bcbs illinois prefix list

<> <> Provider Finder . 4 0 obj XCD. 14 0 obj UAC. Preferred PPOSM Alpha Prefix Codes December 15, 2015 As a reminder, the alpha prefix codes on Blue Cross and Blue Shield of Illinois (BCBSIL) members' ID cards in the BlueCare Direct and Blue Choice Preferred PPO plans have been updated. Prefix ZGP identifies Blue Cross Blue Shield of Texas PPO Product. x\moFn"pI \Mc7 t,\GizffwN(LP4Kuda)\rxD870x(c%BE6q\4i5 #orUcA"QLoHCfG*QRx(aI*uS(IFf,3D*RY3dyGB{Zt|g&Dq~? Third, it can help you make more informed decisions to choose right insurance plan and benefits. So, to answer this query, we have mentioned below few important points to consider. Address: 11070 Katy Fwy, Houston, TX 77043, 2023 Xceed Billing Solution.com - All Rights Reserved. And to manage such a big network, they divided it into different departments state wise or employer specific. We update BCBS prefix list data on daily basis to provide latest BCBS prefix home plan information. BCBS Prefix List 2021 - Alpha State Lookup BCBS Company; PAA: Pennsylvania: Capital Blue-Cross of Pennsylvania: PAB: Tennessee: Blue-Cross Blue-Shield of Tennessee Usually, the provider is responsible for requesting prior authorization before performing a service if the member is seeing an in-network provider. By doing it may cause delay in processing or handling the claim. To identify correct department, they use 3 characters Prefix in the BCBS members plan ID. <> If possible, make copies of the member's ID card (front and . Save my name, email, and website in this browser for the next time I comment. It allows you to quickly and easily identify your insurance home plan, saving you time and hassle. Blue Cross Blue Shield Federal Phone Number. 16 0 obj BCBS member ID prefix help medical billers, health care providers and patients to identify BCBS healthcare plan. To viewrequirements summaries andprocedure code lists, refer to theSupport Materials (Commercial)andSupport Materials (Government Programs)pages. 7 0 obj BCBSIL contracts with Prime to provide pharmacy benefit management and other related services. It means that BCBS members IDs prefix will must have alphabets and they may or may not have numbers. Save my name, email, and website in this browser for the next time I comment. One option is Adobe Reader which has a built-in reader. !D)v&GVr`&dq:1+{maO1DmP[ +|zUma-lT *5+J&E k$T46Bt^:+~/ES" M. members covered. Prior authorization (sometimes called preauthorization or pre-certification) is apre-service utilization management review. endobj Prime Therapeutics LLC (Prime) is a pharmacy benefit management company. In this way, the BCBS holds on compensating the costs and indulges with the maximum support of the customers. Blue Shield has negotiated with the local hospitals and pays off the steep fees for encountering charges on the specific benefits. To view the purposes they believe they have legitimate interest for, or to object to this data processing use the vendor list link below. MedicalBillingRCM.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com. $TbYmVcI^ONr#H2.G uG!`;4%x$;L[| } !1AQa"q2#BR$3br W2A to W9Z. . Here we have listed down all the Blue Cross Shield Prefix along with BCBS home plan name and website for BCBS member IDs ranging from W2A to W9Z. We make sure to update the information on daily basis, however, if you find some kind of inaccurate information, feel free to contact us. Blue Cross Blue Shield of Illinois: Y2M: Blue Cross Blue Shield of Nebraska: YAA: Anthem BCBS of Connecticut: YAB: Regence Blue . One option is Adobe Reader which has a built-in reader. So, to accomplish our goal, we have listed down the complete BCBS alpha prefix list so that you can easily identify correct BCBS plan. The alpha prefix is very important to the identification number. Born in Texas, USA. For Example: ABC, TXX, TEA, A2B, 2AB, 2A2, PAS, XXU etc. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Independence Blue Cross(BC) of Philadelphia(Phi) and the Southeastern Pennsylvania(PA), Carefirst BCBS of Maryland the (MD), District of Columbia (DC) and the Northern Virginia (VA). The following travel insurance helps to deal with all the medical costs and also covers the family expenses. Tdb[+Np/1oz1_(:3^%:\tr'c!HfRY{P#~Kr>S: There is a total of 732 alpha prefixes in the BCBS EAA-EZZ list and 39 are Not Assigned prefixes out of 732. The alpha prefix is always three letters followed by the member's ID number which can be from 6 up to 14 characters total. Have a look at BCBS alpha prefix and alpha numeric prefix directory below. For more than 85 years, we've provided our members with comprehensive, affordable health . BCBS Insurance goes on dealing with the oldest and largest health insurance system. The manual is organized into the following sections for your convenience. An Independent Licensee of the Blue Cross Blue Shield Association 020469 (03-01-2023) Prefix BCBS Plan Prefix BCBS Plan Prefix BCBS Plan A2T Premera Blue Cross A9P Premera Blue Cross ACF Premera Blue Cross AGL Premera Blue Cross/Shared Admin GUJ AHC Premera Blue Cross AJX Premera Blue Cross GVY ALK Premera Blue Cross Secondly, it ensures that you have the most up-to-date information about each and every BCBS prefix home plan because we update the BCBS prefix list on daily basis. endobj The calculation begins from the date of service, discharge date or last date of treatment up to 365days, including weekends. *!uB9^AwjF(v,o Amerihealth Caritas Directory Healthcare, Health Insurance in United States of America, Place of Service Codes List Medical Billing. 