Instructions: 1. BCBS State by State | Blue Cross Blue Shield. %PDF-1.5 If you want a written response, you must request one. complies with applicable Federal and Washington state civil rights laws, Determine the county where the service was performed* (see exceptions below). PDF Provider Dispute Resolution Process Complete and mail or fax a Multiple Coverage Inquiry Form to Regence: Regence BlueShieldAttn: UMP ClaimsPO Box 91015MS BU386Seattle, WA 98111-9115. medical equipment supplier, ambulance services, applied behavior analysis services (ABA) or clinical social worker. To see if you qualify for Extra Help, call: 1-800-633-4227. PO Box 52057 If you have questions, contact Washington State Rx Services Customer Service at 1 (888) 361-1611 (TRS: 711) Monday through Friday 7:30 a.m. to 5:30 p.m. (Pacific). Please do not submit attachments (e.g., X-rays, periodontal chartings) with your pretreatment estimate or initial claims submission. See reviews, salaries & interviews from Regence employees in Lewiston, ID. Oregon's Sustainable Cost Growth program, and the ability the state's We respond to pharmacy requests within 72 hours for standard requests and 24 hours for expedited requests. In every state and every community, BCBS companies are making a difference not just for our members, but For the Health of America. Regence users: make the switch to the Availity Web Portal You have been redirected from the Regence or Asuris Northwest Health Provider Center. Oregon - Blue Cross and Blue Shield's Federal Employee Program Box 1106Lewiston, ID 83501-1106. Send your claim or correspondence to the Blue Cross Blue Shield plan in the state where the laboratory work was sent for testing.Example: The lab service you used is in Arizona but the sample was sent to Nevada for analysis. Any enrollee may appeal a decision made by the School Employees Benefits Board (SEBB) Program regarding SEBB eligibility, enrollment, premium payments, or premium surcharges (if applicable) to the SEBB Appeals Unit. We will notify you once your application has been approved or if additional information is needed. Dental billing - Regence If you or your dependents have other insurance, you must let UMP Customer Service and Washington State Rx Services know so claims are paid correctly. Information current and approximate as of December 31, 2018. Coverage decisionsA coverage decision is a decision we make about what well cover or the amount well pay for your medical services or prescription drugs. Learn more about our customized editing rules, including clinical edits, bundling edits, and outpatient code editor. 7:00 AM - 6:00 PM PSTFax: 877-239-3390 (Claims and Customer Service)Fax: 877-202-3149 (Member Appeals only)Fax: 866-948-8823 (FEP Care Consult theFEP local plan directory to find addresses and telephone numbers Availity and Regence Working with Regence online? If you use mail-order pharmacy and your primary plan uses Costco Mail Order Pharmacy or Postal Prescription Services (PPS) as the network mail-order pharmacy, Costco Mail Order Pharmacy or PPS can process payments for both plans and charge only the remaining unpaid balance. 3 0 obj Regence Blue Shield of Idaho - FEPPO Box 30270Salt Lake City, UT 84131-0207. | Procedure and diagnosis (codes) or description of the injury or illness, d. Provider's name, address, phone number, and National Provider Identifier (NPI) or Tax ID number, e. For ambulance claims, also include the ZIP code where the member was picked up and where they were taken. Ting Vit | Regence: The most trusted name in health insurance To obtain information on the aggregate number of grievances, appeals and exceptions filed with the plan contact Customer Service. stream Coronary Artery Disease. Tagalog | Location. Get 5 free searches. We offer the option to subscribe to receive the following communications via email: Subscribe to receive an email when new editions of the provider newsletters are available. 2023 Regence health plans are Independent Licensees of the Blue Cross and Blue Shield Association serving members in Idaho, Oregon, Utah and select counties of Washington. 2. Congestive Heart Failure. You must submit first-level and second-level appeals no more than 180 days after receiving the previous decision. Seattle, WA 98121, Support Phone Number: 1.888.427.0470 (toll free), Mon-Fri, 7:00 a.m. to 5:00 p.m. (PT), 1.800.AVAILITY (1.800.282.4548) (toll free), Run transactions to obtain member benefit, eligibility and claims information, Access eContracting to view and sign agreement documents, Our online newsletter (6 issues per year). Follow the prompts to submit your claim online. Dissatisfaction with service provided by the health plan. Management - prior auth/pre-service requests), Members: Log in or register - MyBlue Customer eService, Retail Pharmacy Program PO Box 52057 Phoenix, AZ 85072, Retail Pharmacy Program PO Box 52080 Phoenix, AZ 85072, Phone:800-552-0733Fax: 801-333-6523 (Mark claims: Attn New Claims)Email: Log in or register - MyBlue Customer eService, Regence BlueShield - FEPPO Box 857Lewiston, ID 83501, Regence BlueShield - FEPPO Box 1388Lewiston, ID 83501Customer Service. <> TTY/TDD users can call 1-877-486-2048, 24 hours a day/7 days a week. If you wish to appoint someone to act on your behalf, you must complete an appointment of representative form and send it to us with your prescription coverage determination form. 1-800-962-2731. Grievances and