Admin 22. Admin 22A. 2021 Commercial Specialty Pharmacy Prior Authorization Drug List This list was updated with 14 new codes effective Jan. 1, 2021. Ans. BCBS Alpha Numeric Prefix from W2A to W9Z (Updated 2023) January 8, 2023 by Kim Keck. Blue cross coverage goes through the idea of calling out the blue cross blue shield company, which helps to provide the programs benefits. The alpha prefix is always three letters followed by the member's ID number which can be from 6 up to 14 characters total. The 34 independent BCBS companies insure more than 107 million members across all 50 states, the District of Columbia, and Puerto Rico. BAB. For example: A2A12345678. Livestock Protection. Here " ABC" is BCBS alpha prefix. endobj For prior authorization requests handled by BCBSIL: There are two ways to initiate your request. XCE. 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. 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. The information you're accessing may not be provided by Excellus BCBS. <> 18 0 obj Sometimes, a plan may require the member to request prior authorization for services. Join us as we build the next generation of health insurance. A prior authorization isnota guarantee of benefits or payment. 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). Most of the coverages are associated with baggage loss. What is Medical Billing and Medical Billing process steps in USA? One option is Adobe Reader which has a built-in reader. Language Assistance (opens in a new window) and Non-Discrimination Notice . In addition, some sites may require you to agree to their terms of use and privacy policy. Learn more. The following prefix list comes with filling up the health care claims and analyses the correct address of the BSCs sections. It helps to cover up the flights or any delays. Renew Illinois Individual, Family & Medicaid Health Insurance, Blue Cross Community MMAI (Medicare-Medicaid Plan), Making Your Health Insurance Work For You, Prescription Drug Changes and Pharmacy Information, Machine Readable Files for Transparency in Coverage, Learn About Colon Cancer Screening Options. 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. For more than 85 years, we've provided our members with comprehensive, affordable health . For example: ABC12345678. Most PDF readers are a free download. UAC. 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. :C5*|}6_D20&Z+NvN0l+TyX ^:"WJ*~'vW/;3eW0Jx] >Ou#_D4W_H5d"t~"AM)B#z_s*,f0Vy5X]KJ_ BCBS Alpha Prefix Its a three letter alpha prefix followed by id number. Blue Cross and Blue Shield of Illinois is proud to be the states only statewide, customer-owned health insurer. Five most Workers Compensation Mistakes to Avoid in Maryland. 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. The Home and Host plan is also working in the Blue Cross Blue Shield plan. Find a BCBS Company by Prefix. The manual is organized into the following sections for your convenience. AIM Specialty Health (AIM) is an independent company that has contracted with BCBSIL to provide utilization management services for members with coverage through BCBSIL. The programs main benefit is that it allows one to receive and understand the health care benefits. CPT is registered trademark of American Medical Association. It means that BCBS members IDs prefix will must have alphabets and they may or may not have numbers. from the date of service. Information for Blue Cross and Blue Shield of Illinois (BCBSIL) members is found onour member site. <> endstream We have a track record of providing quality medical billing services to multiple healthcare organizations and specialty providers across USA. These BCBS prefix may include alpha and numerical characters. Remember, member benefits and review requirements will vary based on service/drug being rendered and individual/group policy elections. The content shared in this website is for education and training purpose only. Commercial Communications Provider Finder . Second Character G assigned to the BCBS Plan as well. So, to accomplish our goal, we have listed down the complete BCBS alpha prefix list so that you can easily identify correct BCBS plan. endobj One option is Adobe Reader which has a built-in reader. Blue Cross serves over 110 million members across the country, including Washington, DC and Puerto Rico. Include the alpha prefix and all alpha characters preceding the alpha prefix on all correspondence and claims submitted to Blue Cross Blue Shield of Texas. In case, you need any additional information related to BCBS prefix then feel free to reach out to us. It also goes on dealing with the student plan. 11 0 obj 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. It comes up with the facilities such as dental, vision and other body issues. September 30, 2022 by Rebecca Williams. <> Sign up for theLifeTimes newsletterto get health and benefits articles delivered to your inbox every month. Calls will be returned the next . Have a look at our BCBS alpha prefix and BCBS alpha numeric prefix directory below. There is a total of 732 alpha prefixes in the BCBS EAA-EZZ list and 39 are Not Assigned prefixes out of 732. Prior authorization (sometimes called preauthorization or pre-certification) is apre-service utilization management review. 