Please provide the Tax Identification Number, NPI, and if applicable, Medicare Numbers for your provider when contacting Network Management. If you have a question about . The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies. Fax 877-361-7646, Claims submission address: 1999-2022 commercial_footer_copyright_magellan_link. Bundling Rationale (Claims filed before Aug. 25, 2017) BlueCross BlueShield of Tennessee uses a clinical editing database. Box 312599 Detroit, MI 48231-2599. 4 0 obj <>/Metadata 147 0 R/ViewerPreferences 148 0 R>> 9442 Capital of Texas Hwy N, Suite 500 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. Or call your doctor or therapist for help. Email: RxNetworksDept@magellanhealth.com. 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). Vision/Hearing Claim. 1-972-766-8900 Houston, TX 77027-3279 From February 15 to September 30, on weekends and holidays, you may be required to leave a message. P. O. endobj Attention: Claim Department . *interactive voice response (IVR) system to access, you must have document control number (claim number), Blue Cross and Blue Shield of Texas Medicaid. stream Most PDF readers are a free download. The Blue Cross Blue Shield Association is an . Fax: 713-663-1227 Box 629011 El Dorado Hills, CA 95762-9011. Participating physicians, professional providers, ancillary and facility providers may not seek payment from the member for claims submitted after the 95-day filing deadline. (336) 774-5400. Other Adobe accessibility tools and information can be downloaded at https://access.adobe.com. hbbd```b``A$ Mailing address (for paper claims): Blue Shield of California Mental Health Service Administrator (MHSA) P.O. <> Mailing address: 5660 University Parkway. If your ID card is not available, you may use one of the Customer Service telephone numbers below. Box 805107 Chicago, IL 60680-4112. 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 Effective 6/27/2022, a Behavioral Health Service Coordination can help members manage complex conditions related to mental health and substance use. This new site may be offered by a vendor or an independent third party. Check member eligibility, submit and check claims and find important information and more on our provider portal. In Texas, Magellan uses the American Society of Addiction Medicine (ASAM) criteria as the basis for the utilization reviews of substance use disorder cases. Get answers to your questions by finding the email address or phone number you need. We're here to help answer your questions. This means that, subject to applicable state or federal laws, claims must be submitted toMagellan within 60 days of the date of service or inpatientdischarge. Join our extensive provider network today! Box 7026 Wheeling, WV 26003 Wisconsin Anthem Blue Cross Blue Shield Services that require pre-authorization Use the link below to find your local BCBS company's website. To view this file, you may need to install a PDF reader program. Enforcing this clause also brings us in line with industry practices. * (Blue Essentials and Blue Advantage HMO), 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, Email to submit provider inquiries and questions. Providers can refer members by contacting 1-877-214-5630. Blue Cross and Blue Shield of Illinois P.O. Users will obtain immediate feedback regarding the results of the test to ensure compliance with HIPAA rules and codes. Q. View the 2021 GuideWell Social Impact Report. Magellan continuously looks at our processes and procedures to improve service and increase efficiencies. Magellans Primary Care Physician (PCP) Toolkit. The toolkit includes coverage and reimbursement options for postpartum depression through Medicaid, CHIP, the Healthy Texas Women Program, the Family Planning Program and other referral options. The site may also contain non-Medicare related information. We provide free eligibility and benefits verification as part of our billing . Box 710400, San Diego CA 921710400 Phone Number: (877) 263-9952 Blue Shield of CA: Payer ID: BS001 Claims Address: P.O. One option is Adobe Reader which has a built-in reader. By enforcing the timely filing requirement in the provider contract, we are able to focus our resources on what our providers have asked us to do - promptly pay claims. Box 660044 Where do I send the claim information?A. Member Services 1-800-521-6860 TTY: 1-800-684-5505 Representatives are available 24 hours a day, 7 days a week.. If you still need to submit paper claims, use the Claims-Routing Tool to determine the correct mailing address for each member. Contact us By mail. EAP providers can request an EAP authorization by leaving a brief voicemail message. Mail Claims or Claims Correspondence to: Blue Cross Blue Shield of Arizona P.O. 1-800-336-5696 Fax to: 1-888-579-7935 Again, this can be a huge time-suck, calling and being transferred over and over. The following items when submitted with your appeal may be considered evidence that your claim was submitted in a timely manner: Q. BCBS Prefix List. For this reason, your resubmitted claim has been denied. DO NOT COMPLETE THIS FORM IF YOU ARE A MAGELLAN COMPLETE CARE MEMBER OR PROVIDER. Are you a member looking to access behavioral health or EAP services sponsored through your employer? endobj Fax: 1-800-424-5881. Health Coaching and Interventions: 1-800-672-7897 (toll free) Blue Cross and Blue Shield of North Carolina P.O. BlueCross BlueShield of Tennessee payer ID number: 00390. PO Box 660044 Dallas, TX 75266-0044 Fax: (325) 794-2926 Claims, medical and mental health: Send Claims Form to: Blue Cross and Blue Shield of Texas PO Box 660044 Dallas, TX 75266-0044 Learn more about submitting claims. Resubmissions must be submitted within 60 days from the date of denial. Email to submit provider inquiries, Blue Cross and Blue Shield of Texas (BCBSTX). 