BCBS Alpha Prefix Its a three letter alpha prefix followed by id number. Medicare Advantage is an alternative to original Medicare where a private health insurance . 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. Ans. This list of bcbs prefixes includes BC prefix IEO, INE, ILT, IOI, IQQ, IPB, IVV. 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. For more than 85 years, weve provided our members with comprehensive, affordable health plans, making Illinois a healthier place to live, work and play. 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. Search with My Member ID Card: Go. &UMDU}%h UX[_kRGyzte,.-pD?^]Yt%i7=$Foy*ja(5}31$9w}eLvdA oV;_$myuVLW5v^{=GW;ig)aYff,WW(/-"*{Wf;x5qS:@-q$QJLgvCd2>OXe|lqc;Kv.&Pkuz?&jm*1qm1UqmeETH}6Iq?} Dl]mh*MNgUh9dzQ!hTk H:Azif+ ]V"U23 How Long Does the Judge Approval Process for Workers Comp Settlement Take? Anthem Blue-Cross Blue-Shield of Ohio. Menu. The following application indulges with the contraction of providing the best health care services and plans a specific role and coverages for the customers. Always make sure to submit claims to insurance company on time to avoid timely filing denial. Language Assistance (opens in a new window) and Non-Discrimination Notice . BAA. Emergency services are an exception. October 1, 2022 by Rebecca Williams. Find a BCBS Company by Prefix. endobj Returning Shopper? 8 0 obj External link You are leaving this website/app (site). w !1AQaq"2B #3Rbr endobj The following travel insurance helps to deal with all the medical costs and also covers the family expenses. The blue cross deals with the features to make it easier for the customers to deal with the situation. LAB. 9 0 obj Second Character G assigned to the BCBS Plan as well. On the other hand, host plans indicate more services in the health care services and competition within the area. Does blue cross blue shield cover shingles vaccine? Click on a section title to view the content. Policy number is a unique number, which is provided to their insured person by respective insurances in order for identification purposes and also for billing the healthcare claims. giV7Lxp^^YM(_{27e;//3_`|eC9EliUDD.3fJ0]6DT{,dMZRPRWN2C7?HL4fvy|\b%^SKwIOh)xo${A%t7A3_h}AL Blue Cross and Blue Shield of Illinois is proud to be the states only statewide, customer-owned health insurer. Every Blue Cross and Blue Shield plan starts with an alpha prefix so they are called in medical terms BCBS Alpha Prefix. Learn about the many ways we are contributing to the well-being of our local Illinois communities in the latest Corporate Social Responsibility Report. Here " ABC" is BCBS alpha prefix. endobj For Example: ABC, TXX, TEA, A2B, 2AB, 2A2, PAS, XXU etc. A Google Certified Publishing Partner. The employees suggest to the customers select the packages and illustrate more about the service. 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. Most PDF readers are a free download. What is Medical Billing and Medical Billing process steps in USA? The presence of the members in the organization deals with decisions on certain critical conditions of the customers and getting steps to solve the issues. Join us as we build the next generation of health insurance. I have completed my Bachelor of Business Administration in Healthcare Management from University of Texas. Do not create one or use the BCBS prefix from another member ID card. %&'()*456789:CDEFGHIJSTUVWXYZcdefghijstuvwxyz $TbYmVcI^ONr#H2.G uG!`;4%x$;L[| Claims that are submitted after . 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 alpha prefix is very important to the identification number. Blue cross coverage goes through the idea of calling out the blue cross blue shield company, which helps to provide the programs benefits. U2A to U9Z. External link You are leaving this website/app (site). BCBS National accounts are employer groups that have outlets/offices in multiple states but they offer limited coverage to their employees. For commercialprior authorization requests handled by AIM Specialty Health(AIM): Commercial non-HMO prior authorization requests can be submitted to AIM intwo ways. IPA Guidelines for Member Complaints, Inquiries, Appeals and Grievances Policy. BCBSIL contracts with Prime to provide pharmacy benefit management and other related services. How To Identify Blue Cross Blue Shield Member? In that case claim may be denied as Submit the claim to the correct address / Member ID not found. Xceed Billing Solutions motive is to create ease for providers, medical billers, patients and everyone who is involved in revenue cycle process. You may also want to know: United Healthcare Claims Address Information. stream Prefix ZGP identifies Blue Cross Blue Shield of Texas PPO Product. The following prefix list comes with filling up the health care claims and analyses the correct address of the BSCs sections. [ 15 0 R] Remember, member benefits and review requirements will vary based on service/drug being rendered and individual/group policy elections. You can also contact us for specialty medical billing services. This can be especially helpful if youre in a rush or need to access your BCBS prefix home plan information quickly. Log In to the Shopping Cart, Need to Make a Payment? JFIF x x C 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. <> <> An example of data being processed may be a unique identifier stored in a cookie. The Home and Host plan is also working in the Blue Cross Blue Shield plan. 