I have reviewed the following treatment plan. The plan will only pay for care that is medically necessary and not investigational, as determined by us. Blue Cross and Blue Shield of Alabama enrolls and credentials all individual providers as well as ancillary and facility providers. We will give you a response within 72 hours of receiving all information we need to make a decision for a standard review. Dental Blue Plans - bcbsal.org In some cases, the plan requires that you or your treating provider precertify the medical necessity of your care. How to Submit a Claim - Blue Cross and Blue Shield's Federal Employee Please review the terms of use and privacy policies of the new site you will be visiting. 1.833.663.8713 Other ways to connect By mail Credence Blue Cross and Blue Shield 450 Riverchase Parkway East Birmingham, Alabama 35244 Physicians and providers Credence Blue Cross and Blue Shield 450 Riverchase Parkway East Birmingham, Alabama 35244 Thank you for your interest in our Short Term Plan. Double-check every area has been filled in correctly. Your doctor or other prescriber must give us a statement that explains the medical reasons for requesting an exception. Include itemized bills for covered services or supplies. . method: "GET", Not a provider, but want to search our network?Search for Providers. Provider Enrollment Access a wealth of healthcare resources and tools with MyBlue. Home - provider.bcbsal.org Patient & Claim Payment & Refund Visit our COVID-19 Provider Update Center for the latest information about testing, treatment and telehealth coverage. Blue Cross and Blue Shield of Alabama Preferred Long-Term Care Customer Service: 1-888-331-4188 or 1-205-733-7019, Blue Cross and Blue Shield of Alabama Preferred Long-Term Care Customer Accounts: 1-205-220-4503, LifePlans Claims Services:* 1-800-525-7279 extension 273, LifePlans Provider Pathway:* 1-800-886-7404 or. As an Alfa representative, I agree to the payment terms and conditions of Blue Cross and Blue Shield of Alabama and will not collect any checking account, debit card or credit card information on behalf of the consumer for the purchase of health or dental insurance. } Download the Medicare Reimbursement Account (MRA) Pay Me Back claim form: Complete the form following the instructions on the front. Forms, Real Estate Include the date to the document using the. With Blue Cross and Blue Shield of Alabama, all of our dental plans include regular dental exams, x-ray and routine cleaning - at no extra cost. Applicable FARS/DFARS apply. ProviderAccess Professional Claims Submission Help - bcbsal.org If you fail to pay in full all periodic monthly payments due and payable before the end of the grace period for those coverage periods, your coverage under the plan will be retroactively canceled back to the last day of the first month of the grace period. USLegal has been awarded the TopTenREVIEWS Gold Award 9 years in a row as the most comprehensive and helpful online legal forms services on the market today. We reference sites that we think might be useful or of interest to you, but we are not responsible for the content or privacy practices used by other site owners. 2023, Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association. Download and complete the appropriate form below, then submit it by December 31 of the year following the year that you received service. If you are a contracted health plan partner, then you have a dedicated account manager you can call upon at any time for any reason. Technology, Power of Some information on our site is secure; log in to ensure you're seeing all the news. When we receive an electronic claim, you will automatically be set up as an out-of-state provider in our system and can register to use our provider website, ProviderAccess: Once . For more information, view our privacy policy. EDI enrollment is NOT required for submission of electronic claims. An EOB is an outline of what services you received from a provider and how your benefits were applied to cover those services. For general inquiries, please call Blue Cross Blue Shield FEP Dental Customer Service at 1-855-504-BLUE (2583), 8 a.m. - 8 p.m. EST Monday - Friday (TTY 711) You can also submit an online inquiry regarding claims; ID cards; website assistance; grievance or appeal; or fraud, waste, and abuse. Learn more about our Total Care and Blue Distinction Specialty Care designation programs and find a designated doctor or hospital that meets your needs. If you do not know this information, please contact us at 205-220-7725 or fax your request to 205-220-6354. In these cases, you are responsible for payment to the provider. *Please do not contact LifePlans unless you have already contacted Blue Cross and Blue Shield of Alabama to start your claim. the page. function() { Box 302150 Montgomery, AL 36130 or 135 South Union Street Montgomery, AL www.rsa.state.al.us Customer Service Blue Cross Blue Shield of Alabama. Call Preferred Long-Term Care (LTC) Customer Service (1-888-331-4188) to complete the Claims Intake Form over the telephone. You can view your personal EOBs through your MyBlue account. Drug exceptions timeframes and enrollee responsibilities. if (jsonStr.Availability === 'YES') { If you receive out-of-network services for a medical emergency in the emergency room of a hospital, those services will be paid at the applicable in-network coinsurance amounts for benefits described in your benefit booklet, but