The three-character prefixes listed do not represent an exhaustive listing of prefixes. Contact us to learn how we can improve your revenue cycle. Medical providers - Arkansas Blue Cross and Blue Shield 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. To view this file, you may need to install a PDF reader program. Blue Shield (BS) of California. So, to accomplish our goal, we have listed down the complete BCBS alpha prefix list so that you can easily identify correct BCBS plan. This includes our Medicaid Blue Cross Community Health PlansSM (BCCHPSM) and Blue Cross Community MMAI (Medicare-Medicaid Plan)SM and Blue Cross Medicare Advantage (PPO)SM(MA PPO) members. 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. 1268 0 obj <>stream plan. To identify correct blue cross blue shield department, they use three characters BCBS prefix in the start of each BCBS member plan ID. 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. Blue Cross Select Silver. Most PDF readers are a free download. Do not create one or use the BCBS prefix from another member ID card. The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. For Federal Employee Program (FEP) precertification requirements, please see the separate FEP precertification list. Wheelchairs - Mobility Assistive Equipment (Manual & Power) & Scooters - Wheelchair Purchase only -Motorized) Wheelchair: E1050, E1060, E1070, E1083, E1084, E1085 . BCBS Railroad member IDs starts with a letter R. Working or retired, we'll help you every step of the way to find the right plan. O}BAXv:OP)Qt9>PN,RG4uZu~?raYW+Q`|w[OD klW1Kg|'6'8=rRW00+,oD~`Ox(4DLMm,$Uy69r!$w0.<5>gJd'0?wf\2t| :\xQ cwh)}Ycb8I5vg~TQNnx^Y$M'JL+0?\:3Y(+Sb1:_%^uur(h>mS External link You are leaving this website/app (site). Independence Blue Cross* Quick Reference Guide . These BCBS prefix may include alpha and numerical characters. PAH. 'MNiXG]dRBC; 0'Va~9&c}Ag$Pge;\UY,$MtN endstream endobj 1230 0 obj <. In case, you need any additional information related to BCBS prefix then feel free to reach out to us. Its critical to check member eligibility and benefits through the Availity Provider Portal or your preferred vendor portal prior to every scheduled appointment. Note: BCBS FEP (Federal Employee Program) ID starts with the alphabet R follow by the insured ID number (For Example: R987654321). If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly. 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 These BCBS prefix may include alpha and numerical characters. The site may also contain non-Medicare related information. Not assigned prefix. BCBS prefix is a three character prefixes followed by the id number except for the following products and programs. Independence Blue Cross (BC) of Philadelphia (Phi) and the Southeastern Pennsylvania (PA) PAI. 0 No, the BCBS policy number is not typically the same as the BCBS member ID number. View Medicare information Radiology utilization for Arkansas Blue Cross FEP 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. for medical policies and prior authorization requests . %%EOF BCBS is one of the largest medical insurance company by total members of more than 45 million. 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 Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. For more information, contact your Network Provider Consultant or call 406-437-6100. This indicates that the claims are excluded from the BlueCard Program. hb```I! 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. BCBS Alpha Prefix list is useful for both providers and BCBS enrolled members/patients. Its important to remember that benefit plans differ in their benefits, and details such as prior authorization requirements are subject to change. One option is Adobe Reader which has a built-in reader. B}hJu`n+Z9>)2B~feo,TV [ZI^ylRr8DGo;ckrA;X2SjUlW]$4_vN(Tvh6#moc0!pbJ;oW)A'oR&bH=`1K}P(u3gD9:#1!m2saW1SD5/p2 'Su &x@`N.e#U(Fne]4;$"o*k;$~gn-Sd"mjdTY2R*I:w8w3;fpCfQH& 0|kEMi_a*-Yfj#uqEcA/6 .M.6YNw4cyo>lESMC\)H~L 1B> 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. 8772287268 Mail Administrator P.O. 365 0 obj <> endobj Check any internal documents you may have and update any references of "alpha prefix" to "prefix". Due to the exceeding number of BCBS insurance members, Alpha-Only Prefix member IDs exhausted. Each BCBS alpha numeric prefix represents different BCBS home plan. 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. hbbd```b``A$ endstream endobj 742 0 obj <. It clarifies a utilization management vendor change for specific members. BCBS Alpha Numeric prefix are three characters at the start of each BCBS insurance member ID. We update BCBS prefix list data on daily basis to provide latest BCBS prefix home plan information. Our Health Choice plans are available to Arizonans who qualify for Medicaid. Prior Authorization List for Blue Shield Effective April 1, 2023 (This list is updated monthly) blueshieldca.com 601 12th Street | Oakland, CA 94607 Blue Shield of California is an independent member of the Blue Shield Association April 1, 2023 Page 1 of 8 Policy Name/Program Procedure Code (To search, press Ctrl + F) . The three-character prefix at the beginning of the members identification number is the key element used to identify and correctly route out-of-state claims to the appropriate BCBS Plan. eviCore healthcare (eviCore) is an independent specialty medical benefits management company that provides utilization management services for BCBSIL. Born in Texas, USA. Stand-alone dental products, vision and pharmacy when delivered through an intermediary model. PDF BCBSAZ/TPA Co-Administered Group Plans - AZBlue PDF 2022 Commercial PA Code Lists December Updates - BCBSIL
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