bcbs illinois prefix list

endobj It covers the plans and analyses the services with the complete access of the employees. The manual is organized into the following sections for your convenience. BCBS Company. The Home and Host plan is also working in the Blue Cross Blue Shield plan. Click on a section title to view the content. FA%[: 8 0 obj The health of your eyes and teeth can affect your overall health. 17 0 obj Every Blue Cross and Blue Shield plan starts with an alpha prefix so they are called in medical terms BCBS Alpha Prefix. BCBS is one of the biggest insurance companies in USA and serving more than 106 million people. Learn more about Ezoic here. Access Your Payment Options. Prefixes are also used to identify and correctly route claims to the appropriate Blue Cross Blue Shield [] :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 prefix ranging from BAA to BZZ. within 365 days . BCBS National accounts are employer groups that have outlets/offices in multiple states but they offer limited coverage to their employees. State Lookup. The content shared in this website is for education and training purpose only. Emergency services are an exception. BAB. endobj 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 . Member Prefix List Patient Roster Claims & Payments. 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 16 0 obj The blue cross deals with the features to make it easier for the customers to deal with the situation. There are several benefits of using our BCBS Prefix Lookup tool. For Example: ABC, A2B, 2AB, 2A2 etc. These prefixes may include alpha and numerical characters. How Long Does the Judge Approval Process for Workers Comp Settlement Take? 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. Curious to know what are national Accounts? Blue Cross Blue Shield insurance Companies - Statewise. 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). 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. knowledge of BCBS alpha prefix is compulsory if you are handling denials and AR follow up. To request a hard copy of Blue Advantage's provider directory, please call our Member Service Department at 1-888-234-8266, 8 a.m. to 8 p.m., seven (7) days a week. 7 0 obj 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. endobj 3 0 obj Note: BCBS FEP (Federal Employee Program) ID starts with the alphabet R follow by the insured ID number (For Example: R987654321). 2021 Commercial Specialty Pharmacy Prior Authorization Drug List This list was updated with 14 new codes effective Jan. 1, 2021. Stand-alone dental products, vision and pharmacy when delivered through an intermediary model. It also suggests that the members enjoy the networks participating with the hospital and other medical costs. Most of the expenses get exposed through the treatments, and for that, the coverages are built up. BCBS Alpha Prefix List from CAA to CZZ Updated (2023) BCBS Alpha Prefix List of "C"-series. 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? Hi, Im Kim Keck! Sample BCBS prefix list. BCBS Insurance mainly focuses on medical treatments and providing maximum support for the financial condition. <>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S>> 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 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. 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. Note: Checking eligibility and benefits is key, butwe also have other resources to help you prepare. BCBS Prefix List 2021 - Alpha State Lookup BCBS Company; PAA: Pennsylvania: Capital Blue-Cross of Pennsylvania: PAB: Tennessee: Blue-Cross Blue-Shield of Tennessee These documents are located inhttp://www.hisccompliance.com. October 1, 2022 by Rebecca Williams. One of the biggest issues in todays generation is where medical treatments and conditions lie. 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. ]c\RbKSTQ C''Q6.6QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ 0*" Once a prior authorization request is received and processed, the decision is communicated to the provider. Prior authorization requests for our Blue Cross Medicare Advantage (PPO)SM(MA PPO), Blue Cross Community Health PlansSM(BCCHPSM) and Blue Cross Community MMAI (Medicare-Medicaid Plan)SMmembers can be submitted to eviCore in two ways. Do not delay the billing of a claim for any reason. <> The consent submitted will only be used for data processing originating from this website. CAA. The prefix acts as a key element in confirming the members' eligibility and coverage information. UAA. 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. 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 holds a huge role in the cancellation policy, hotel booking and loss of passports. endobj Step 2If prior authorization is required, have the following information ready: Step 3 Submit Your Prior Authorization Request. The site may also contain non-Medicare related information. This new site may be offered by a vendor or an independent third party. Prefix UTS assigned to University of Texas. 4 0 obj For example, baggage and other items will get lost if you fall sick before or during the trip. 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. The Blue cross blue shield company mainly provides proper health insurance coverages. 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. Most PDF readers are a free download. BCBS member ID have maximum 17 characters but most of the member IDs have 12 characters. XCC. Blue cross blue shield itself is a federation of 35 separate health insurance in the United States. CPT is registered trademark of American Medical Association. Health insurance is nowadays the most wanted series of getting rid of the expenses from the high medical costs. Returning Shopper? We recently received a query from a provider that how I can identify that patient is BCBS health insurance member. I Don't Have My Member ID Card. We and our partners use data for Personalised ads and content, ad and content measurement, audience insights and product development. 