appeals - Regence REGENCE BS OF UTAH. Marvin Thomas email address & phone number | Regence Bluecross A retroactive decision to deny coverage based on eligibility. Diabetes. Step 2: Next, locate the "Login" button at the top-right corner. Regence BlueCross BlueShield of Utah is an independent licensee of the Blue Cross and Blue Shield Association. An appeal is an oral or written request submitted by you or your authorized representative to Regence BlueShield or Washington State Rx Services to reconsider: You or someone you authorize to represent you may request an appeal. Cancel Proceed User name or email Find forms that will aid you in the coverage decision, grievance or appeal process. Note: If the pick-up location is in Washington, refer to theWashington claims submission map to determine where to send your claim for processing. x][o%~`C?3=k7A I87ggglM"_Unx9d,*Wdx cwU74/_C&$jTD/ew|/_t_~suJo~/X7/fTjz=u?|1w_k;vZ]!w??!~pw!cw DG6JOw{v?M.>~h9{/|0 _&CrOL%be_/WWc9U~;?#*bX Fz-w~7`e_ :5ZmLme'UFSgs\\@=~!r)Q;ZDf}Z1^W8qw`v0]wcEo5tLBn-4%x\I[s$8eBM:)$2dY9s>E;& Username. Waiting too long on the phone, waiting room, in the exam room or when getting a prescription, The length of time required to fill a prescription or the accuracy of filling a prescription, Access to health care benefits, including a pre-authorization request denial, Claims payment, handling or reimbursement for health care services, A person who has bought insurance for themselves (also called a contract holder) and any dependents they choose to enroll. You are about to leave regence.com and enter another website that is not affiliated with or licensed by the Blue Cross Blue Shield Association. You can also get information and assistance on how to submit a written appeal by calling the Customer Service number on the back of your member ID card. Learn more about global periods, modifiers, virtual care, unlisted codes and NCCI bypass modifiers. You can also get information and assistance on how to submit an appeal by calling the Customer Service number on the back of your member ID card. Identify BlueCard members, verify eligibility and submit claims for out-of-area patients. Dental billing. Learn about electronic funds transfer, remittance advice and claim attachments. Claims Submission Map | FEP | Premera Blue Cross For more information about the appeals process, including expedited appeals for urgent or life-threatening conditions and requesting an external review by an Independent Review Organization, read the "Complaint and appeal procedures" section in your plan's certificate of coverage. Why choose Regence Individual & family plans Regence BlueCross BlueShield of Utah PO Box 1106 Lewiston, Idaho 83501 Or Fax claim to: (888) 606-6582 FORM PD020-UT Page 2 of 3 (Eff. Regence BlueCross BlueShield of Oregon. You cannot ask for a tiering exception for a drug in our Specialty Tier. If you have questions about submitting a claim for services outside the U.S., call UMP Customer Service.. Claims determinations The plan will notify you of action taken on a claim within 30 days of the plan receiving it. Learn about Regence Lewiston, ID office. Consult theFEP local plan directory to find addresses and telephone numbers for other plans.Note: If the equipment was sent from a DME provider in Washington, refer to thesubmission map to determine where to send your claim for processing. Management - prior auth/pre-service requests), Email: Members: Log in/register at MyBlue Customer eService, Regence BlueShield - FEPPO Box 21709Seattle, WA 98111. As one of the state's largest health insurers, Regence BlueCross BlueShield of Oregon is committed to addressing current and emerging health needs for the nearly one million Oregonians we serve. Premera Blue Cross Blue Shield of Alaska - FEP PO Box 33932 Seattle, WA 98133-0932 Phone: 800-562-1011 6:00 AM - 5:00 PM AST Fax: 877-239-3390 (Claims and Customer Service) Fax: 877-202-3149 (Member Appeals only) Fax: 866-948-8823 (FEP Care Management - prior auth/pre-service requests) Email Members: Log in or register - MyBlue Customer eService If services were rendered in New York or Pennsylvania, then use the state-specific file address PDF. MAXIMUS will review the file and ensure that our decision is accurate. Manage your claimsGet your prescription claims history, view your benefits and claims information, and more by logging in to your Washington State Rx Services Account. A complaint or grievance is an oral statement or written document submitted by or on behalf of a member regarding: Note: If your issue is regarding a denial, reduction, or termination of payment or non-provision of medical services, it is an appeal. Blue Cross Blue shield claim submission address | Medical Billing and When we make a decision about what services we will cover or how well pay for them, we let you know. If you have any questions about your member appeal process, call our Customer Service department at the number on the back of your member ID card. Blue Cross Blue Shield Association (BCBS, BCBSA) is a federation, or supraorganization, of, in 2022, 34 independent and locally operated BCBSA companies that provide health insurance in the United States to more than 115 million people. People with a hearing or speech disability can contact us using TTY: 711. If requested, we will supply copies of the relevant records we used to make our initial decision or appeal decision for free. Learn about dental billing