Blue Cross Blue Shield members can search for doctors, hospitals and dentists: In the United States, Puerto Rico and U.S. Virgin Islands. Blue Cross Blue Shield of Massachusetts 101 Huntington Avenue, Suite 1300 Boston, MA 02199 . Blue Cross and Blue Shield of Texas. Participating physicians, professional providers, ancillary and facility providers may not seek payment from the member for claims submitted after the 95-day filing deadline. Upon receipt of the completed form(s), Magellan will begin the prior authorization process. Make sure to send your claim form to the appropriate claims payer and specific address. 1 Magellan Behavioral Health of Pennsylvania evaluation including claims data, the Consumer Health Inventory survey, and housing and income data <> Arboretum Plaza II Claims submission address: Blue Cross and Blue Shield of Texas P O Box 660044 Dallas, TX 75266-0044. P.O. Other Adobe accessibility tools and information can be downloaded at https://access.adobe.com. The short answer is yes! 1-800-336-5696 *interactive voice response (IVR) system to access, you must have document control number (claim number), Eligibility and benefits contact your electronic connectivity vendor, Availity or other electronic connectivity vendor or call 1-800-451-0287*. Utilization Management/Medical Management/Case Management. Availity provides administrative services to BCBSTX. Resubmission of Claims: Claims that must be revised and resubmitted after adjudication must be stamped resubmission or otherwise noted on box 22 of the CMS-1500 form. Through increased access to evidence-based treatment options and effective preventive measures, we are making it easier for members to recover and stay out of hospitals. Go directly to an emergency room. Box 312599 Detroit, MI 48231-2599. endobj Visit our Help Center . For prior authorization and referrals managed by Magellan: Magellan Behavioral Health Providers of Texas, Inc. 1-800-729-2422: Behavioral health services - claims status inquiries. Click to skip to content, You are on secondary menu. 4 0 obj stream Behavioral health benefits are integrated into Anthem medical plans for a full spectrum of coordinated care for our members. We are committed to reducing stigma so no one is afraid to ask for help. BCBS Prefix List. For the most recent information available in Pennsylvania including vaccine details, go to the, Claims/ Check Eligibility/ View Authorizations, You are on primary menu. Horizon BCBSNJ: 1-800-624-1110 or 1-800-626-2212. Copy of EOP from the medical/health plan vendor substantiating their denial date. Magellan employs many methods to identify members with complex needs to match them with the appropriate level of specialized case management services, including: Our team provides the compassionate extra support individuals need to overcome significant behavioral health and life challenges. . Fax: 512-349-4853 As a first step, always review the Explanation of Payment (EOP) or Explanation of Benefits (EOB) and determine the reason why the claim was denied before resubmitting a new claim. Birmingham, Alabama 35244-2858. Email to submit provider inquiries and questions, Blue Cross and Blue Shield of Texas These members enjoy the same level of coverage as other Medicare Advantage members with no network restrictions. The site may also contain non-Medicare related information. Fax: 713-663-1227 hbbd```b``A$ MagellansMedical Providers Behavioral Health Toolkitgives medical practitioners the information and screening tools needed to assist in making behavioral health referrals. Mailing address (for paper claims): Magellan Health Services . When your BCBS ID card arrives in the mail, take a moment to look for these five things: 1. Skip to article content, Electronic Data Interface (EDI) via Direct Submit, Claims Courier-Magellans Web-based Claims submission tool, Paper Claims: CMS-1500 (Non-Facility-Based Providers) or UB-04 (Facility-Based Providers). Email to submit provider inquiries, Blue Cross and Blue Shield of Texas (BCBSTX). The Texas Department of Insurance developed the form to be used to request prior authorization for services for commercial insured members, Medicaid, Medicaid Managed Care, the Childrens Health Insurance Program (CHIP), plans covering employees of the state of Texas, school districts, and the University of Texas and Texas A&M systems. This functionality is available for claims transactions with a status of Received/ Accepted. No. BCBSTX Behavioral Health Unit Registertoday with no set-up fees, monthly fees or per-claim fees charged to providers by visiting theAvaility websiteand selecting"Register". There is a simple testing process to determine if Direct Submit is right for you. D2Ed0L^lA$0D`X|6MlK(4S$3Al"@?MV3H{r qJAGg` Contact Magellan Healthcare. Call 1-800-528-7264 or the phone number listed on the back of the member's/subscriber's ID card. Please note: as these requirements can be subject to change, thegrid may not contain a complete list of exceptions. Ask them where out of state claims should be filed. (See item #2 below to learn how to contact your BCBS company to address any errors.) This new site may be offered by a vendor or an independent third party. 800-637-0171, press 3 Main telephone number 1-215-937-8000. If you have a question about . A Claims Courier Demo can be accessed at: Claims Courier is a free web-based data entry application. Box 9000 London, KY 40742 Phone: (866) 510-8778 Blue Shield Medicare Advantage Blue Shield Medicare Advantage Plan P.O. EAP providers can request an EAP authorization by leaving a brief voicemail message. External link You are leaving this website/app (site). This new site may be offered by a vendor or an independent third party. Box 7026 Wheeling, WV 26003 Wisconsin Anthem Blue Cross Blue Shield Corporate Address. In addition, some sites may require you to agree to their terms of use and privacy policy. Log into the Availity Provider Portal, select Payer Spaces from the top navigation menu and select BCBSTX. Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association. All claims for covered services provided to HealthChoices Members must be submitted to and received by Magellan as follows: Within sixty (60) days from date of service for most levels of care except as provided below; Within sixty (60) days from date of discharge for 24/hr level of care; Within sixty (60) days of the last day of the month or the discharge date, whichever is earlier when billing monthly for longer treatment episodes of care at a 24/hr level facility; Within sixty (60) days of the claim settlement for third party claims. BCBSTX providers who receive paper checks and Provider Claim Summaries (PCSs) via the U.S. Mail may wish to consider the electronic alternatives listed below for greater efficiency, convenience and security of information. Attention: Claim Department . Fax: 1-713-663-1227 As a result of this determination, remittance advice, known as an Explanation of Payment (EOP) is sent to you. Many times, primary care physicians are the first place a member goes when they have a problem. Dental Expense Claim. 195 0 obj <>stream PO Box 10191. Most people don't view their physical and mental health as separate, and neither do we. Claim status inquiries contact Availity or other electronic connectivity. BCBS Prefix List - Alpha. Services that require pre-authorization P. O. Vision/Hearing Claim. For service questions, such as benefits, claims, bill pay or other issues: Call: 1-800-495-2583, 8 a.m.-8 p.m . 114 Mesa Park Dr. Suite #300 Contact Magellan Health Services or call 1-800-788-4005, For prior authorization, benefits, eligibility, or claims status or questions contact Magellan at 1-800-327-7390. Magellan Behavioral Health Providers! ), For services managed by Magellan: %PDF-1.5 % Magellans Primary Care Physician (PCP) Toolkit. Use the link below to find your local BCBS company's website. San Diego, CA 92171 . Horizon Behavioral Health. Box 710400 . Please emailwomenshealth@hhsc.state.tx.uswith any questions. 9~zfH. Submit completed forms to: Fax: 1-713-663-1227 2. Magellan has separate post office boxes for the accounts for which we provide claims payment services. Double-Check Details Check your new card to ensure details like the spelling of your name and the type of plan you selected are correct. As a Behavioral Health-Managed Care Organization (BH-MCO), Magellan manages members' benefits in coordination with you - our network providers. <>/Metadata 147 0 R/ViewerPreferences 148 0 R>> %PDF-1.7 APPEALS . Please be aware that inquiries and email boxes are not monitored 24/7. Blue Cross and Blue Shield of Texas Upon receipt of your message, New Directions will fax or mail you the . This claim is a resubmit; why was it denied for timely filing?A. Make sure to send your claim form to the appropriate claims payer and specific address. BlueCard is our out-of-area program that allows members from other Blue Cross and Blue Shield Plans to receive health care benefits when travelling or residing in another Blue Plan's service area. Box 85042. Clean claims are defined as claims that can be processed without obtaining any additional information from the provider or from a third party. 1-361-878-1623 Paper Claim Filing; Dental Providers. Note: For the requests below, utilize the indicated links: All other inquiries submit an email by selecting the office closest to your location and provide the Tax Identification Number, NPI, and if applicable, Medicare Numbers for your provider when contacting Network Management. Authorization In an effort to make the authorization process easier for our EAP providers, New Directions EAP offers an authorization prompt on its telephone system (800-624-5544, prompt 3). Providers can refer members by contacting 1-877-214-5630. You are on primary menu. Or call your doctor or therapist for help. Enforcing this clause also brings us in line with industry practices. Effective 6/27/2022, a Behavioral Health Service Coordination can help members manage complex conditions related to mental health and substance use. Medicaid Network Management Email to submit provider inquiries and questions. When the confirmation message displays, select, To enroll online for EFT, you must be a registered Availity, Texas Medicaid claims are normally finalized weekly on Mondays. hb```@(]K@1% V!iD3 7+S#UBCm0#LiF j9vvfL4 q* You will be assigned an IT analyst to guide you through the process and address any questions. Explore more about our programs and services addressing behavioral health, including substance use disorder treatment, and integration with physical health. EDI Support: Contact Magellans EDI Hotline for support and/or assistance:1-800-450-7281ext. Customer Service. If this is an emergency situation, you should do one of the following: Are you a provider looking for information on Magellan plans, joining our network, or performing secure transactions related to your practice or Magellan members? Box 30271 Salt Lake City, UT 84130-0271 *Washington Regence Group Administrators Attn: Claims P. O. For this reason, your resubmitted claim has been denied. 1800 West Loop South, Suite 600 The EPSarrives fasterthan the PCS andis easier to archivefor future retrieval. (Note:For behavioral health professional providers, refer to the Network Management Office Locations listed above). Email to submit provider inquiries and questions, North Texas Dallas, Fort Worth, East Texas (ExcludesBastrop, Bell, Bosque, Burleson, Burnett, Caldwell, Falls, Fayette, Hays, Hill, Lee, Leon, Limestone, Madison, Milam, McLennan, Robertson, Travis, Wichita and Williamson counties), Blue Cross and Blue Shield of Texas Are you a member looking to access behavioral health or EAP services sponsored through your employer? Blue Cross and Blue Shield of Texas The ERA can be automatically posted to your patient accounting system. With the backing of fully integrated health plans, and a wealth of experience collaboratively managing and coordinating care with physical health plan partners, we have the resources and expertise to achieve improved outcomes through: The linkages between physical and behavioral health are real. There, claims submission information is broken out by prefix/product name. It is important for you to stay current with your specific state and/or plan/program requirements. 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