It comes up with the facilities such as dental, vision and other body issues. The most important and easy way to identify BCBS member is his BCBS member ID alpha prefix. This includes strict observance of and compliance with the laws and regulations governing the business operations of HCSC, and in particular, the services that it performs or has delegated to others to perform pursuant to its Medicare and Medicaid contract(s). In the USA, people prefer to use and apply for BCBS insurance as it is considered one of the trustworthy applications and has the maximum facilities to deal with. BCBS Alpha Prefix List of "Z"-series. endobj The site may also contain non-Medicare related information. The following prefix list comes with filling up the health care claims and analyses the correct address of the BSCs sections. Among these principles are a commitment to the highest standard of business ethics and integrity. 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. As noted above, when you check eligibility and benefits, in addition to confirming if prior authorization is required, youll also be directed to the appropriate vendor, if applicable. Even BCBS Insurance provides COVID-19 protocols, which has become a big issue in todays generation. <> An Independent Licensee of the Blue Cross Blue Shield Association 020469 (03-01-2023) Prefix BCBS Plan Prefix BCBS Plan Prefix BCBS Plan A2T Premera Blue Cross A9P Premera Blue Cross ACF Premera Blue Cross AGL Premera Blue Cross/Shared Admin GUJ AHC Premera Blue Cross AJX Premera Blue Cross GVY ALK Premera Blue Cross In this way, the BCBS holds on compensating the costs and indulges with the maximum support of the customers. BCBS prefix is a three character prefixes followed by the id number except for the following products and programs. 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 . BCBS Alpha prefix and BCBS Alpha numeric prefix are very important to submit claims to BCBS insurance. Correct BCBS home plan can easily be identified using our BCBS prefix lookup directory. Provider Finder . Independence Blue Cross (BC) of Philadelphia (Phi) and the Southeastern Pennsylvania (PA) ZAB. 855-854-1438. 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. You may also be interested to read about denial code 27 reason and solutions. The employees suggest to the customers select the packages and illustrate more about the service. Below in our BCBS prefix lookup directory, you can lookup all the BCBS prefix appropriate home plans and their contact information. <> Continue with Recommended Cookies. First, it saves you time and hassle by allowing you to quickly identify correct BCBS insurance home plan without having to call customer service. 9 0 obj BCBS is one of the largest medical insurance company by total members of more than 45 million. Most of the expenses get exposed through the treatments, and for that, the coverages are built up. Search with My Member ID Card: Go. 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. PDF Chapter 6: Billing and Payment endobj October 1, 2022 by Rebecca Williams. For Example: ABC, TXX, TEA, A2B, 2AB, 2A2, PAS, XXU etc. stream 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: Anthem Blue-Cross Blue-Shield of Nevada: AAF: BCBS Prefix List - Alpha Lookup by State 2022 - Finder BCBS Prefix List 2021 - Alpha. The cross also goes through the analysis of gaining health insurance and forms a series of packages. from the date of service. 13 0 obj First Character P is symbolizing that member plan/product type is BCBS PPO. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. FA%[: Also its not a sequential order hence its hard to find unless we check with first 3 alpha prefix. Second Character G assigned to the BCBS Plan as well. Claim Explanation Codes | Providers - Excellus BCBS %&'()*456789:CDEFGHIJSTUVWXYZcdefghijstuvwxyz giV7Lxp^^YM(_{27e;//3_`|eC9EliUDD.3fJ0]6DT{,dMZRPRWN2C7?HL4fvy|\b%^SKwIOh)xo${A%t7A3_h}AL Every Blue Cross and Blue Shield plan starts with an alpha prefix so they are called in medical terms BCBS Alpha Prefix. Some requests are handled by BCBSIL; others are handled by utilization management vendors. For Example: ABC, A2B, 2AB, 2A2 etc. Bcbs prefix list is showing the exact BCBS plan of the patient, so you can easily call to exact location plan and handle AR follow-up effectively. Create an account. For Example: XYZ123456789. 3 0 obj Preferred PPOSM Alpha Prefix Codes December 15, 2015 As a reminder, the alpha prefix codes on Blue Cross and Blue Shield of Illinois (BCBSIL) members' ID cards in the BlueCare Direct and Blue Choice Preferred PPO plans have been updated. Health Care Providers | Blue Cross Blue Shield of Illinois - BCBSIL 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. Ans. 2/1/2023. BCBSIL contracts with Prime to provide pharmacy benefit management and other related services. BCBS Alpha Prefix List from EAA to EZZ Updated (2023) Insurance Identifier Lookup; Plan Phone Numbers; Medicare Contractors; State Medicaid Plans; Home; Medicare Advantage List; . Click on New Document and select the file importing option: upload Xxu blue cross prefix from your device, the cloud, . <> Medical Billing and Coding Information Guide. On the other hand, host plans indicate more services in the health care services and competition within the area. The prefixes identify the member's BCBS prefix list plan or national account and become essential when routing claims for processing. Admin 22. First Character Z assigned to the BCBS Plan. 12 0 obj . It also issues for automation extension of the travel insurance plan. Most of the coverages are associated with baggage loss. BCBS alpha prefixes list and claim submission address - Updated list Blue Cross and Blue Shield of Illinois (BCBSIL) members' ID cards in the BlueCare Direct and Blue Choice Preferred PPO plans have . Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. Choose the best payment option for your Blue Cross and Blue Shield of Illinois (BCBSIL) monthly bill. BCBS Prefix List 2021 - Alpha State Lookup BCBS Company; PAA: Pennsylvania: Capital Blue-Cross of Pennsylvania: PAB: Tennessee: Blue-Cross Blue-Shield of Tennessee Assistance Available For Members Impacted by Severe Weather, 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). endobj Anthem BCBS of Wisconsin (WI) In case, you need any additional information related to BCBS prefix then feel free to reach out to us. BCBS is one of the biggest insurance companies in USA and serving more than 106 million people. Does United Healthcare cover the cost of dental implants? BCBS Alpha Numeric Prefix from W2A to W9Z (Updated 2023) We recently received a query from a provider that how I can identify that patient is BCBS health insurance member. The address and its verification of the members eligibility cover the areas of all the departments and claim the perfect status. 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. To view this file, you may need to install a PDF reader program. <> J7Wr}pY+Gqpgx ck 4=!omPyC]6bRw@;-:.L^]UMw6xAjAA8 et Hi, Im Kim Keck! It means that BCBS members IDs prefix will must have alphabets and they may or may not have numbers. Search articles and watch videos; ask questions and get answers. CPT is registered trademark of American Medical Association. BCBSIL, as well as several independent Blue Cross and Blue Shield Plans, has an ownership interest in Prime. We make sure to share latest data but in case you find some misinformation, please let us know so that we can help you to provide most accurate BCBS Alpha Prefix List.
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