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. <> For . M+. Learn more about timely filing limits and CO 29 Denial Code. Coupon "NSingh10" for 10% Off onFind-A-CodePlans. It covers the plans based on associating them with the testing, measuring the protocols at the time of the trip and many more. In general, there arethreestepsprovidersshould follow. T2A to T9Z. So the next time you need to identify accurate BCBS prefix home plan, remember to use the BCBS prefix list lookup finder. 18 0 obj In this way, the BCBS holds on compensating the costs and indulges with the maximum support of the customers. 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. 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. BCBS Alpha Numeric Prefix from W2A to W9Z (Updated 2023) January 8, 2023 by Kim Keck. 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. x\moFn"pI \Mc7 t,\GizffwN(LP4Kuda)\rxD870x(c%BE6q\4i5 #orUcA"QLoHCfG*QRx(aI*uS(IFf,3D*RY3dyGB{Zt|g&Dq~? 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, Behavioral Health IP PA - IVR Caller Guide, Behavioral Health OP PA - IVR Caller Guide, Inpatient Preauthorization - IVR Caller Guide, Outpatient Preauthorization - IVR Caller Guide, Preauthorization: Check Request Status - IVR Caller Guide, Utilization Management Process Overview (Commercial), Patients medical or behavioral health condition, Date of service, estimated length of stay (if the patient is being admitted), Provider name, address and National Provider Identifier (NPI), Government Programs 877-774-8592 (MA PPO); 877-860-2837 (BCCHP); 877-723-7702 (MMAI). <> BCBS Alpha Prefix Lookup. For prior authorization requests handled by BCBSIL: There are two ways to initiate your request. So, to accomplish our goal, we have listed down the complete BCBS alpha prefix list so that you can easily identify correct BCBS plan. However it has several policies for its customers. Below is a list of the old and new alpha prefix codes. All claims must be submitted to Blue Cross Blue Shield. Earn Money by doing small online tasks and surveys, McKesson Corporation: Company Overview & History (2023), AAPC: What it is and why it matters in the Healthcare (2023). ]c\RbKSTQ C''Q6.6QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ 0*" The blue cross blue shield coverage deals with the best services for its customers and involves a better statement of the medical treatments. Blue Cross Blue Shield of Illinois: IBU: Blue Cross Blue Shield of Alabama: IBV: Blue Cross Blue Shield of Massachusetts: IBW: Blue Cross . 4 0 obj Highmark BCBS of Pennsylvania (PA) ZAC. Save my name, email, and website in this browser for the next time I comment. <> These BCBS prefix may include alpha and numerical characters. Most of the expenses get exposed through the treatments, and for that, the coverages are built up. Blue cross blue shield itself is a federation of 35 separate health insurance in the United States. BCBS prefix lookup directory is a valuable resource for anyone who is looking for right Blue Cross Blue Shield home plan. State Lookup. Certain employer groups may require prior authorization or pre-notification through other vendors. Information for Blue Cross and Blue Shield of Illinois (BCBSIL) members is found onour member site. For example, baggage and other items will get lost if you fall sick before or during the trip. Account Specific Prefix are assigned by BCBS to national accounts. The information you're accessing may not be provided by Excellus BCBS. 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. First Character Z assigned to the BCBS Plan. BCBS Prefix will not only have numbers and the digits 0 and 1. Home plans are generally used as a member of the former application. BCBS Prefix will not only have numbers and the digits 0 and 1. BCBS Alpha prefix lookup contains all the Blue Cross Blue Shield alpha prefix along with their home plan and website. BCBS Blue Care Network Michigan (MI) UAB. Check out our Corporate Social Responsibility Report and learn about the ways we are serving our community. <> One of the biggest issues in todays generation is where medical treatments and conditions lie. These BCBS prefix may include alpha and numerical characters. Blue Cross and Blue Shield of Illinois is proud to be the state's only statewide, customer-owned health insurer. One option is Adobe Reader which has a built-in reader. :C5*|}6_D20&Z+NvN0l+TyX ^:"WJ*~'vW/;3eW0Jx] >Ou#_D4W_H5d"t~"AM)B#z_s*,f0Vy5X]KJ_ Here I have shared the list of BCBS alpha numeric prefix ranging from T2A to T9Z. 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. Some requests are handled by BCBSIL; others are handled by utilization management vendors. BCBS Company. 13 0 obj Manage Settings BCBS member ID prefix help medical billers, health care providers and patients to identify BCBS healthcare plan. 5 0 obj The prefix acts as a key element in confirming the members' eligibility and coverage information. What If BCBS Member ID doesnt have Prefix mentioned on Card? 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 . 