So, to accomplish our goal, we have listed down the complete BCBS alpha prefix list so that you can easily identify correct BCBS plan. hb``` eaXm.; `Umap@LDPpN jM*,BDu|m_(2*u x y-a`b` #; The three-character prefix identifies the Blue Cross and Blue Shield Plan to which the member belongs. 1229 0 obj <> endobj 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. Now, with more than 15 years of experience as a medical biller and revenue cycle manager, I am on a mission to serve the medical billing industry with my vast knowledge and years of expertise. ;MTK A follow-up article with additional information on transition of member care was posted Dec. 4, 2020. 404 0 obj <>stream Please look for claim filing instructions on the back of the ID card. Does BCBS Cover Wegovy for Weight Loss? In the District of Columbia and . If you have any questions or need help submitting a prior authorization, please call 816-395-3989 for assistance. This new site may be offered by a vendor or an independent third party. Blue Cross Select Silver. We've provided the following resources to help you understand Anthem's prior authorization process and obtain authorization for your patients when it's required. Here Letter R indicates BCBS FEP prefix. This new site may be offered by a vendor or an independent third party. endstream endobj startxref BCBS Prefix will not only have numbers and the digits 0 and 1. Additionally, the following services require Prior Authorization regardless of place of service or level of care: To submit a prior authorization request you may also fax or mail your request. bcbs prefix list PDF,Doc ,Images [PDF] Common Prefix Portal List PBC Premera Blue Cross Three Character Prefixes. Here are links to some recent communications that were posted to notify you of important changes: Government Programs Prior Authorization Summary and Code Lists No, the BCBS policy number is not typically the same as the BCBS member ID number. 365 0 obj <> endobj So the next time you need to identify accurate BCBS prefix home plan, remember to use the BCBS prefix list lookup finder. endstream endobj 1230 0 obj <. Below in our BCBS prefix lookup directory, you can lookup all the BCBS prefix appropriate home plans and their contact information. In case, you need any additional information related to BCBS prefix then feel free to reach out to us. These BCBS prefix may include alpha and numerical characters. hbbd```b``A$ Coverage For: Individual + Family. Benefits will be determined once a claim is received and will be based upon, among other things, the members eligibility and the terms of the members certificate of coverage applicable on the date services were rendered. Right after completing my degree in 2011, I started my job career as an Accounts Receivable in a medical billing company. External link You are leaving this website/app (site). endstream endobj 742 0 obj <. Stand-alone dental products, vision and pharmacy when delivered through an intermediary model. 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: We make it easy for you to offer the healthcare coverage that delivers for your business. 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. by calling 1-844-377-1278 (BCN) or 1-800-728-8008 (Blue Cross) or by logging oncology and in to the AIM ProviderPortal. 01/01/2021 . The main difference between BCBS alpha prefix and BCBS alpha numeric prefix is that BCBS alpha prefix only contains alphabets whereas BCBS alpha numeric prefix consists of alphabets as well as numbers ranging from 1 to 9. For example: ABC12345678 Here " ABC" is BCBS alpha prefix. You can also contact us for specialty medical billing services. We recently received a query from a provider that how I can identify that patient is BCBS health insurance member. It is used to identify and track the healthcare coverage and benefits for that specific member. BCBS is one of the largest medical insurance company by total members of more than 45 million. Plan Type: PPO . therapy) Prefix ZGP identifies Blue Cross Blue Shield of Texas PPO Product. Prefix Group Address Group Name TPA Name & Address Claims Filing Claims & Benefit Contact Name Phone . BCBS member ID card will have a suitcase logo at the bottom of card which will also help you to identify patient plan like HMO, PPO, POS etc. Does policy number same as member ID number? (Note: For changes to come later this year, refer to this notice, posted Dec. 28, 2020: Commercial Prior Authorization Code Changes, Effective April 1, 2021. Use this guide to see prior approval information for members with ID card prefixes: AEE, AXC, EXX, XCB, XCQ, XCR View guides [pdf] Medicare plans Learn more about providing care for Medicare members. ). This includes our Medicaid Blue Cross Community Health PlansSM (BCCHPSM) and Blue Cross Community MMAI (Medicare-Medicaid Plan)SM and Blue Cross Medicare Advantage (PPO)SM(MA PPO) members. 2021, for some of our commercial non-HMO members, such as those listed below: - PPO - Blue Choice Preferred PPO(SM) - Blue Choice PPO(SM) - Blue Options(SM)/Blue Choice Options(SM) - Blue High Performance Network(SM) [Blue HPN(SM)] This is not an exhaustive listing of all codes. For 2021, there were no changes to overall care categories, but some of the codes within certain categories may have been updated. Prior Authorization for Some Commercial Members Will Transition from eviCore to AIM, Effective Jan. 1, 2021 This notice was posted Oct. 1, 2020, to alert you of a utilization management vendor change. Individuals & Families We offer a wide choice of individual plans to fit your health needs and budget. BCBS Railroad member IDs are assigned to members who served in railroad organizations. Save my name, email, and website in this browser for the next time I comment. Third, it can help you make more informed decisions to choose right insurance plan and benefits. BCBS of Illinois (IL) PAK. Lo-+J52(h' Always use the BCBS prefix on the members current ID card followed by the member id number. 