2/1/2023. Regardless of any prior authorization or benefit determination, the final decision regarding any treatment or service is between the patient and the health care provider. BCBS National accounts are employer groups that have outlets/offices in multiple states but they offer limited coverage to their employees. Search your plan's drug list, find a pharmacy, and more. ( Note: See Medicaid page for BCCHP and MMAI Provider Finder links.) Lets dig into it! In all adverse conditions, their health insurance programs go on providing the facilities to help out the customers in all possible ways. It shows that these type of BCBS member IDs are different. External link You are leaving this website/app (site). The prefix acts as a key element in confirming the members' eligibility and coverage information. It comes up with the facilities such as dental, vision and other body issues. BCBS Alpha prefix and BCBS Alpha numeric prefix are very important to submit claims to BCBS insurance. %PDF-1.5 endobj 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. In certain situations, the baggage gets lost or goes on delaying for the baggage from the airport by claiming to the insurance company and policies for losing the baggage. By using this directory, you can ensure that you have the most up-to-date information about BCBS home plans and make more informed decisions about choosing right insurance plan. You may also want to know: United Healthcare Claims Address Information. Hi, Im Kim Keck! Blue Cross and Blue Shield of Illinois (BCBSIL) members' ID cards in the BlueCare Direct and Blue Choice Preferred PPO plans have . The site may also contain non-Medicare related information. endobj Information current and approximate as of December 31, 2018. <> Below is a list of the old and new alpha prefix codes. 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. Ans. T2A to T9Z. <> However it has several policies for its customers. Independence Blue Cross (BC) of Philadelphia (Phi) and the Southeastern Pennsylvania (PA) BCBS Prefix BCBS Plan Name E2A Blue Cross Blue Shield Texas E2B Blue Cross Blue Shield Texas E2C Anthem BCBS Indiana E2E Regence Blue Cross . BCBSIL makes no endorsement, representations or warranties regarding any products or services provided by third party vendors. Blue-Cross Blue-Shield of Illinois. Check Claims Claim Explanation Codes Request a Claim Adjustment View Fee Schedules . Certain employer groups may require prior authorization or pre-notification through other vendors. In order to get rid of this denial or sometimes delay in processing, Provider or Billing companies has to find out the correct address by BCBS prefix from the above list before filing the claim. Search articles and watch videos; ask questions and get answers. HOME; . Want to be part of our amazing team? 8 0 obj Stand-alone dental products, vision and pharmacy when delivered through an intermediary model. The blue cross deals with the features to make it easier for the customers to deal with the situation. Always make sure to submit claims to insurance company on time to avoid timely filing denial. For Example: ABC, TXX, TEA, A2B, 2AB, 2A2, PAS, XXU etc. Health Care DeliveryPolicy and Procedures, Blue Cross Community Health Plans ProviderManual, Medicaid Provider Orientation(Professional), Medicaid Prior Authorization RequestForm, Medicaid Provider Orientation (Professional), Blue Cross Community OptionsSMBehavioral Health Benefit Grid. Final Instructions about BCBS Prefix Lookup, United Healthcare Claims Address Information, BCBS Alpha Numeric Prefix from U2A to U9Z (Updated 2023), BCBS Alpha Prefix from TAA to TZZ (Updated 2023). To view this file, you may need to install a PDF reader program. BCBS Alpha Prefix from BAA to BZZ. BCBSIL, as well as several independent Blue Cross and Blue Shield Plans, has an ownership interest in Prime. The Home and Host plan is also working in the Blue Cross Blue Shield plan. This list of bcbs prefixes includes BC prefix YUP, YRK, YPN, YPJ, YTD, YRH, YTP, YIF. To view this file, you may need to install a PDF reader program. AIM Specialty Health (AIM) is