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. Most of the expenses get exposed through the treatments, and for that, the coverages are built up. Note: Checking eligibility and benefits is key, butwe also have other resources to help you prepare. Our trusted community experts can give you the one-on-one help you need to shop for health insurance. 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). Once a prior authorization request is received and processed, the decision is communicated to the provider. It also suggests that the members enjoy the networks participating with the hospital and other medical costs. *!uB9^AwjF(v,o Medical Billing and Coding Information Guide. 10 0 obj For Example: XYZ123456789. The Blue Cross helps to deal with the coverage of finding out medical costs and other emergencies. _( ~ G+[~:d#y8J5)-*]4hLFk-P3sI77O. XCD. BCBS Prefix List 2021 - Alpha. Here " A2A" is BCBS alpha numeric prefix. Ans. So, to accomplish our goal, we have listed down the complete BCBS alpha prefix list so that you can easily identify correct BCBS plan. Certain employer groups may require prior authorization or pre-notification through other vendors. It also issues for automation extension of the travel insurance plan. w !1AQaq"2B #3Rbr We and our partners use data for Personalised ads and content, ad and content measurement, audience insights and product development. The consent submitted will only be used for data processing originating from this website. 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. endobj The calculation begins from the date of service, discharge date or last date of treatment up to 365days, including weekends. Availity provides administrative services to BCBSIL. In case, you need any additional information related to BCBS prefix then feel free to reach out to us. 7aM- I|x,# On the other hand, host plans indicate more services in the health care services and competition within the area. BCBS Alpha Prefix List from CAA to CZZ Updated (2023) BCBS Alpha Prefix List of "C"-series. 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. To view this file, you may need to install a PDF reader program. How To Identify Blue Cross Blue Shield Member? What is Medical Billing and Medical Billing process steps in USA? New to Blue Access for Members? Also, these BCBS prefixes helps providers and medical billers to reach the correct claims department for claims and benefits inquiry. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. 2/1/2023. Sometimes, a plan may require the member to request prior authorization for services. BCBS member ID prefix help medical billers, health care providers and patients to identify BCBS healthcare plan. <> Prior authorization requests for our Blue Cross Medicare Advantage (PPO) SM (MA PPO), Blue Cross Community Health Plans SM (BCCHP SM) and Blue Cross Community MMAI (Medicare-Medicaid Plan) SM members can be submitted to eviCore in two ways. Account Specific Prefix are assigned by BCBS to national accounts. within 365 days . For example: ABC12345678. 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. Not assigned prefix: GAX: BCBS Illinois: GAY: Anthem Central Region (OH, IN, KY) GAZ: Not assigned prefix: GBA: BCBS Montana: GBB: Anthem Blue Cross California: GBC: Wellmark BCBS: GBD: Skip to content. Do not create one or use the BCBS prefix from another member ID card. Manage Settings When does health insurance expire after leaving job? What If BCBS Member ID doesnt have Prefix mentioned on Card? The site may also contain non-Medicare related information. Join us as we build the next generation of health insurance. Here you can find the BCBS prefix finder along with BCBS home plan name and website for BCBS member IDs ranging from F2A to F9Z. BCBS Prefix List 2021 - Alpha. It allows you to quickly and easily identify your insurance home plan, saving you time and hassle. Choose a state to see how Blue Cross Blue Shield is working in your community. We are also the largest provider of health benefits in Illinois, serving more than 8.1 million members in all 102 counties across the state. !(!0*21/*.-4;K@48G9-.BYBGNPTUT3? So, to answer this query, we have mentioned below few important points to consider. 107. Prime Therapeutics LLC (Prime) is a pharmacy benefit management company. This new site may be offered by a vendor or an independent third party. <> 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 Company. BCBS of Kansas City. State Lookup. $4%&'()*56789:CDEFGHIJSTUVWXYZcdefghijstuvwxyz ? The main benefits of having insurance plans and coverages are not only getting monotonous services but also enjoying the perfect scheduling of other facilities, i.e., international travel and coverages. For more than 85 years, we've provided our members with comprehensive, affordable health . 