BCBS Prefix BCBS Plan Name E2A Blue Cross Blue Shield Texas E2B Blue Cross Blue Shield Texas E2C Anthem BCBS Indiana E2E Regence Blue Cross . The site may also contain non-Medicare related information. Blue Shield has negotiated with the local hospitals and pays off the steep fees for encountering charges on the specific benefits. The health of your eyes and teeth can affect your overall health. BCBS is one of the biggest insurance companies in USA and serving more than 106 million people. Skip to content. Ans. The information you're accessing may not be provided by Excellus BCBS. We always make sure to keep BCBS prefix list and BCBS provider phone numbers directory up to date. 2nd Character G Plan Specific (letter assigned to the BCBS Plan), 3rd Character P PPO Product (letter assigned by the BCBS Plan to identify product type elected by the member). It has also helped customers during emergencies by providing the proper medical treatments and other sources. 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: One option is Adobe Reader which has a built-in reader. &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 For example: A2A12345678. Learn more about timely filing limits and CO 29 Denial Code. September 30, 2022 by Rebecca Williams. 12 0 obj endstream For . CPT is registered trademark of American Medical Association. BCBS Alpha Prefix List from CAA to CZZ Updated (2023) BCBS Alpha Prefix List of "C"-series. BCBS member ID prefix help medical billers, health care providers and patients to identify BCBS healthcare plan. Join us as we build the next generation of health insurance. As you transition to Medicare, we hope you'll Stay with Blue and get Medicare coverage from a company you trust. Some requests are handled by BCBSIL; others are handled by utilization management vendors. Today you will find The BCBS Alpha Prefix List from SAA to SZZ. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Independence Blue Cross(BC) of Philadelphia(Phi) and the Southeastern Pennsylvania(PA), Carefirst BCBS of Maryland the (MD), District of Columbia (DC) and the Northern Virginia (VA). It also files on checking the incorrect address and submits the correct form of claiming the right details. 2021 Commercial Specialty Pharmacy Prior Authorization Drug List This list was updated with 14 new codes effective Jan. 1, 2021. Independence Blue Cross (BC) of Philadelphia (Phi) and the Southeastern Pennsylvania (PA) ZAB. Always check eligibility and benefits first,via theAvailityEssentialsor your preferred web vendor, prior to rendering care and services. ]c\RbKSTQ C''Q6.6QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ 0*" One option is Adobe Reader which has a built-in reader. BAA. So, to accomplish our goal, we have listed down the complete BCBS alpha prefix list so that you can easily identify correct BCBS plan. Click on a section title to view the content. BCBS prefix is a three character prefixes followed by the id number except for the following products and programs. The calculation begins from the date of service, discharge date or last date of treatment up to 365days, including weekends. <> Prime Therapeutics LLC (Prime) is a pharmacy benefit management company. If you have questions on a request handled by AIM or eviCore, call the appropriate vendor, as noted above. BCBS Alpha Numeric Prefix from L2A to L9Z (Updated 2023), BCBS Provider Phone Number for Claims and Eligibility Verification, PR 27 Denial Code Description and Solution, How to Improve Your Coding Accuracy? LAA. Once a prior authorization request is received and processed, the decision is communicated to the provider. <> So the next time you need to identify accurate BCBS prefix home plan, remember to use the BCBS prefix list lookup finder. We recently received a query from a provider that how I can identify that patient is BCBS health insurance member. We and our partners use cookies to Store and/or access information on a device. Learn more about Ezoic here. The prefix acts as a key element in confirming the members' eligibility and coverage information. Also its not a sequential order hence its hard to find unless we check with first 3 alpha prefix. Availity is a trademark of Availity, LLC., a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Example: Prefix ZGP (Blue Cross Blue Shield of Texas it is a PPO Product). It covers the plans based on associating them with the testing, measuring the protocols at the time of the trip and many more. endobj Claims that are submitted after . But dont worry because our BCBS prefix finder include alpha numeric prefix information as well. There is a total of 732 alpha prefixes in the BCBS EAA-EZZ list and 39 are Not Assigned prefixes out of 732. % What kind of cases do personal injury lawyers handle? This list of bcbs prefixes includes BC prefix YUP, YRK, YPN, YPJ, YTD, YRH, YTP, YIF. Medical Billing and Coding Information Guide. 