15 0 obj endobj Does united healthcare community plan cover chiropractic treatments? knowledge of BCBS alpha prefix is compulsory if you are handling denials and AR follow up. 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 FEP Prefix - BCBS Federal Employee Program is identified by the letter "R" followed by the number. Save my name, email, and website in this browser for the next time I comment. Prefix ZGP identifies Blue Cross Blue Shield of Texas PPO Product. Illinois. <> Sample BCBS prefix list. Anthem BCBS of Connecticut. 2021 Commercial Outpatient Behavioral Health Prior Authorization Code List This list is a new addition on our website for 2021. They always offer packages within the amounts mentioned. It has also helped customers during emergencies by providing the proper medical treatments and other sources. X2A to X9Z. It holds a huge role in the cancellation policy, hotel booking and loss of passports. We make sure to update the information on daily basis, however, if you find some kind of inaccurate information, feel free to contact us. Blue cross blue shield itself is a federation of 35 separate health insurance in the United States. New to Blue Access for Members? *!uB9^AwjF(v,o Member Prefix List Patient Roster Claims & Payments. If you would like to change your settings or withdraw consent at any time, the link to do so is in our privacy policy accessible from our home page.. The calculation begins from the date of service, discharge date or last date of treatment up to 365days, including weekends. <> It is one of the giant sectors that provide more than 106 million health facilities. Ans. Final Instructions about BCBS Prefix Lookup, United Healthcare Claims Address Information, BCBS Alpha Numeric Prefix from U2A to U9Z (Updated 2023), BCBS Alpha Prefix from TAA to TZZ (Updated 2023). It also files on checking the incorrect address and submits the correct form of claiming the right details. T2*uug)T%D._M/5WIdB;zg@W01>X_b( vkWXth$OYD8x$Ygt{" BB> BCBS FEP Prefix BCBS Federal Employee Program is identified by the letter R followed by the number. To view this file, you may need to install a PDF reader program. ]c\RbKSTQ C''Q6.6QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ 0*" The policies and regulations provided by the organization convey great statements and activities into the proper placement. 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. The cross also goes through the analysis of gaining health insurance and forms a series of packages. Most PDF readers are a free download. _( ~ G+[~:d#y8J5)-*]4hLFk-P3sI77O. 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 . BCBSIL makes no endorsement, representations or warranties regarding any products or services provided by third party vendors. BCBS Prefix List 2021 - Alpha. If the provider or member doesnt get prior authorization for out-of-network services, the claim may be denied. 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. endobj ZAA. Insurance Identifier Lookup; Plan Phone Numbers; Medicare Contractors; State Medicaid Plans; Home; Medicare Advantage List; . Independence Blue Cross (BC) of Philadelphia (Phi) and the Southeastern Pennsylvania (PA) ZAB. 107. External link You are leaving this website/app (site). 17 0 obj If you donotget prior approval via the prior authorization process for services and drugs on our prior authorization lists: When and how should prior authorization requests be submitted? One option is Adobe Reader which has a built-in reader. For government programs prior authorization requests handled by eviCore healthcare (eviCore): Step 1 Confirm if Prior Authorization is Required. . Blue Cross Blue Shield Federal Phone Number. The site may also contain non-Medicare related information. Contact us to learn how we can improve your revenue cycle. 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. Log In to the Shopping Cart, Need to Make a Payment? Note: BCBS FEP (Federal Employee Program) ID starts with the alphabet R follow by the insured ID number (For Example: R987654321). PUJyf\P )} 9\7R8lSJ|y:mYY p!+uUxSACJQ;,#3X_xR 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. Save my name, email, and website in this browser for the next time I comment. The organization is famous just for this particular service apart from the other policies. Create an account. endobj Other providers are available in our network. |d&`{ ^^I|Wp:K|~._s 3 0 obj <> In all adverse conditions, their health insurance programs go on providing the facilities to help out the customers in all possible ways. The prefixes include filling up the claims of the insurance details.It also checks out the incorrect members of gaining the claim setting up the correct number about the IDs. For Example: XYZ123456789. 