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. If you have questions on a request handled by AIM or eviCore, call the appropriate vendor, as noted above. The prefix acts as a key element in confirming the members' eligibility and coverage information. The first two alphabets of the prefix denote the plan and the third alphabet prefix denotes the type of product the insured choose for coverage. 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. In that situation, health insurance makes the right baggage and passport coverage decisions. Find a BCBS Company by Prefix. The site may also contain non-Medicare related information. Step 1 Confirm if Prior Authorization is Required. endobj 1 0 obj For prior authorization requests handled by BCBSIL: There are two ways to initiate your request. 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. Therefore, the majority of the USA goes on featuring health insurance and has helped manage travel expenses. endobj BCBS Insurance mainly focuses on medical treatments and providing maximum support for the financial condition. It means that BCBS members IDs prefixes will must have alphabets. 13 0 obj It shows that these type of BCBS member IDs are different. To view this file, you may need to install a PDF reader program. Click on a section title to view the content. Most of the coverages are associated with baggage loss. endobj 2021 Commercial Outpatient Behavioral Health Prior Authorization Code List This list is a new addition on our website for 2021. 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. endobj In all adverse conditions, their health insurance programs go on providing the facilities to help out the customers in all possible ways. Provided on the website you will find the following documents: Medicare and Government Contracts Compliance Program, Blue Cross Medicare Advantage HMO Non-Delegated Model Manual, Blue Cross Medicare Advantage PPO ProviderManual, CMS Qualified Medicare Beneficiary Program, 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). Lets dig into it! This new site may be offered by a vendor or an independent third party. Blue Cross Blue Shield of Illinois: IBU: Blue Cross Blue Shield of Alabama: IBV: Blue Cross Blue Shield of Massachusetts: IBW: Blue Cross . BCBS Alpha Numeric Prefix - It's a three letter Alpha numeric prefix followed by id number. Blue-Cross Blue-Shield of Illinois. <> For example: A2A12345678. Admin 83A. Member Prefix List Patient Roster Claims & Payments. . 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. LAA. Checking eligibility and/or benefit information and/or obtaining prior authorization is not a guarantee of payment. BCBS Alpha Prefix Lookup. State Lookup. ]c\RbKSTQ C''Q6.6QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ 0*" x\moFn"pI \Mc7 t,\GizffwN(LP4Kuda)\rxD870x(c%BE6q\4i5 #orUcA"QLoHCfG*QRx(aI*uS(IFf,3D*RY3dyGB{Zt|g&Dq~? The organization is famous just for this particular service apart from the other policies. Normally, account specific prefix associates to the employer group name. However it has several policies for its customers. T2*uug)T%D._M/5WIdB;zg@W01>X_b( vkWXth$OYD8x$Ygt{" BB> Does United Healthcare cover the cost of dental implants? You may also be interested to read about denial code 27 reason and solutions. Yes, Policy number same as member ID number and also known as subscriber ID number. One of the biggest issues in todays generation is where medical treatments and conditions lie. Highmark BCBS of Pennsylvania (PA) ZAC. BCBS Alpha prefix and BCBS Alpha numeric prefix are very important to submit claims to BCBS insurance. stream . Today you will find The BCBS Alpha Prefix List from UAA to UZZ. 800-676-2583. Topics include everything from improving your well-being to explaining health coverage. This can be especially helpful if youre in a rush or need to access your BCBS prefix home plan information quickly. External link You are leaving this website/app (site). We recently received a query from a provider that how I can identify that patient is BCBS health insurance member. External link You are leaving this website/app (site). The following travel insurance helps to deal with all the medical costs and also covers the family expenses. Does blue cross blue shield cover shingles vaccine? BCBS Alpha Numeric Prefix Its a three letter Alpha numeric prefix followed by id number. The Blue cross blue shield company mainly provides proper health insurance coverages. I have completed my Bachelor of Business Administration in Healthcare Management from University of Texas. 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. A prior authorization isnota guarantee of benefits or payment. 4/1/2022. Continue with Recommended Cookies. Any individuals who impact HCSC's Medicare or Medicaid contract(s) are expected to abide by the Medicare and Government Contracts Compliance Program, the Code of Business Ethics and Conduct and the Medicare Compliance Policies. 