an independent company that has contracted with BCBSIL to provide utilization management services for members with coverage through BCBSIL. IPA Guidelines for Member Complaints, Inquiries, Appeals and Grievances Policy. stream In the USA, the BCBS is a very well-known health insurance statement that conveys more association and deals with numerous activities. We recently received a query from a provider that how I can identify that patient is BCBS health insurance member. Sometimes, a plan may require the member to request prior authorization for services. This new site may be offered by a vendor or an independent third party. This includes strict observance of and compliance with the laws and regulations governing the business operations of HCSC, and in particular, the services that it performs or has delegated to others to perform pursuant to its Medicare and Medicaid contract(s). The insurance company also provides facilities for the senior citizens and claims to give the best facilities for them and get them admitted to the nearest hospital. BCBS Prefix will not only have numbers and the digits 0 and 1. Log In to the Shopping Cart, Need to Make a Payment? BCBS member ID card will have a suitcase logo at the bottom of card which will also help you to identify patient plan like HMO, PPO, POS etc. Even BCBS Insurance provides COVID-19 protocols, which has become a big issue in todays generation. It holds a huge role in the cancellation policy, hotel booking and loss of passports. <> 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. <> 17 0 obj There are two types of BCBS prefixes which are mentioned below: Plan Specific prefix are assigned by BCBS to each plan. Information for Blue Cross and Blue Shield of Illinois (BCBSIL) members is found onour member site. First Character Z assigned to the BCBS Plan. We are also the largest provider of health benefits in Illinois, serving more than 8.1 million members in all 102 counties across the state. The 34 independent BCBS companies insure more than 107 million members across all 50 states, the District of Columbia, and Puerto Rico. For accurate and quick claims processing, it is necessary to get complete patient insurance information. BCBS Alpha Numeric Prefix from T2A to T9Z. Join us as we build the next generation of health insurance. Business health insurance plans designed to fit any size small business and budget. In general, there arethreestepsprovidersshould follow. In some case provider or billing company may file the claim to an incorrect address without checking the correct BCBS address. BCBS is one of the biggest insurance companies in USA and serving more than 106 million people. So, all BCBS plans, including Anthem and Non-Anthem plans announced that member IDs will also be Alpha Numeric from 2018 onwards. These BCBS prefix may include alpha and numerical characters. The prefixes identify the member's BCBS prefix list plan or national account and become essential when routing claims for processing. 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. Amerihealth Caritas Directory Healthcare, Health Insurance in United States of America, Place of Service Codes List Medical Billing, Independence Blue-Cross of Philadelphia and Southeastern Pennsylvania, Maryland/District of Columbia/Northern Virginia, Anthem Blue-Cross Blue-Shield of Virginia, Excellus Blue-Cross Blue-Shield of New York, Anthem Blue-Cross Blue-Shield of Missouri, Blue-Cross Blue-Shield of Western New York, Empire Blue-Cross Blue-Shield of New York, Anthem Blue-Cross Blue-Shield of Colorado, Anthem Blue-Cross Blue-Shield of Wisconsin, Highmark Blue-Cross Blue-Shield of Pennsylvania, Horizon Blue-Cross Blue-Shield of New Jersey, Anthem Blue-Cross Blue-Shield of Connecticut, Anthem Blue-Cross Blue-Shield of Kentucky. FA%[: T2*uug)T%D._M/5WIdB;zg@W01>X_b( vkWXth$OYD8x$Ygt{" BB> XCE. JFIF x x C <> -x0cjH4`f4`c:A 9K+)tnapM"f2:d+-%0|[FpPDRtZd)@@0,4|(a8`0XE3Fx"K@dd`vF[VgGs.OO'wAl~B~P%sr:|7Rz Returning Shopper? Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. The health of your eyes and teeth can affect your overall health. BCBS Alpha Numeric Prefix from F2A to F9Z (Updated 2023) January 7, 2023 by Kim Keck. Anthem Blue-Cross Blue-Shield of Ohio. Choose a state to see how Blue Cross Blue Shield is working in your community. endobj Compliance, Fraud, Waste and Abuse Program and Reporting: HCSC and its subsidiaries are founded on the basic principles of good business behavior. 