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. The address and its verification of the members eligibility cover the areas of all the departments and claim the perfect status. Blue Cross Blue Shield insurance Companies - Statewise. It means that BCBS members IDs prefixes will must have alphabets. Always make sure to submit claims to insurance company on time to avoid timely filing denial. BCBS Alpha Numeric Prefix from F2A to F9Z (Updated 2023) January 7, 2023 by Kim Keck. And to manage such a big network, they divided it into different departments state wise or employer specific. endobj Have a look at BCBS alpha prefix and alpha numeric prefix directory below. Prefix UTS assigned to University of Texas. For Example: ABC, TXX, TEA, A2B, 2AB, 2A2, PAS, XXU etc. Here we have listed down all the Blue Cross Shield Prefix along with BCBS home plan name and website for BCBS member IDs ranging from W2A to W9Z. -x0cjH4`f4`c:A 9K+)tnapM"f2:d+-%0|[FpPDRtZd)@@0,4|(a8`0XE3Fx"K@dd`vF[VgGs.OO'wAl~B~P%sr:|7Rz XCC. <> BCBS Company. In the case of baggage cover, the organization holds on compensating for the loss or any kind of delay. 8 0 obj 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: Below is a list of the old and new alpha prefix codes. BCBS Prefix will not only have numbers and the digits 0 and 1. . We update BCBS prefix data on daily basis to provide latest BCBS prefix information. Below in our BCBS prefix lookup directory, you can lookup all the BCBS prefix appropriate home plans and their contact information. What kind of cases do personal injury lawyers handle? Correct BCBS home plan can easily be identified using our BCBS prefix lookup directory. Few times, BCBS plan members doesnt have prefix mentioned on their BCBS Insurance card. The site may also contain non-Medicare related information. Medicare Advantage is an alternative to original Medicare where a private health insurance . Learn about the many ways we are contributing to the well-being of our local Illinois communities in the latest Corporate Social Responsibility Report. First Character P is symbolizing that member plan/product type is BCBS PPO. Carefirst BCBS of Maryland the (MD), District of Columbia (DC), and the Northern Virginia (VA) CAB. 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. 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 . Learn more about Ezoic here. giV7Lxp^^YM(_{27e;//3_`|eC9EliUDD.3fJ0]6DT{,dMZRPRWN2C7?HL4fvy|\b%^SKwIOh)xo${A%t7A3_h}AL V2A to V9Z. endobj It also suggests that the members enjoy the networks participating with the hospital and other medical costs. eviCore healthcare (eviCore) is an independent company that has contracted with BCBSIL to provide prior authorization for expanded outpatient and specialty utilization management for members with coverage through BCBSIL. In that case claim may be denied as Submit the claim to the correct address / Member ID not found. Click on New Document and select the file importing option: upload Xxu blue cross prefix from your device, the cloud, . J7Wr}pY+Gqpgx ck 4=!omPyC]6bRw@;-:.L^]UMw6xAjAA8 et 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. Skip to content. endobj BCBS prefix list EAA-EZZ. From April 1 to September 30, on weekends and holidays you may be required to leave a message. Search articles and watch videos; ask questions and get answers. 7aM- I|x,# For more than 85 years, weve provided our members with comprehensive, affordable health plans, making Illinois a healthier place to live, work and play. BCBS Insurance goes on dealing with the oldest and largest health insurance system. IPA Guidelines for Member Complaints, Inquiries, Appeals and Grievances Policy. This new site may be offered by a vendor or an independent third party. BCBS member ID have maximum 17 characters but most of the member IDs have 12 characters. 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 Search with My Member ID Card: Go. 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. These documents are located inhttp://www.hisccompliance.com. Complete Guideline and Strategy, Tips to Create the Perfect Medical Provider Resume, Benefits and Eligibility Verification Services. Does policy number same as member ID number? 1 0 obj MedicalBillingRCM.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com. 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. Also its not a sequential order hence its hard to find unless we check with first 3 alpha prefix. 