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). <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 19 0 R 25 0 R 26 0 R] /MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> [Maryland and WDC] Offers healthcare insurance to residents of Maryland and Washington, DC. Under Magellan's policies and procedures, the standardtimely filing limit is 60 days. This functionality is available for claims transactions with a status of Received/ Accepted. Box 7355 . Box 32593 Detroit, MI 48232-0593. This claim is a resubmit; why was it denied for timely filing?A. Blue Cross and Blue Shield of Texas For preauthorization of psychological testing, in addition to the Texas Standard Prior Authorization Request Form for Health Care Services, Magellan also requires the provider to complete and submit the Request for Psychological Testing Preauthorization form found on our clinical forms page. Contact Information. As a Magellan provider, you are required to hold HealthChoices members harmless and cannot bill them for the difference between your contracted rate with Magellan and your standard rate. 114 Mesa Park Dr. Suite #300 Email to submit provider inquiries and questions, Blue Cross and Blue Shield of Texas % Paper Claims must be submitted to the below addresses (claims are not accepted at the Care Management Center in Newtown): MBH-Bucks, PO Box 1715, Maryland Heights, MO 63043 MBH-Cambria, PO Box 2157, Maryland Heights, MO 63043 MBH-Lehigh, PO Box 2127, Maryland Heights, MO 63043 MBH-Montgomery, PO Box 2277, Maryland Heights, MO 63043 %PDF-1.5 % 17806 IH 10 West, Bldg II, Suite 200 What is the appeals process? Place of Service 22. Magellan's quality improvement program to reduce inpatient mental health readmissions was selected by NCQA for inclusion in its benchmarking publication, Quality Profiles. In addition, some sites may require you to agree to their terms of use and privacy policy. Tricare Phone Number and Claim Address. If your state has multiple brands (WA, CA, OR, NY, NJ, to name just a few) then you'll want to ask for the exact address to file to. Main telephone number 1-215-937-8000. The site may also contain non-Medicare related information. Call 1-800-528-7264 or the phone number listed on the back of the member's/subscriber's ID card. ), For services managed by Magellan: Become an Anthem provider and join the nation's second- largest health plan-owned behavioral health company, serving more than 13 . Secure Provider Web Portal (Electronic Verification System - EVS) Online Provider Enrollment (OPE) Online Prior Authorization (PA) system Online Claims Submission Online Provider Claim Appeals Audio Response System (ARS) (800-942-6511) Real time CAQH/CORE EDI eligibility and claim verification Provider PASRR Nevada Medicaid COVID-19 For status call: Upon receipt of your message, New Directions will fax or mail you the . A Claims Courier Demo can be accessed at: Claims Courier is a free web-based data entry application. Complete the appropriate claim form - CMS-1500 forms are required for outpatient services and UB-04 forms are required for inpatient services. BlueCare Tennessee is an Independent Licensee of the Blue Cross Blue Shield Association. Email to submit provider inquiries, 1001 E. Lookout Drive Does this timely filing limit apply to all claims for all members (e.g., COB, Medicare, etc.)?A. You are leaving this website/app (site). 1800 West Loop South, Suite 600 Pharmacy Claim. Many times, primary care physicians are the first place a member goes when they have a problem. (Note:For behavioral health professional providers, refer to the Network Management Office Locations listed above). You may direct any questions about the form to Magellan at the phone number on the form. Magellan Behavioral Health Providers! There is a simple testing process to determine if Direct Submit is right for you. Medical Care Management Customer Service: If you have questions or need additional support, BCBSTX Personal Health Assistants are available to help. Copyright 2022Health Care Service Corporation. Email to submit provider inquiries and questions, Austinand Central TX (Bastrop, Bell, Bosque, Burleson, Burnett, Caldwell, Falls, Fayette, Hays, Hill, Lee, Leon, Limestone, Madison, Milam, McLennan, Robertson, Travis, Williamson counties), Blue Cross and Blue Shield of Texas Dallas, TX 75266-0241 Magellan Behavior Health Services coordinates all behavioral health (mental health and chemical dependency) services for Medicaid (STAR), CHIP, and STAR Kids members. Credentialing Status. Blue Cross Blue Shield members can search for doctors, hospitals and dentists: In the United States, Puerto Rico and U.S. Virgin Islands. Open in Google Maps Business Hours. Q. Box 2064 . Box 30271 Salt Lake City, UT 84130-0271 *Washington Regence Group Administrators Attn: Claims P. O. Eligibility and benefits contact Availity or other electronic connectivity vendor or call 1-800-442-4607*, Behavioral health services mental health and chemical dependency prior authorization and referrals (includes inpatient, residential treatment center (RTC) programs, partial hospitalization and outpatient behavioral health services) call 1-800-528-7264, Behavioral health services claims status inquiries contact Availity or other electronic connectivity vendor or call 1-800-442-4607*, Behavioral health services claim adjustments call 1-800-442-4607, Eligibility and benefits contact Availity or other electronic connectivity vendor or call 1-877-299-2377*, Claim status inquiries contact Availity or other electronic connectivity vendor, Medical Management Correspondence for the Health Insurance Marketplace for Blue Advantage HMO Members, Blue Cross Blue Shield of Texas The form form if you are a Magellan COMPLETE CARE member or provider inquiries, Blue Blue... 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