'MNiXG]dRBC; 0'Va~9&c}Ag$Pge;\UY,$MtN It clarifies a utilization management vendor change for specific members. Have a look at our BCBS alpha prefix and BCBS alpha numeric prefix directory below. 2021 Commercial Specialty Pharmacy Prior Authorization Drug List This list was updated with 14 new codes effective Jan. 1, 2021. b(f{YH^tn}u62\}TgT>ENWJB=J #=a$oXIq(n,tU+D'j}L(t#,w?!^oZUQR, 7a. claims_and_billing/edi/ibc_ professional_payer_id.pdf 54704 -SX083 837I -12X26 Claims Address Claims Receipt Center Box 211184 Eagan, MN 55121 Adjustment Claims Inquiries P.O. The three-character prefix at the beginning of the member's identification number is the key element used to identify and correctly route out-of-state claims to the appropriate BCBS Plan. One option is Adobe Reader which has a built-in reader. Prior authorization requirements are specific to each patients policy type and the procedure(s) being rendered. It shows that these type of BCBS member IDs are different. 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). There are three variants; a typed, drawn or uploaded signature. A2Z, G2A, J4K etc. PAJ. Account Specific Prefix are assigned by BCBS to national accounts. Hi, Im Kim Keck! Carefirst BCBS of Maryland the (MD), District of Columbia (DC) and the Northern Virginia (VA) In that case claim may be denied as Submit the claim to the correct address / Member ID not found. In order to get rid of this denial or sometimes delay in processing, Provider or Billing companies has to find out the correct address by BCBS prefix from the above list before filing the claim. Does BCBS policy number same as BCBS member ID number? Its critical to check member eligibility and benefits through the Availity Provider Portal or your preferred vendor portal prior to every scheduled appointment. endstream endobj startxref The three-character prefixes listed do not represent an exhaustive listing of prefixes. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. 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. hbbd```b``@$Df/i #D2lE``vd@ "@,iZ R R2H{v# k 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. Unraveling the Truth, United Healthcare Claims Address, Payer ID, Fax and Phone Number, BCBS Prefix List 2023 Alpha Prefix and Alpha Number Prefix Lookup, BCBS Alpha Numeric Prefix from L2A to L9Z (Updated 2023), BCBS Provider Phone Number for Claims and Eligibility Verification, Benefits and Eligibility Verification Services. The most important and easy way to identify BCBS member is his BCBS member ID alpha prefix. 2021 Commercial Outpatient Behavioral Health Prior Authorization Code List This list is a new addition on our website for 2021. BCBS Alpha Prefix list is useful for both providers and BCBS enrolled members/patients. I have completed my Bachelor of Business Administration in Healthcare Management from University of Texas. We have a track record of providing quality medical billing services to multiple healthcare organizations and specialty providers across USA. 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. NBT . Summaries and code lists are posted as a reference to help you determine when prior authorization may be required for non-HMO government programs members. These plans provide health insurance coverage for railroad employees, retirees, and their eligible dependents. Checking eligibility and/or benefit information and/or the fact that a service has been prior authorized is not a guarantee of payment. K8Y . endstream endobj 366 0 obj <>>>/Filter/Standard/Length 128/O(`iYJhD[>R`Xq)/P -1324/R 4/StmF/StdCF/StrF/StdCF/U(ETWBQcf )/V 4>> endobj 367 0 obj <>/Metadata 16 0 R/PageLayout/OneColumn/Pages 363 0 R/StructTreeRoot 28 0 R/Type/Catalog>> endobj 368 0 obj <>/Font<>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 369 0 obj <>stream Physicians and other health care providers are encouraged to use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment. BCBS is one of the biggest insurance companies in USA and serving more than 106 million people. 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. To view this file, you may need to install a PDF reader program. %{!]/Ox^ A[BXe S#(Df BCBS prefix is a three character prefixes followed by the id number except for the following products and programs. Contact us to learn how we can improve your revenue cycle. BCBS prefix List plays a vital role in filing the health care claims properly to the correct BCBS address and also to verify members eligibility, health insurance coverage information and to reach the correct BCBS department to check the claim status or disputes of the claim. DIGNITY HEALTH YAVAPAI REGIONAL MEDICAL CENTER AND BLUE CROSS BLUE SHIELD OF ARIZONA REACH AGREEMENT, FIESTA BOWL AND BLUE CROSS BLUE SHIELD OF ARIZONA OPEN APPLICATIONS FOR FOURTH ANNUAL EMPOWERING DIVERSITY SCHOLARSHIP, PCMH PROGRAM DELIVERS HEALTHIER PATIENTS AND HAPPIER PROVIDERS. 761 0 obj <>/Filter/FlateDecode/ID[]/Index[741 37]/Info 740 0 R/Length 98/Prev 110535/Root 742 0 R/Size 778/Type/XRef/W[1 2 1]>>stream Second Character G assigned to the BCBS Plan as well. External link You are leaving this website/app (site). Blue Shield (BS) of California. In addition, some sites may require you to agree to their terms of use and privacy policy. 