12 0 obj One option is Adobe Reader which has a built-in reader. Prefix ZGP identifies Blue Cross Blue Shield of Texas PPO Product. Illinois. In the USA, the BCBS is a very well-known health insurance statement that conveys more association and deals with numerous activities. % BCBS Alpha Numeric Prefix from T2A to T9Z. Does United Healthcare cover the cost of dental implants? In general, there arethreestepsprovidersshould follow. 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. You can: Pay a bill online or sign up for auto bill pay. When does health insurance expire after leaving job? <> <> Related forms. Prior authorization (sometimes called preauthorization or pre-certification) is apre-service utilization management review. Connecticut. Also, these BCBS prefixes helps providers and medical billers to reach the correct claims department for claims and benefits inquiry. 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. endobj 5 0 obj 2021 Commercial Outpatient Behavioral Health Prior Authorization Code List This list is a new addition on our website for 2021. N9=*io1*sLxfLf9`El/Ou:!fUKc3'I"UIcL 0 d.|XbY!&e|&1'b[7N!B!axHgY&K8Ugxl ]j.,pj,$&GHox If you are using electronic submission then prefix is important to submit claims successfully and received by insurance correctly. BCBS Alpha prefix and BCBS Alpha numeric prefix are very important to submit claims to BCBS insurance. Make sure to make copies of the front and back of member ID card. 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 Character P is symbolizing that member plan/product type is BCBS PPO. The perfect members of BCBS insurance get more flexibility and facilities in terms of health insurance. The alpha prefix is very important to the identification number. Blue Cross and Blue Shield of Illinois is proud to be the states only statewide, customer-owned health insurer. The following prefix list comes with filling up the health care claims and analyses the correct address of the BSCs sections. To identify correct department, they use 3 characters Prefix in the BCBS members plan ID. <> The organization is famous just for this particular service apart from the other policies. Choose the best payment option for your Blue Cross and Blue Shield of Illinois (BCBSIL) monthly bill. 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. BCBS member ID prefix help medical billers, health care providers and patients to identify BCBS healthcare plan. 2 0 obj Right after completing my degree in 2011, I started my job career as an Accounts Receivable in a medical billing company. Information for Blue Cross and Blue Shield of Illinois (BCBSIL) members is found onour member site. <> What is Medical Billing and Medical Billing process steps in USA? If you have questions on a request handled by AIM or eviCore, call the appropriate vendor, as noted above. It also files on checking the incorrect address and submits the correct form of claiming the right details. stream Some of our partners may process your data as a part of their legitimate business interest without asking for consent. In all adverse conditions, their health insurance programs go on providing the facilities to help out the customers in all possible ways. stream What is Medical Billing and Medical Billing process steps in USA? We make sure to update the information on daily basis, however, if you find some kind of inaccurate information, feel free to contact us. How To Identify Blue Cross Blue Shield Member? For commercialprior authorization requests handled by AIM Specialty Health(AIM): Commercial non-HMO prior authorization requests can be submitted to AIM intwo ways. It is one of the giant sectors that provide more than 106 million health facilities. will be denied. Check Claims Claim Explanation Codes Request a Claim Adjustment View Fee Schedules . Tdb[+Np/1oz1_(:3^%:\tr'c!HfRY{P#~Kr>S: endobj They always offer packages within the amounts mentioned. endstream Save my name, email, and website in this browser for the next time I comment. To view this file, you may need to install a PDF reader program. Compliance, Fraud, Waste and Abuse Program and Reporting: HCSC and its subsidiaries are founded on the basic principles of good business behavior. It shows that these type of BCBS member IDs are different. BCBS Alpha prefix lookup contains all the Blue Cross Blue Shield alpha prefix along with their home plan and website. UAC. BCBS Alpha Prefix List of "U"-series. In this way, the BCBS holds on compensating the costs and indulges with the maximum support of the customers. [ 15 0 R] Provider Finder . The employees suggest to the customers select the packages and illustrate more about the service. Highmark BCBS of Pennsylvania (PA) ZAC. The site may also contain non-Medicare related information. Normally, account specific prefix associates to the employer group name. <> 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. Blue Cross Blue Shield Federal Phone Number. Account Specific Prefix are assigned by BCBS to national accounts. External link You are leaving this website/app (site). Assistance Available For Members Impacted by Severe Weather, 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). Sign up for theLifeTimes newsletterto get health and benefits articles delivered to your inbox every 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. These blue shield companies negotiate with the doctors and the other hospitals. Yes, Policy number same