2 0 obj But dont worry because our BCBS prefix finder include alpha numeric prefix information as well. So, all BCBS plans, including Anthem and Non-Anthem plans announced that member IDs will also be Alpha Numeric from 2018 onwards. In addition, some sites may require you to agree to their terms of use and privacy policy. BCBSIL, as well as several independent Blue Cross and Blue Shield Plans, has an ownership interest in Prime. For Example: ABC, A2B, 2AB, 2A2 etc. BCBS Alpha Prefix List from GAA to GZZ updated 2021-List of Blue Cross Blue Shield insurance Companies - Statewise with prefix. BCBS Alpha Prefix List of "E"-series: Blue Cross Blue Shield insurance Companies - Statewise: EAA: Not assigned prefix: EAB: BCBS of Kansas City: EAC: Anthem BCBS of Virginia (VA) EAD: BCBS of Illinois (IL) EAE: Regence BCBS: EAF: BCBS of Massachusetts (MA) EAG: Capital Blue Cross of Pennsylvania (PA) EAH: BCBS of Alabama (AL) EAI: Not . Request a new replacement member ID card, or download a temporary copy. 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. <> XCC. For more than 85 years, weve provided our members with comprehensive, affordable health plans, making Illinois a healthier place to live, work and play. 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. 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. 15 0 obj Prior authorization (sometimes called preauthorization or pre-certification) is apre-service utilization management review. It also states the important papers for identification that would help safeguard the situation and also save the expenses. Search with My Member ID Card: Go. Independence Blue Cross (BC) of Philadelphia (Phi) and the Southeastern Pennsylvania (PA) ZAB. It also goes on dealing with the student plan. &UMDU}%h UX[_kRGyzte,.-pD?^]Yt%i7=$Foy*ja(5}31$9w}eLvdA oV;_$myuVLW5v^{=GW;ig)aYff,WW(/-"*{Wf;x5qS:@-q$QJLgvCd2>OXe|lqc;Kv.&Pkuz?&jm*1qm1UqmeETH}6Iq?} Dl]mh*MNgUh9dzQ!hTk H:Azif+ ]V"U23 Carefirst BCBS of Maryland the (MD), District of Columbia (DC), and the Northern Virginia (VA) CAB. In plan-specific alpha prefixes, the first two characters denote a given plan, while the third character identifies the product type chosen by the member, explains the BCBS of Texas. 3 0 obj UAC. 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. Amerihealth Caritas Directory Healthcare, Health Insurance in United States of America, Place of Service Codes List Medical Billing, Independence Blue-Cross of Philadelphia and Southeastern Pennsylvania, Maryland/District of Columbia/Northern Virginia, Anthem Blue-Cross Blue-Shield of Virginia, Excellus Blue-Cross Blue-Shield of New York, Anthem Blue-Cross Blue-Shield of Missouri, Blue-Cross Blue-Shield of Western New York, Empire Blue-Cross Blue-Shield of New York, Anthem Blue-Cross Blue-Shield of Colorado, Anthem Blue-Cross Blue-Shield of Wisconsin, Highmark Blue-Cross Blue-Shield of Pennsylvania, Horizon Blue-Cross Blue-Shield of New Jersey, Anthem Blue-Cross Blue-Shield of Connecticut, Anthem Blue-Cross Blue-Shield of Kentucky. Most PDF readers are a free download. Search your plan's drug list, find a pharmacy, and more. The terms of the members plan control the available benefits. <>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S>> Remember, member benefits and review requirements will vary based on service/drug being rendered and individual/group policy elections. <> 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. Regardless of any prior authorization or benefit determination, the final decision regarding any treatment or service is between the patient and the health care provider. BCBS member ID have maximum 17 characters but most of the member IDs have 12 characters. BCBS prefix lookup directory is a valuable resource for anyone who is looking for right Blue Cross Blue Shield home plan. endobj BCBSIL makes no endorsement, representations or warranties regarding any products or services provided by third party vendors. What kind of cases do personal injury lawyers handle? Related forms. Home plans are generally used as a member of the former application. endobj In case, you need any additional information related to BCBS prefix then feel free to reach out to us. The prefix acts as a key element in confirming the members' eligibility and coverage information. Prefixes are also used to identify and correctly route claims to the appropriate Blue Cross Blue Shield [] This list of bcbs prefixes includes BC prefix IEO, INE, ILT, IOI, IQQ, IPB, IVV. To view the purposes they believe they have legitimate interest for, or to object to this data processing use the vendor list link below. The perfect members of BCBS insurance get more flexibility and facilities in terms of health insurance. The blue cross blue shield coverage deals with the best services for its customers and involves a better statement of the medical treatments. Health Care DeliveryPolicy and Procedures, Blue Cross Community Health Plans ProviderManual, Medicaid Provider Orientation(Professional), Medicaid Prior Authorization RequestForm, Medicaid Provider Orientation (Professional), Blue Cross Community OptionsSMBehavioral Health Benefit Grid.
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