The policy number is a unique identifier which may cover multiple members under the same policy, such as a family or a group. for medical policies and prior authorization requests . 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. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. Blue KC Commercial Prior Authorization and Notification List In case, you need any additional information related to BCBS prefix then feel free to reach out to us. Benefits and eligibility should be verified for all members prior to rendering services. Plan Type: PPO . Last updated: 07/01/2022. BCBS Railroad refers to Blue Cross Blue Shield health insurance plans that are specifically designed for members who are affiliated with railroad organizations in the United States. Correct BCBS home plan can easily be identified using our BCBS prefix lookup directory. %%EOF 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. So, to accomplish our goal, we have listed down the complete BCBS alpha prefix list so that you can easily identify correct BCBS plan. 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: BCBS Alpha Prefix Lookup 2023 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 In that case claim may be denied as Submit the claim to the correct address / Member ID not found. BCBS Prefix List 2023 - Alpha Prefix and Alpha Number Prefix Lookup BCBS Prefix List AAA to AZZ - Alpha Lookup by State 2022 First Character Z assigned to the BCBS Plan. All prefixes are unique. 741 0 obj <> endobj AIM Specialty Health (AIM) is an independent company that has contracted with BCBSIL to provide utilization management services for members with coverage through BCBSIL. 1254 0 obj <>/Filter/FlateDecode/ID[]/Index[1229 40]/Info 1228 0 R/Length 122/Prev 219460/Root 1230 0 R/Size 1269/Type/XRef/W[1 3 1]>>stream For Example: ABC, AQT, TXX, TEA, A2B, 2AB, 2A2, PAS, ZGP, XXU etc. Title: In some case provider or billing company may file the claim to an incorrect address without checking the correct BCBS address. View Medicare information Radiology utilization for Arkansas Blue Cross FEP You may also be interested to read about denial code 27 reason and solutions. 1229 0 obj <> endobj BCBS Alpha Prefix Its a three letter alpha prefix followed by id number. Right after completing my degree in 2011, I started my job career as an Accounts Receivable in a medical billing company. Independence Blue Cross (BC) of Philadelphia (Phi) and the Southeastern Pennsylvania (PA) PAI. See the Medical oncology prior authorization list for Blue Cross and BCN commercial members for a supportive care drugs (other than CAR -T comprehensivelist of managed by AIM, and groupsincluded in the program. 2021 Prior Authorization Requirement Summaries, Code Lists and Related Second Character G assigned to the BCBS Plan as well. BCBS alpha numeric prefix contains alphabets as well as digits ranging from 1 to 9. BCBS Prefix List Lookup 2023 - Latest Blue Cross Blue Shield Directory 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. 777 0 obj <>stream "Y24Oz>V ?I L r%dl=vHd z/;/X #k> Gq Final Remarks about BCBS Prefix Lookup Directory. It shows that these type of BCBS member IDs are different. You may also want to know: United Healthcare Claims Address Information. These plans provide health insurance coverage for railroad employees, retirees, and their eligible dependents. Most PDF readers are a free download. The most important and easy way to identify BCBS member is his BCBS member ID alpha prefix. New BCBS Alpha Numeric Prefixes | My Payer Directory Prefix Group Address Group Name TPA Name & Address Claims Filing Claims & Benefit Contact Name Phone . This new site may be offered by a vendor or an independent third party. (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. 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. Individuals & Families We offer a wide choice of individual plans to fit your health needs and budget. I have completed my Bachelor of Business Administration in Healthcare Management from University of Texas. Also, pre-authorization information and medical policy for out of state plans may be found on the Blue Cross Blue Shield of Texas provider website section under Standards and Requirements, and then select "Medical Policy and Precertification/Preauthorization for Out of Area Members. PDF HMO Networks - Blue Cross and Blue Shield of Illinois Blue Cross Select Silver. $=0j]xkM#[f4YgI|in Z(0zF1-9gk!D @WeUUn/R%$'c|J6:z}\}8ZNd+SL5-h"\wE$w{3\zO>,Vta$a`D7rHmr$bwZm7yYO)&^E<2@9#&UDOz In addition, some sites may require you to agree to their terms of use and privacy policy. The member ID number may be different for each member covered under the same policy, and it is typically used when seeking