information to help ensure your dental claims are processed quickly and correctly. MAXIMUS Federal Services is a contracted provider hired by the Center for Medicare and Medicaid Services (also known as CMS) and has no affiliation with us. Contact Us | Blue Cross Blue Shield Your life. Para humingi ng tulong sa Tagalog, pakitawagan ang numero ng telepono ng Serbisyo sa Kostumer (Customer Service) na nakasulat sa likod ng inyong kard bilang miyembro. Learn more about informational, preventive services and functional modifiers. PO BOX 25956 SALT LAKE CITY, UT 84125 800-662-0876. Regence BlueCross BlueShield of Oregon Availity Web Portal Support Phone Number 1.800.AVAILITY (1.800.282.4548) (toll free) Support Hours Mon-Fri, 7:00 a.m. to 4:00 p.m. (PT) Site URL http://www.regence.com What's available in the portal On the Availity Web Portal, you can: Regence BlueShield in accordance with the terms of your Provider contract with Regence. for other plans. You must appeal within 60 days of getting our written decision. The second high-deductible health plan cannot include an HSA. Don't have your card? We're ready. 2023 Regence health plans are Independent Licensees of the Blue Cross and Blue Shield Association serving members in Idaho, Oregon, Utah and select counties of Washington. Contact us as soon as possible because time limits apply. State/Alpha Prefix Claims Filing Address Alabama BCBS of Alabama P.O. We will accept verbal expedited appeals. In the left-hand column, locate the state where services were rendered. Once that review is done, you will receive a letter explaining the result. A list of reciprocal partners as well as membership benefits can be found at lifeflight.org. Sign in to your Regence account. <>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> 6:00 AM - 5:00 PM ASTFax: 877-239-3390 (Claims and Customer Service)Fax: 877-202-3149 (Member Appeals only)Fax: 866-948-8823 (FEP Care 0. First, you'll need to gather these documents: An itemized bill from your provider that describes the services and charges. Regency Blue Cross Blue Shield Of Oregon (541) 772-8906 Visit Website Map & Directions 2057 Commerce Dr Medford, OR 97504 Write a Review. Kreyl Ayisyen | Regence BlueShield of Idaho is an independent licensee of the Blue Cross and Blue Shield Association. Rev 3/2007 Regence BlueShieldAttn: UMP ClaimsP.O. *If you are asking for a formulary or tiering exception, your prescribing physician must provide a statement to support your request. Ask your provider. Overpayment Recovery Process - Regence An appeal is a request from a member, or an authorized representative, to change a decision we have made about: Other matters included in your plan's contract with us or as required by state or federal law, Someone who has insurance through an employer, and any dependents they choose to enroll. Programs View our programs and requirements for radiology, inpatient admissions and patient care management. For any appeals that are denied, we will forward the case file to MAXIMUS Federal Services for an automatic second review. | Learn more. You may need to submit a claim to UMP for payment if: UMP does not cover nor coordinate benefits with workers' compensation claims. If you have questions about submitting a claim for services outside the U.S., call UMP Customer Service. Care Management Programs. View the toolkit Claims submission Step 1: Start your internet browser, and then go to the official regence bluecross blueshield of oregon address website. Excluded pharmacies are pharmacies that have been excluded due to fraud, waste, or abuse. Regence BlueShield serves select counties in the state of Washington and is an Independent Licensee of the Blue Cross and Blue Shield Association. Regence BlueCross BlueShield of Oregon providers located in Clark County, Washington: Within 24 months after payment of the claim or notice that the claim was denied or within 30 months for claims subject to coordination of benefits. View our clinical edits and model claims editing. Examples: medical doctor, osteopath, optometrist, chiropractor, physical therapist, audiologist, independent laboratory, nurse practitioner, durable Library Access our Administrative Manual and keep up to date with news. Member's name and member ID number, including the alpha prefix (three letters and the "W" before member ID number), b. You can download the appeal form and submit your written appeal by fax or mail: Mail:WSRxS If the decision was after the 60-day timeframe, please include the reason you delayed filing the appeal. For Providers | Healthcare Management Administrators | Healthcare You have other insurance that pays first and UMP is secondary. For questions about appeals, call the SEBB Appeals Unit at 1 (800) 351-6827. If your prescribing physician asks for a faster decision for you, or supports you in asking for one by stating (in writing or through a phone call to us) that he or she agrees that waiting 72 hours could seriously harm your life, health or ability to regain maximum function, we will give you a decision within 24 hours. Call UMP Customer Service for help with any questions when you or a family member is covered by more than one plan. Recommended Reviews. Box 999Appleton, WI 54912-0999Fax: 1 (855) 668-8550. Coordination of Benefits or Other Party Liability . When the plan is the primary payer (pays first), UMP pays its normal benefit as described in the certificate of coverage.