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. Account Specific Prefix are assigned by BCBS to national accounts. BAB. Other providers are available in our network. Y2A to Y9A. The plans and system go on covering up the international travel ventures. Health Equity and Social Determinants of Health (SDoH), Over the Counter Equivalent Exclusion Program, Prior Authorization and Step Therapy Programs, Consolidated Appropriations Act & Transparency in Coverage, Medical Policy/Pre-certification: Out-of-area Members, Behavioral Health IP PA - IVR Caller Guide, Behavioral Health OP PA - IVR Caller Guide, Inpatient Preauthorization - IVR Caller Guide, Outpatient Preauthorization - IVR Caller Guide, Preauthorization: Check Request Status - IVR Caller Guide, Utilization Management Process Overview (Commercial), Patients medical or behavioral health condition, Date of service, estimated length of stay (if the patient is being admitted), Provider name, address and National Provider Identifier (NPI), Government Programs 877-774-8592 (MA PPO); 877-860-2837 (BCCHP); 877-723-7702 (MMAI). Health Equity and Social Determinants of Health (SDoH), Over the Counter Equivalent Exclusion Program, Prior Authorization and Step Therapy Programs, Consolidated Appropriations Act & Transparency in Coverage, Medical Policy/Pre-certification: Out-of-area Members, HMO Medical Service Agreement Highlight and Process Summary, 3rd Trimester Pregnancy IPA Transfer Policy, 3rd Trimester Pregnancy IPA Transfer Procedure, Ancillary Hospital Institution Care Transition Exceptions Policy, Ancillary Hospital Institution Care Transition Exceptions Procedure, Contract Management Firms Confidentiality Agreement Policy, Contract Management Firms Confidentiality Agreement Procedure, Corrective Action for Failed Utilization Management Audit of Participating IPAs Policy, Corrective Action for Failed Utilization Management Audit of Participating IPAs Procedure, Collaborative Improvement Coaching for HMO Quality Improvement Projects Policy, Collaborative Improvement Coaching for HMO Quality Improvement Projects Procedure, IPA Availability andAccessibility Requirements forImmediate Care Services Policy, IPA Availability andAccessibility Requirements forImmediate Care Services Procedure, IPA Guidelines for Member Complaints, Inquiries, Appeals and Grievances Policy, IPA Guidelines for Member Complaints, Inquiries, Appeals and Grievances Procedure, IPA Process for Establishing Out of Area for Emergency Services Policy, IPA Process for Establishing Out of Area for Emergency Services Procedure, IPAs Request for Member Transfer Procedure, Member Access to Behavioral Health Services Policy, Member Access to Behavioral Health Services Procedure, Member Notification Process when a Provider Leaves the IPA Policy, Member Notification Process when a Provider Leaves the IPA Procedure, Oversight of Contracted Infertility Vendor Policy, Oversight of Contracted Infertility Vendor Procedure, Primary Care Physician (PCP) Affiliation with Multiple IPAs Policy, Primary Care Physician (PCP) Affiliation with Multiple IPAs Procedure, Utilization Management and Case ManagementAdherence Audit of Participating IPAs Policy, Utilization Management and Case ManagementAdherence Audit of Participating IPAs Procedure, Accountable Care Organization (ACO) Dual Claimed Physician Policy and Procedure, BCBSIL Marketing Communications HLA Policy Procedure, Blue Cross Blue Shield of Illinois Quality of Complaints & Occurrences Process Policy, Blue Cross Blue Shield of Illinois Quality of Complaints & Occurrences Process Procedure, Provider Handling of Member Inquiries Complaints and Appeals, Provider Urgent/Expedited Clinical Appeal Process, Recovery of Provider Overpayments due BCBSIL, MA HMO Detailed Explanation ofNon-coverage, MA HMO Notice of Dismissal of Organization Determination Request, MA HMO UM Approval In Network ProviderLetter, MA HMO UM Approval Out of Network ProviderLetter, MA HMO Sample Provider Appeal Language for Explanation ofPayment, MA HMO Sample Waiver of LiabilityStatement, MA HMO Transition to Transplant ManagementForm, HMO Provider Credentialing Pre-application. ZAA. New to Blue Access for Members? BCBS Alpha Numeric Prefix from L2A to L9Z (Updated 2023), BCBS Provider Phone Number for Claims and Eligibility Verification, PR 27 Denial Code Description and Solution, How to Improve Your Coding Accuracy? To run such a large number of people, they divided Blue Cross Blue Shield Insurance Association into different departments which is employer specific or state wise. I have completed my Bachelor of Business Administration in Healthcare Management from University of Texas. Skip to content. Blue Cross Blue Shield insurance Companies - Statewise. Learn more. IPA Guidelines for Member Complaints, Inquiries, Appeals and Grievances Procedure. M+. If the provider or member doesnt get prior authorization for out-of-network services, the claim may be denied. The prefixes include filling up the claims of the insurance details.It also checks out the incorrect members of gaining the claim setting up the correct number about the IDs. endobj endobj What is 25 modifier and how to use it for insurance Payment, How to code