medical services, submitting claims, or accessing healthcare benefits. Wheelchairs - Mobility Assistive Equipment (Manual & Power) & Scooters - Wheelchair Purchase only -Motorized) Wheelchair: E1050, E1060, E1070, E1083, E1084, E1085 . BCBSIL makes no endorsement, representations or warranties regarding any products or services provided by third party vendors such as eviCore, AIM or Availity. hbbd``b`f3$ bE FM Dmb"@ $$@z$u ad#B cG To accommodate our increasing lines of business, Blue Cross and Blue Shield of Montana (BCBSMT) has adopted several new three character prefixes as part of the member identification numbers. BCBS Alpha prefix lookup contains all the Blue Cross Blue Shield alpha prefix along with their home plan and website. For Example: ABC, AQT, TXX, TEA, A2B, 2AB, 2A2, PAS, ZGP, XXU etc. hbbd```b``@$Df/i #D2lE``vd@ "@,iZ R R2H{v# k Does BCBS policy number same as BCBS member ID number? Yes, Policy number same as member ID number and also known as subscriber ID number. b(f{YH^tn}u62\}TgT>ENWJB=J #=a$oXIq(n,tU+D'j}L(t#,w?!^oZUQR, 7a. BCBS Alpha prefix are the three characters at the start of each BCBS insurance member ID. Member identification numbers beginning with R belong to Federal Employee Program (FEP) and will not have a three-character prefix when filing. (Note: For changes to come later this year, refer to this notice, posted Dec. 31, 2020: New Prior Authorization Requirements for Advocate Aurora Health Members Will Take Effect April 1, 2021.). To get information about such member IDs, you can contact BCBS prefix directory phone number i.e. Prefix ZGP identifies Blue Cross Blue Shield of Texas PPO Product. therapy) If you have any questions, call the number on the members ID card. BCBS Prefix List - Alpha Lookup by State 2022 - Finder BCBS FEP Prefix BCBS Federal Employee Program is identified by the letter R followed by the number. Let's start with you. Checking eligibility and/or benefit information and/or the fact that a service has been prior authorized is not a guarantee of payment. Note: Current three-character, alpha-only prefixes will not be affected by this change. Third, it can help you make more informed decisions to choose right insurance plan and benefits. 01/01/2021 . Current prefixes will still be valid once the new alpha-numeric prefixes are issued, unless there is another need to change or remove a prefix . 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. Account-specific prefixes are assigned to centrally processed national accounts, which are employer groups that have offices or branches in more than one area, but offer uniform . 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. q8-_?UT"X e+1?#7DMKHY]?R,-e;PE\mL Three-Character Prefixes. 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. Baltimore, MD 21237 . PREFIXES . 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 Also, these BCBS prefixes helps providers and medical billers to reach the correct claims department for claims and benefits inquiry. First Care, Inc. are independent licensees of the Blue Cross and Blue Shield Association. We have the right plan for you to keep you and your family covered. Does BCBS Cover Wegovy for Weight Loss? This step will help you determine if prior authorization may be required for a specific member and service. `xn_F-y(MQ&O!y1?-uZ=t'=E$r2$IA)gYWp&g` 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. Coverage For: Individual + Family. 0 The notice also refers to a medical policy for more information to help clarify when and how prior authorization requirements may apply. No, the BCBS policy number is not typically the same as the BCBS member ID number. eviCore healthcare (eviCore) is an independent specialty medical benefits management company that provides utilization management services for BCBSIL. K8Z : Page 2 . PDF Blue Cross and Blue Shield of Minnesota and Blue Plus Commercial Prior For example: ABC12345678 Here " ABC" is BCBS alpha prefix. 15456 0 obj <>stream We offer a wide choice of individual plans to fit your health needs and budget. Services that require precertification As of January 1, 2022, this list applies to all Independence Blue Cross HMO, PPO, and POS products, including Flex products. Hi, Im Kim Keck! We make it easy for you to offer the healthcare coverage that delivers for your business. endstream endobj 15364 0 obj <>>>/EncryptMetadata false/Filter/Standard/Length 128/O(a;uY[7y\\ Y)/P -1036/R 4/StmF/StdCF/StrF/StdCF/U(ZgYX: )/V 4>> endobj 15365 0 obj <>/Metadata 280 0 R/PageLayout/OneColumn/Pages 15351 0 R/StructTreeRoot 2939 0 R/Type/Catalog>> endobj 15366 0 obj <>/Font<>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 15367 0 obj <>stream PDF Provider Quick Reference Guide - CareFirst