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. For commercialprior authorization requests handled by AIM Specialty Health(AIM): Commercial non-HMO prior authorization requests can be submitted to AIM intwo ways. U2A to U9Z. Here I have shared the list of BCBS alpha numeric prefix ranging from T2A to T9Z. Correct BCBS home plan can easily be identified using our BCBS prefix lookup directory. w !1AQaq"2B #3Rbr % If you have questions on a request handled by BCBSIL, contact our Medical Management department. 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. Click on a section title to view the content. <> $ 382. 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. Blue Access for MembersSM is a powerful tool for managing all your health plan benefits. BCBS Alpha Prefix List from UAA to UZZ Updated 2023. 855-854-1438. What is 25 modifier and how to use it for insurance Payment, How to code for diagnosis and procedures related to Monkey pox, BCBS Alpha Prefix List from YAA to YZZ Updated 2023, Timely Filing Limits for all Insurances updated (2023), Blue Cross Blue Shield insurance Companies Statewise, BCBS of South Carolina (SC) / Southcarolinablues, Highmark Blue Shield (BS) of Pennsylvanaia (PA), Blue shield(BS) of Northeastern New York (NeNY). Note: Checking eligibility and benefits is key, butwe also have other resources to help you prepare. 12 0 obj There are several benefits of using our BCBS Prefix Lookup tool. BCBS Alpha Prefix from BAA to BZZ. For Example: ABC, TXX, TEA, A2B, 2AB, 2A2, PAS, XXU etc. What is Medical Billing and Medical Billing process steps in USA? $TbYmVcI^ONr#H2.G uG!`;4%x$;L[| 5 0 obj Compliance, Fraud, Waste and Abuse Program and Reporting: HCSC and its subsidiaries are founded on the basic principles of good business behavior. If possible, make copies of the member's ID card (front and . Insurance Identifier Lookup; Plan Phone Numbers; Medicare Contractors; State Medicaid Plans; Home; Medicare Advantage List; . BCBS member ID prefix help medical billers, health care providers and patients to identify BCBS healthcare plan. In general, there arethreestepsprovidersshould follow. Z2A to Z9A. CAA. Every Blue Cross and Blue Shield plan starts with an alpha prefix so they are called in medical terms BCBS Alpha Prefix. 800-676-2583. Blue Cross and Blue Shield of Illinois is proud to be the state's only statewide, customer-owned health insurer. $4%&'()*56789:CDEFGHIJSTUVWXYZcdefghijstuvwxyz ? For Example: ABC, A2B, 2AB, 2A2 etc. Blue Cross Blue Shield of Illinois: Y2M: Blue Cross Blue Shield of Nebraska: YAA: Anthem BCBS of Connecticut: YAB: Regence Blue . In addition to verifying membership/coverage status and other important details,this step returns information on prior authorization requirements and utilization management vendors, if applicable. Today you will find The BCBS Alpha Prefix List from UAA to UZZ. Independence Blue Cross (BC) of Philadelphia (Phi) and the Southeastern Pennsylvania (PA) We and our partners use data for Personalised ads and content, ad and content measurement, audience insights and product development. BCBS is the biggest private insurance company in the United States after federal insurance and there are hundreds of BCBS plans according to state and geographical areas. First, it saves you time and hassle by allowing you to quickly identify correct BCBS insurance home plan without having to call customer service. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. BCBS of Arkansas Blue Advantage Administrators. BCBS Prefix List 2021 - Alpha. It covers the plans and analyses the services with the complete access of the employees. This new site may be offered by a vendor or an independent third party. In most ways, the policy numbers and their section move forward with a unique number to get respective orders and their identification to analyze the main purposes of billing the healthcare system. Manage Settings BCBS is one of the largest medical insurance company by total members of more than 45 million. endobj stream Medical Billing and Coding Information Guide. Want to be part of our amazing team? Xceed Billing Solutions motive is to create ease for providers, medical billers, patients and everyone who is involved in revenue cycle process. M+. When does health insurance expire after leaving job? The blue cross deals with the features to make it easier for the customers to deal with the situation. Step-by-Step Guide for Provider Finder . BCBS Prefix will not only have numbers and the digits 0 and 1. Connecticut. Information current and approximate as of December 31, 2018. Prime Therapeutics LLC (Prime) is a pharmacy benefit management company. Here " A2A" is BCBS alpha numeric prefix. The alpha prefix is very important to the identification number. 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). There are two types of BCBS prefixes which are mentioned below: Plan Specific prefix are assigned by BCBS to each plan. The Blue Cross helps to deal with the coverage of finding out medical costs and other emergencies. 365days . <>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S>>