for diagnosis and procedures related to Monkey pox, BCBS Alpha Prefix List from YAA to YZZ Updated 2023, Timely Filing Limits for all Insurances updated (2023), Blue Cross Blue Shield insurance Companies Statewise, BCBS of South Carolina (SC) / Southcarolinablues, Highmark Blue Shield (BS) of Pennsylvanaia (PA), Blue shield(BS) of Northeastern New York (NeNY). External link You are leaving this website/app (site). Here " A2A" is BCBS alpha numeric prefix. endobj Phone - Call eviCore toll-free at 855-252-1117 . BCBS Alpha Prefix List from GAA to GZZ updated 2021-List of Blue Cross Blue Shield insurance Companies - Statewise with prefix. . Blue Cross and Blue Shield of Illinois is proud to be the states only statewide, customer-owned health insurer. BCBS Alpha Numeric Prefix Its a three letter Alpha numeric prefix followed by id number. What is Medical Billing and Medical Billing process steps in USA? %&'()*456789:CDEFGHIJSTUVWXYZcdefghijstuvwxyz Ans. |d&`{ ^^I|Wp:K|~._s BCBS member ID have maximum 17 characters but most of the member IDs have 12 characters. Some of our partners may process your data as a part of their legitimate business interest without asking for consent. October 1, 2022 by Rebecca Williams. Blue Cross Blue Shield Federal Phone Number. BCBS Alpha Prefix List from CAA to CZZ Updated (2023) BCBS Alpha Prefix List of "C"-series. $4%&'()*56789:CDEFGHIJSTUVWXYZcdefghijstuvwxyz ? document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Xceed Billing Solutions is amedical billing company for outsourcing medical billing services. Renew Illinois Individual, Family & Medicaid Health Insurance, Blue Cross Community MMAI (Medicare-Medicaid Plan), Making Your Health Insurance Work For You, Prescription Drug Changes and Pharmacy Information, Machine Readable Files for Transparency in Coverage, Learn About Colon Cancer Screening Options. Here Letter R indicates BCBS FEP prefix. The prefix acts as a key element in confirming the members' eligibility and coverage information. We make sure to share latest data but in case you find some misinformation, please let us know so that we can help you to provide most accurate BCBS Alpha Numeric Prefix list. Member Prefix List Patient Roster Claims & Payments. Yes, Policy number same as member ID number and also known as subscriber ID number. 4/1/2022. Have a look at our BCBS alpha prefix and BCBS alpha numeric prefix directory below. To get information about such member IDs, you can contact BCBS directory phone number i.e. Once a prior authorization request is received and processed, the decision is communicated to the provider. V!E5y"w Dx])Vq_j.xwuUgq>bmh`M.hjsw Y_8NzZtAj&4B8%5"a t@BpweUI#t@SsRR)tx6a5B+sPWO^p[,U\ewdRyN@! XCC. Make sure to make copies of the front and back of member ID card. For government programs prior authorization requests handled by eviCore healthcare (eviCore): BCBS FEP Prefix - BCBS Federal Employee Program is identified by the letter "R" followed by the number. BCBS prefix are easy to identify using our BCBS prefix lookup because they're part of every BCBS member ID and we included all of them here in the BCBS prefix list. In addition to verifying membership/coverage status and other important details,this step returns information on prior authorization requirements and utilization management vendors, if applicable. When does health insurance expire after leaving job? Michigan. endobj If you have any questions, call the number on the member's ID card. Here I have shared the list of BCBS alpha prefix ranging from BAA to BZZ. 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. Below in our BCBS prefix lookup directory, you can lookup all the BCBS prefix appropriate home plans and their contact information. The Blue Cross helps to deal with the coverage of finding out medical costs and other emergencies. endobj Click on a section title to view the content. The following prefix list comes with filling up the health care claims and analyses the correct address of the BSCs sections. State Lookup. Prefix UTS assigned to University of Texas. These blue shield companies negotiate with the doctors and the other hospitals. For more than 85 years, weve provided our members with comprehensive, affordable health plans, making Illinois a healthier place to live, work and play. Get all the coverage of Original Medicare plus prescription drugs and extra benefits, with plan premiums as low as $0/month. 107. The BCBSIL Commercial Provider Manual is organized into the following sections for providers participating in PPO, Blue Choice PPOSM, HMO and the Blue High Performance NetworkSM(Blue HPNSM)EPO. We make sure to share latest data but in case you find some misinformation, please let us know so that we can help you to provide most accurate BCBS Alpha Prefix List.

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