9 0 obj This new site may be offered by a vendor or an independent third party. <> In the case of baggage cover, the organization holds on compensating for the loss or any kind of delay. Alpha Prefix means plan id starts with three alphabets like ABC, XYZ, etc. BCBS Alpha prefix lookup contains all the Blue Cross Blue Shield alpha prefix along with their home plan and website. within 365 days . . By doing it may cause delay in processing or handling the claim. It is one of the giant sectors that provide more than 106 million health facilities. Home plans are generally used as a member of the former application. From April 1 to September 30, on weekends and holidays you may be required to leave a message. These documents are located inhttp://www.hisccompliance.com. AIM Specialty Health (AIM) is an independent company that has contracted with BCBSIL to provide utilization management services for members with coverage through BCBSIL. 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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. Correct BCBS home plan can easily be identified using our BCBS prefix lookup directory. 2021 Commercial Outpatient Behavioral Health Prior Authorization Code List This list is a new addition on our website for 2021. Blue Cross and Blue Shield of Illinois is proud to be the state's only statewide, customer-owned health insurer. Save my name, email, and website in this browser for the next time I comment. Second Character G assigned to the BCBS Plan as well. <> It holds a huge role in the cancellation policy, hotel booking and loss of passports. V2A to V9Z. If the provider or member doesnt get prior authorization for out-of-network services, the claim may be denied. Illinois. x\moFn"pI \Mc7 t,\GizffwN(LP4Kuda)\rxD870x(c%BE6q\4i5 #orUcA"QLoHCfG*QRx(aI*uS(IFf,3D*RY3dyGB{Zt|g&Dq~? BCBS Alpha Prefix List from UAA to UZZ Updated 2023. F1Xkt~ n_]}M,h>@iB;jVhX8M5%s9A}SHB+;zwOUR*7Y@"Z/j[xW[,5ygwxxe7cjgj;=d sXT >oTL{ $(5V7Ev-BNlJaZw7F^Uv >U$+o\!je mR[D-h?jkC: .cJ]QC,1p 9ArnWP) v5s]M*I'vv '/&s0k?Nb~$;,KAz1J X#!&H&K8 '!q15O*e g'<2Aq$04g[ UmKU80xxR The prefix acts as a key element in confirming the members' eligibility and coverage information. Most PDF readers are a free download. Blue Cross serves over 110 million members across the country, including Washington, DC and Puerto Rico. BCBS Prefix List 2021 - Alpha. You may also want to know: United Healthcare Claims Address Information. Born in Texas, USA. First Character P is symbolizing that member plan/product type is BCBS PPO. The Blue Cross helps to deal with the coverage of finding out medical costs and other emergencies. Anthem BCBS of Connecticut. Final Remarks about BCBS Prefix Lookup Directory. Calls will be returned the next . BCBS Prefix will not only have numbers and the digits 0 and 1. For prior authorization requests handled by BCBSIL: There are two ways to initiate your request. The 34 independent BCBS companies insure more than 107 million members across all 50 states, the District of Columbia, and Puerto Rico. <> Admin 22. To identify correct blue cross blue shield department, they use three characters BCBS prefix in the start of each BCBS member plan ID. M+. We update BCBS prefix data on daily basis to provide latest BCBS prefix information. The alpha prefix is very important to the identification number. Prefixes are also used to identify and correctly route claims to the appropriate Blue Cross Blue Shield [] It also goes on dealing with the student plan. Also, these BCBS prefixes helps providers and medical billers to reach the correct claims department for claims and benefits inquiry. These blue shield companies negotiate with the doctors and the other hospitals. mr+*W@B Coupon "NSingh10" for 10% Off onFind-A-CodePlans. Usually, the provider is responsible for requesting prior authorization before performing a service if the member is seeing an in-network provider. ( Note: See Medicaid page for BCCHP and MMAI Provider Finder links.) First Character Z assigned to the BCBS Plan. If you are using electronic submission then prefix is important to submit claims successfully and received by insurance correctly. I have completed my Bachelor of Business Administration in Healthcare Management from University of Texas. endobj endobj 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. 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. 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. 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. Admin 83A. <> 855-854-1438. 1 0 obj IPA Availability and Accessibility Requirements for Immediate Care Services Procedure. Check out our Corporate Social Responsibility Report and learn about the ways we are serving our community. 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. 5 0 obj xyl prefix provider phone number aqt bcbs prefix bcbs of minnesota prefix bcbs prefix lookup anthem prefixes by state 2022 bcbs illinois prefix list 2022. 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.
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