bcbs prefix list 2021 pdf

%%EOF American Health Group (AHG) Call 1-800-847-7605 . For more information, contact your Network Provider Consultant or call 406-437-6100. for medical policies and prior authorization requests. BCBS Alpha Numeric Prefix - It's a three letter Alpha numeric prefix followed by id number. 2021, for some of our commercial non-HMO members, such as those listed below: - PPO - Blue Choice Preferred PPO(SM) - Blue Choice PPO(SM) - Blue Options(SM)/Blue Choice Options(SM) - Blue High Performance Network(SM) [Blue HPN(SM)] This is not an exhaustive listing of all codes. So, to answer this query, we have mentioned below few important points to consider. We update BCBS prefix list data on daily basis to provide latest BCBS prefix home plan information. Does policy number same as member ID number? 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. The following summaries and related prior authorization lists were posted on the Support Materials (Government Programs) page as of Jan. 1, 2021: Important Reminder: Check Eligibility and Benefits First 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. 0|kEMi_a*-Yfj#uqEcA/6 .M.6YNw4cyo>lESMC\)H~L 1B> The site may also contain non-Medicare related information. You can also contact us for specialty medical billing services. ", Blue Cross and Blue Shield of Texas, 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). PAGE : Amkor Technology, Inc. Group # 039176 : AmeriBen . endstream endobj 742 0 obj <. ?} AN The notice also refers to a medical policy for more information to help clarify when and how prior authorization requirements may apply. Independence Blue Cross* Quick Reference Guide . 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. Wheelchairs - Mobility Assistive Equipment (Manual & Power) & Scooters - Wheelchair Purchase only -Motorized) Wheelchair: E1050, E1060, E1070, E1083, E1084, E1085 . Coverage Period: 01/01/2021 - 12/31/2021 . Services that require precertification - IBX Coverage For: Individual + Family. 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. It means that BCBS members IDs prefixes will must have alphabets. This step will help you determine if prior authorization may be required for a specific member and service. 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. The SBC shows you how you and the plan would share t. he cost for covered health care services. 0 BCBS Alpha Numeric prefix are three characters at the start of each BCBS insurance member ID. For Federal Employee Program (FEP) precertification requirements, please see the separate FEP precertification list. 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. The three-character prefix identifies the Blue Cross and Blue Shield Plan to which the member belongs. BCBS Prefix should be included along with ID number, exactly as it appears on the member ID card when filing the claims to insurance company. BCBSIL makes no endorsement, representations or warranties regarding any products or services provided by third party vendors such as eviCore, AIM or Availity. Note: Current three-character, alpha-only prefixes will not be affected by this change. (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. 0t9~pE_ >if}~t~iM 'yn8Pgi |hxQD_Y. Third, it can help you make more informed decisions to choose right insurance plan and benefits. An incorrect or missing three-character prefix may cause possible delays in the processing of your claims. I have completed my Bachelor of Business Administration in Healthcare Management from University of Texas. Its important to remember that benefit plans differ in their benefits, and details such as prior authorization requirements are subject to change. For Example: ABC, AQT, TXX, TEA, A2B, 2AB, 2A2, PAS, ZGP, XXU etc. Medicare Working or retired, we'll help you every step of the way to find the right plan. To identify correct blue cross blue shield department, they use three characters BCBS prefix in the start of each BCBS member plan ID. To view this file, you may need to install a PDF reader program. 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. DIGNITY HEALTH YAVAPAI REGIONAL MEDICAL CENTER AND BLUE CROSS BLUE SHIELD OF ARIZONA REACH AGREEMENT, FIESTA BOWL AND BLUE CROSS BLUE SHIELD OF ARIZONA OPEN APPLICATIONS FOR FOURTH ANNUAL EMPOWERING DIVERSITY SCHOLARSHIP, PCMH PROGRAM DELIVERS HEALTHIER PATIENTS AND HAPPIER PROVIDERS. 15388 0 obj <>/Encrypt 15364 0 R/Filter/FlateDecode/ID[]/Index[15363 94]/Info 15362 0 R/Length 122/Prev 932133/Root 15365 0 R/Size 15457/Type/XRef/W[1 3 1]>>stream BCBS Alpha Numeric Prefix Its a three letter Alpha numeric prefix followed by id number. This article offers an overview of 2021 prior authorization support materials and related communications that may apply for some of our non-HMO commercial and government programs members, effective Jan. 1, 2021. BlueCard. First Character P is symbolizing that member plan/product type is BCBS PPO. This new site may be offered by a vendor or an independent third party. Customer Service: 1-800-409-9462 HCSC-PORT. Commercial Communications BCBS Prefix List Z2A to Z9Z - Alpha Numeric Lookup 2022 741 0 obj <> endobj Commercial Prior Authorization Summary and Code Lists 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. 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. eah xp`}L s1zIq%A9Zc~(Iz~HQu;AT#2$ Wp`Hlpp6NQIV0hg`,g H20[20* ": Its critical to check member eligibility and benefits through the Availity Provider Portal or your preferred vendor portal prior to every scheduled appointment. Medical providers - Arkansas Blue Cross and Blue Shield

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