as member ID number and also known as subscriber ID number. Step-by-Step Guide for Provider Finder . It covers the plans based on associating them with the testing, measuring the protocols at the time of the trip and many more. Anthem BCBS of Connecticut. Michigan. Save my name, email, and website in this browser for the next time I comment. Blue Access for MembersSM is a powerful tool for managing all your health plan benefits. M+. BCBS Alpha Prefix Its a three letter alpha prefix followed by id number. Prefixes are also used to identify and correctly route claims to the appropriate Blue Cross Blue Shield [] LAB. An example of data being processed may be a unique identifier stored in a cookie. Manage Settings 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). The calculation begins from the date of service, discharge date or last date of treatment up to 365days, including weekends. Medicare Advantage is an alternative to original Medicare where a private health insurance . Search articles and watch videos; ask questions and get answers. V!E5y"w Dx])Vq_j.xwuUgq>bmh`M.hjsw Y_8NzZtAj&4B8%5"a t@BpweUI#t@SsRR)tx6a5B+sPWO^p[,U\ewdRyN@! BCBS Alpha Numeric Prefix from W2A to W9Z (Updated 2023) January 8, 2023 by Kim Keck. All claims must be submitted to Blue Cross Blue Shield. To view this file, you may need to install a PDF reader program. Lets dig into it! $ 382. Admin 22A. Business health insurance plans designed to fit any size small business and budget. LAA. Unassigned Prefix. endobj Here Letter R indicates BCBS FEP prefix. In case, you need any additional information related to BCBS prefix then feel free to reach out to us. . J7Wr}pY+Gqpgx ck 4=!omPyC]6bRw@;-:.L^]UMw6xAjAA8 et Our trusted community experts can give you the one-on-one help you need to shop for health insurance. Blue Cross Blue Shield of Illinois: IBU: Blue Cross Blue Shield of Alabama: IBV: Blue Cross Blue Shield of Massachusetts: IBW: Blue Cross . What kind of cases do personal injury lawyers handle? BCBS Alpha Prefix from BAA to BZZ. BCBS Prefix will not only have numbers and the digits 0 and 1. Does blue cross blue shield cover shingles vaccine? BCBSIL makes no endorsement, representations or warranties regarding any products or services provided by third party vendors. BCBS Alpha Prefix List from UAA to UZZ Updated 2023. Third, it can help you make more informed decisions to choose right insurance plan and benefits. For accurate and quick claims processing, it is necessary to get complete patient insurance information. Independence Blue Cross (BC) of Philadelphia (Phi) and the Southeastern Pennsylvania (PA) Final Remarks about BCBS Prefix Lookup Directory. X2A to X9Z. But dont worry because our BCBS prefix finder include alpha numeric prefix information as well. Most of the coverages are associated with baggage loss. $4%&'()*56789:CDEFGHIJSTUVWXYZcdefghijstuvwxyz ? 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. For more than 85 years, weve provided our members with comprehensive, affordable health plans, making Illinois a healthier place to live, work and play. Medical Billing and Coding Information Guide. BCBS Prefix will not only have numbers and the digits 0 and 1. 107. The main benefits of BSBC are that it provides travel assistance and covers personal liability, accidents, and other pertaining baggage. %&'()*456789:CDEFGHIJSTUVWXYZcdefghijstuvwxyz Also its not a sequential order hence its hard to find unless we check with first 3 alpha prefix. The alpha prefix is always three letters followed by the member's ID number which can be from 6 up to 14 characters total. Commercial Communications I have completed my Bachelor of Business Administration in Healthcare Management from University of Texas. 7aM- I|x,# BCBS Prefix List EAA-EZZ (2023) November 3, 2020 by medicalbillingrcm. -x0cjH4`f4`c:A 9K+)tnapM"f2:d+-%0|[FpPDRtZd)@@0,4|(a8`0XE3Fx"K@dd`vF[VgGs.OO'wAl~B~P%sr:|7Rz <> 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. Admin 83A. BCBS Alpha Prefix list is useful for both providers and BCBS enrolled members/patients. Find a BCBS Company by Prefix. Few times, BCBS plan members doesnt have prefix mentioned on their BCBS Insurance card. Correct BCBS home plan can easily be identified using our BCBS prefix lookup directory. To get information about such member IDs, you can contact BCBS directory phone number i.e. BCBS prefix lookup directory is a valuable resource for anyone who is looking for right Blue Cross Blue Shield home plan. Here I have shared the list of BCBS alpha numeric prefix ranging from T2A to T9Z. The prefix acts as a key element in confirming the members' eligibility and coverage information. Usually, the provider is responsible for requesting prior authorization before performing a service if the member is seeing an in-network provider. Calls will be returned the next . XCE. Remember, member benefits and review requirements will vary based on service/drug being rendered and individual/group policy elections. BSBS insurance involves unique prefixes and follows up a unique ID number. Here " ABC" is BCBS alpha prefix. Always use the BCBS prefix on the members current ID card followed by the member id number. 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. endobj 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). 13 0 obj Blue Cross serves over 110 million members across the country, including Washington, DC and Puerto Rico. BCBS FEP Prefix BCBS Federal Employee Program is identified by the letter R followed by the number. |d&`{ ^^I|Wp:K|~._s In that situation, health insurance makes the right baggage and passport coverage decisions. endobj If you have any questions, call the number on the member's ID card. 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.