwest Arizona Employee Benefit Trust (NAEBT) Group # 037461 . We update BCBS prefix list data on daily basis to provide latest BCBS prefix home plan information. Prior Authorization Services For Fully Insured and ASO, Prior Authorizations Lists for Blue Cross Medicare Advantage (PPO) and Blue Cross Medicare Advantage (HMO), Prior Authorizations Lists for Designated Groups, Prior Authorization Exemptions (Texas House Bill 3459), Medicare Advantage Private Fee-for-Service (PFFS), Eligibility and Benefits Inquiry (HIPAA 270/271), Behavioral Health Care Management Program, Quality Care Partner With Your Patients, Preventive Care Guidelines/Patient Wellness Guidelines, Health Equity and Social Determinants of Health (SDoH), Prescription Drug List and Prescribing Guidelines, Prior Authorization and Step Therapy Programs, Medical Policy and Pre-certification/Pre-authorization Information for Out-of-Area Members, Consolidated Appropriations Act and Transparency in Coverage Final Rule, Blue Cross Blue Shield of Texas provider website. 8772287268 Mail Administrator P.O. TPA Name & Address. For accurate and quick claims processing, it is necessary to get complete patient insurance information. Prefix ZGP identifies Blue Cross Blue Shield of Texas PPO Product. AIM Specialty Health (AIM) is an independent company that has contracted with BCBSIL to provide utilization management services for members with coverage through BCBSIL. 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. External link You are leaving this website/app (site). 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. We make sure to update the information on daily basis, however, if you find some kind of inaccurate information, feel free to contact us. For example: A2A12345678 Here " A2A" is BCBS alpha numeric prefix. You may also be interested to read about denial code 27 reason and solutions. 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. K8Y . %PDF-1.6
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BCBS Alpha Numeric Prefix Its a three letter Alpha numeric prefix followed by id number. Right after completing my degree in 2011, I started my job career as an Accounts Receivable in a medical billing company. BCBS Alpha Numeric prefix are three characters at the start of each BCBS insurance member ID. BCBS FEP Its indicated with letter R followed by the id number. 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. endstream
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Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. Prefix Group Address Group Name TPA Name & Address Claims Filing Claims & Benefit Contact Name Phone . hbbd```b``"`r9LLN`DR,>6l30&U$60D2HO rH+H
f`bdV8J Here are links to some recent communications that were posted to notify you of important changes: Government Programs Prior Authorization Summary and Code Lists By doing it may cause delay in processing or handling the claim. Health Equity and Social Determinants of Health (SDoH), Over the Counter Equivalent Exclusion Program, Prior Authorization and Step Therapy Programs, Consolidated Appropriations Act & Transparency in Coverage, Medical Policy/Pre-certification: Out-of-area Members, 2021 Commercial Prior Authorization Requirements Summary, 2021 Commercial Outpatient Medical Surgical Prior Authorization Code List, 2021 Commercial Specialty Pharmacy Prior Authorization Drug List, 2021 Commercial Outpatient Behavioral Health Prior Authorization Code List, New Prior Authorization Requirements for Some Custom Account Members Will Take Effect Jan. 1, 2021, 2021 Medicaid Prior Authorization Requirements Summary, 2021 Medicaid Prior Authorization Code List, 2021 MA PPO Prior Authorization Requirements Summary, 2021 MA PPO Prior Authorization Code List, BCBSIL Provider Network Consultant (PNC) team, Update: Utilization Management Change for Advocate Aurora Health Members, Effective Jan. 1, 2021 This News and Updates was posted Dec.15, 2020, and updated Dec. 31, 2020 to reflect a corrected phone number. By using this directory, you can ensure that you have the most up-to-date information about BCBS home plans and make more informed decisions about choosing right insurance plan. Carefirst BCBS of Maryland the (MD), District of Columbia (DC) and the Northern Virginia (VA) Checking eligibility and/or benefit information and/or the fact that a service has been prior authorized is not a guarantee of payment. We always make sure to keep BCBS prefix list and BCBS provider phone numbers directory up to date. BCBS Prefix can be classified as follows: BCBS Alpha Prefix - It's a three letter alpha prefix followed by id number. For Example: XYZ123456789. TT$%b"Dg!h^`]-ce?i8xRiu1IrD-%oR#yt;JBOJ#"TXwD0L Fw,]xS_CU3zf]06_T} PNGCqWV^UET6X~`U PPO 837P Prefixes are also applicable, . 404 0 obj
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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. BlueCard Program Alpha Prefixes | Blue Cross and Blue Shield - BCBSTX 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.