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. Blue Cross Blue Shield insurance Companies - Statewise. Correct BCBS home plan can easily be identified using our BCBS prefix lookup directory. BCBS Prefix List 2021 - Alpha State Lookup BCBS Company; PAA: Pennsylvania: Capital Blue-Cross of Pennsylvania: PAB: Tennessee: Blue-Cross Blue-Shield of Tennessee 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? FA%[: Livestock Protection. BCBS Alpha Prefix are first three letters of BCBS Member ID to identify correct Blue Cross Blue Shield department responsible for managing the patient eligibility, benefits and claims etc. BCBS FEP Its indicated with letter R followed by the id number. Topics include everything from improving your well-being to explaining health coverage. Stand-alone dental products, vision and pharmacy when delivered through an intermediary model. Business health insurance plans designed to fit any size small business and budget. In recent years medical treatment and its cost has increased, which has become unbearable to manage. For more than 85 years, we've provided our members with comprehensive, affordable health . Sometimes, a plan may require the member to request prior authorization for services. Y2A to Y9A. 12 0 obj BCBS Alpha prefix and BCBS Alpha numeric prefix are very important to submit claims to BCBS insurance. Get all the coverage of Original Medicare plus prescription drugs and extra benefits, with plan premiums as low as $0/month. AIM Specialty Health (AIM) is an independent company that has contracted with BCBSIL to provide utilization management services for members with coverage through BCBSIL. To view this file, you may need to install a PDF reader program. Address: 11070 Katy Fwy, Houston, TX 77043, 2023 Xceed Billing Solution.com - All Rights Reserved. In addition, some sites may require you to agree to their terms of use and privacy policy. Here I have shared the list of BCBS alpha prefix ranging from BAA to BZZ. Yes, Policy number same as member ID number and also known as subscriber ID number. If you are using electronic submission then prefix is important to submit claims successfully and received by insurance correctly. 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. Have a look at BCBS alpha prefix and alpha numeric prefix directory below. The alpha prefix is always three letters followed by the member's ID number which can be from 6 up to 14 characters total. endobj Always use the BCBS prefix on the members current ID card followed by the member id number. . What is Medical Billing and Medical Billing process steps in USA? BCBS of Kansas City. Correct BCBS home plan can easily be identified using our BCBS prefix lookup directory. 2021 Commercial Specialty Pharmacy Prior Authorization Drug List This list was updated with 14 new codes effective Jan. 1, 2021. $ 382. 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. Commercial Communications Some of our partners may process your data as a part of their legitimate business interest without asking for consent. 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 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). Continue with Recommended Cookies. 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. The health of your eyes and teeth can affect your overall health. Born in Texas, USA. . BCBS of Arkansas Blue Advantage Administrators. 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). 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. For Example: ABC, A2B, 2AB, 2A2 etc. Once a prior authorization request is received and processed, the decision is communicated to the provider. We and our partners use cookies to Store and/or access information on a device. Member Prefix List Patient Roster Claims & Payments. -x0cjH4`f4`c:A 9K+)tnapM"f2:d+-%0|[FpPDRtZd)@@0,4|(a8`0XE3Fx"K@dd`vF[VgGs.OO'wAl~B~P%sr:|7Rz If the provider or member doesnt get prior authorization for out-of-network services, the claim may be denied. Blue Access for MembersSM is a powerful tool for managing all your health plan benefits. LAA. Search your plan's drug list, find a pharmacy, and more. The coverage that the organization holds on travel, medical and other conditions. One option is Adobe Reader which has a built-in reader. Complete Guideline and Strategy, Tips to Create the Perfect Medical Provider Resume, Benefits and Eligibility Verification Services. Search articles and watch videos; ask questions and get answers. For accurate and quick claims processing, it is necessary to get complete patient insurance information. BCBS Alpha Prefix from BAA to BZZ. Prefixes are also used to identify and correctly route claims to the appropriate Blue Cross Blue Shield [] It means that BCBS members IDs prefix will must have alphabets and they may or may not have numbers. Anthem BCBS of Wisconsin (WI) BCBS Alpha Numeric Prefix Its a three letter Alpha numeric prefix followed by id number. We and our partners use data for Personalised ads and content, ad and content measurement, audience insights and product development. Blue Shield has negotiated with the local hospitals and pays off the steep fees for encountering charges on the specific benefits. 855-854-1438. Does United Healthcare cover the cost of dental implants? endobj Prior authorization (sometimes called preauthorization or pre-certification) is apre-service utilization management review. Michigan. Compliance, Fraud, Waste and Abuse Program and Reporting: HCSC and its subsidiaries are founded on the basic principles of good business behavior. Livestock Protection. Due to the exceeding number of BCBS insurance members, Alpha-Only Prefix member IDs exhausted. endobj BCBS Alpha Numeric Prefix - It's a three letter Alpha numeric prefix followed by id number. To identify correct blue cross blue shield department, they use three characters BCBS prefix in the start of each BCBS member plan ID. Illinois. endobj BCBS Insurance goes on dealing with the oldest and largest health insurance system.