1268 0 obj <>stream Complete patient information, on the other hand, allows your claims to process without delays. 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. BCBS alpha numeric prefix digits are usually in between the prefix e.g. In addition, some sites may require you to agree to their terms of use and privacy policy. ?} AN BCBS Alpha prefix lookup contains all the Blue Cross Blue Shield alpha prefix along with their home plan and website. 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 Independence Blue Cross (BC) of Philadelphia (Phi) and the Southeastern Pennsylvania (PA) PAI. ", Blue Cross and Blue Shield of Texas, 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). Three-Character Prefixes. BCBS Alpha Prefix Its a three letter alpha prefix followed by id number. TPA Name & Address. Working or retired, we'll help you every step of the way to find the right plan. 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. BCBS Prefix AAA Home Plan and Phone Number, BCBS Alpha Numeric Prefix from Y2A to Y9Z, BCBS Alpha Numeric Prefix from X2A to X9Z, BCBS Alpha Numeric Prefix from W2A to W9Z, BCBS Alpha Numeric Prefix from V2A to V9Z, Frequently Asked Questions Related to BCBS Prefix. 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. %%EOF Yes, Policy number same as member ID number and also known as subscriber ID number. for medical policies and prior authorization requests . The first two characters of such BCBS prefix spots member plan and the third character is to identify the type of product in which the BCBS member is enrolled. Last updated: 07/01/2022. BlueCard. BCBS Prefix List 2021 - Alpha Numeric State Lookup BCBS Company; Z2A-Prefix Unallocated/Not Assigned: Z2B: Indiana: Anthem Blue-Cross Blue-Shield of Indiana: Z2C-Prefix Unallocated/Not Assigned: Z2D-Prefix Unallocated/Not Assigned: Z2E-Prefix Unallocated/Not Assigned: Z2F: Minnesota: 8772287268 Mail Administrator P.O. Choose My Signature. 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. 0 Wheelchairs - Mobility Assistive Equipment (Manual & Power) & Scooters - Wheelchair Purchase only -Motorized) Wheelchair: E1050, E1060, E1070, E1083, E1084, E1085 . %%EOF Amerihealth Caritas Directory Healthcare, Health Insurance in United States of America, Place of Service Codes List Medical Billing. 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. Address: 11070 Katy Fwy, Houston, TX 77043, 2023 Xceed Billing Solution.com - All Rights Reserved, Blue Cross Blue Shield BCBS Prefix List Lookup. Most PDF readers are a free download. 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. It means that BCBS members IDs prefixes will must have alphabets. So, to answer this query, we have mentioned below few important points to consider. We update BCBS prefix list data on daily basis to provide latest BCBS prefix home plan information. BCBS Alpha Numeric Prefix Its a three letter Alpha numeric prefix followed by id number. The three-character prefix identifies the Blue Cross and Blue Shield Plan to which the member belongs. Independence Blue Cross* Quick Reference Guide . `xn_F-y(MQ&O!y1?-uZ=t'=E$r2$IA)gYWp&g` BCBS FEP Prefix BCBS Federal Employee Program is identified by the letter R followed by the number. %PDF-1.6 % BCBS FEP Its indicated with letter R followed by the id number. "Y24Oz>V ?I L r%dl=vHd z/;/X #k> Gq 800-676-2583. Prefix UTS assigned to University of Texas. The notice also refers to a medical policy for more information to help clarify when and how prior authorization requirements may apply. Benefits and eligibility should be verified for all members prior to rendering services. 0 Coverage Period: 01/01/2021 - 12/31/2021 . e@'SZD/KCbv*pKq~ Baltimore, MD 21237 . To get information about such member IDs, you can contact BCBS prefix directory phone number i.e. BCBS Prefix will not only have numbers and the digits 0 and 1. %PDF-1.6 % 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. 0|kEMi_a*-Yfj#uqEcA/6 .M.6YNw4cyo>lESMC\)H~L 1B> BCBS Prefix can be classified as follows: BCBS Alpha Prefix - It's a three letter alpha prefix followed by id number. To view this file, you may need to install a PDF reader program. BCBS prefix lookup directory is a valuable resource for anyone who is looking for right Blue Cross Blue Shield home plan. 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. But dont worry because our BCBS prefix finder include alpha numeric prefix information as well. Commercial Communications Also, these BCBS prefixes helps providers and medical billers to reach the correct claims department for claims and benefits inquiry. plan. Call 1-800-388-3193 . Codes may chan ge, and this list may be updated throughout the year. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Xceed Billing Solutions is amedical billing company for outsourcing medical billing services. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. 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. American Health Group (AHG) Call 1-800-847-7605 . Correct BCBS home plan can easily be identified using our BCBS prefix lookup directory. The prefix routes eligibility/benefits inquiries and claims to the appropriate BCBS Plan or system for timely processing. If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly. PPO 837P Prefixes are also applicable, . endstream endobj startxref 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 .

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