subject to the out-of-network calendar year deductible.For emergency services for medical emergencies provided within the emergency room department of an out-of-network hospital, the allowed amount will be determined in accordance with the Affordable Care Act. Get your online template and fill it in using progressive features. Resources - provider.bcbsal.org Three forms are also available to aid providers in preparing an appeal request. Using this login enables you to manage the account for your organizations participating members. Additionally, out-of-network providers have not contracted with us or any Blue Cross and/or Blue Shield plan for negotiated discounts and can bill you for amounts in excess of the allowed amounts under the plan. Information contained in the external sites is not endorsed by BCBSAL. Node:bclrprvappp1001.corp.bcbsal.org:8080 If you want to stay on Blue Cross' website, click "Cancel.". The protection of your privacy will be governed by the privacy policy of that site. Use this form to submit a claim to be reimbursed for services that are covered under Service Benefit Plan dental benefits. Please review your information to continue. }); A primary plan is one whose benefits for a person's healthcare coverage must be determined first without taking the existence of any other plan into consideration. Call Customer Service at 1-855-504-BLUE (2583), 8 a.m. - 8 p.m. EST Monday - Friday, or Contact Us for further assistance. url: "/ChatAvailabilityService/getAvailability?queueName=CID" As a CHA representative, I agree to the payment terms and conditions of Blue Cross and Blue Shield of Alabama and will not collect any checking account, debit card or credit card information on behalf of the consumer for the purchase of health or dental insurance. From October 1 through February 14, we are available 7 days a week. If you use a provider outside of our network, you'll need to complete and file a claim form to be reimbursed. Box 3836, Scranton, PA 18505; Blue Cross Medicare Advantage, c/o Provider Services, P.O. To save time and incorrect billing process you can check the below table for the insurance numbers along with the respective states of the BCBS. A Blue Cross representative from LifePlans will contact you to discuss your initial needs and to clarify any questions you have about your policy. Fax (provider credentialing applications and related documents): 205-220-9545. Note: If you are a Blue Cross and Blue Shield of Alabama customer and need to reach us by phone, please use the telephone number (s) on the back of your ID card. Are you a provider?Click to be directed to our Providers area. Health . All Rights Reserved. Please attach any additional information and/or medical records at the time of filing the appeal for consideration. All rights reserved. Are you reporting a new case? If the out-of-network services are covered, in most cases, you will have to pay significantly more than what you would pay an in-network provider because of lower benefit levels and higher cost sharing. Here are the forms/documents to add locations and make changes to information and other requests. Search for Doctors, Hospitals and Dentists Blue Cross Blue Shield members can search for doctors, hospitals and dentists: In the United States, Puerto Rico and U.S. Virgin Islands. Listed below are claims payment policies and other information for Qualified Health Plans offered by Blue Cross and Blue Shield of Alabama. window.open('https://cicqaaux.corp.bcbsal.org/I3Root/chatpopup.html?qname=cid_chat&fromUrl='+fromUrl, '', 'width=700, height=600'); Overseas members must file claim forms for any covered medical or pharmacy servicesreceived outside of the United States. Each time Blue Cross processes a claim submitted by you or your healthcare provider, we send you an Explanation of Benefits (EOB). Reimbursement will be sent to claimant; no claims are paid directly to provider. Payer Name: Blue Cross Blue Shield of Alabama Payer ID: 510 Enrollment Required (ENR): Yes Type / Model: Commercial/Par State: AL Professional (CMS1500)/Institutional (UB04) [Hospitals] Real Time Eligibility (RTE): NO Real Time Claim Status (RTS): NO Electronic Remittance Advice (835) [ERA]: YES Secondary Electronic Claims (SEC): YES Blue Cross and Blue Shield of Alabama will send you a Claims Packet to be completed and returned to us. (You can fill the form in electronically or complete it by hand.). Claims Administrator . If you use our Care Coordinator services in developing your Plan of Care, and your claim is initiated with Home or Community Services, then your Lifetime Waiting Period will be reduced by half. PDF Dental Expense Claim - bcbsal.org $('#chat-available').show(); As an Alfa representative, I agree to the payment terms and conditions of Blue Cross and Blue Shield of Alabama and will not collect any checking account, debit card or credit card information on behalf of the consumer for the purchase of health or dental insurance. Contact Us | Blue Cross and Blue Shield of Alabama - bcbsal.org For example, if an Alabama physician provides services to a member with Blue Cross and Blue Shield of Kansas coverage and a post-service appeal is needed, the physician should fill out the appropriate form from above and submit it to Blue Cross and Blue Shield of Alabama. #1 Internet-trusted security seal. Include proof that you paid a Medicare Part B premium. Dental Blue
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