Q. I have never had a claim denied for timely filing reasons before; why is it being denied now?A. BlueCare / TennCare Select Claims Service Center 1 Cameron Hill Circle, Suite 0002 Chattanooga, . endobj The site may also contain non-Medicare related information. What should I do? Phone: 1-713-354-7033 . Government Programs Claims Electronic claim submission is preferred, as noted above. 1 0 obj Braven Health: 1-888-444-0501. 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. PO Box 660044. Why was my claim denied? Blue Cross Blue Shield members can search for doctors, hospitals and dentists: In the United States, Puerto Rico and U.S. Virgin Islands. In addition, some sites may require you to agree to their terms of use and privacy policy. Box 710400 . Box 52890 Bellevue, WA 98015- 2890 West Virginia Highmark BCBS of WV P.O. To obtain an aggregate number of grievances, appeals, and exceptions filed with BlueRx (PDP) contact Member Services at 1-800-327-3998 (BlueRx AL) or 1-888-311-7508 (BlueRx TN), 8 a.m. to 8 p.m., seven (7) days a week. This new site may be offered by a vendor or an independent third party. 2 0 obj Blue Cross and Blue Shield of Texas - Claims PO Box 660044 Dallas, TX 75266-0044 How to submit an international claim You can submit your completed international claim form and documentation using one of the following methods: By mail: Service Center P.O. External link You are leaving this website/app (site). Once you get to your company's site, click on "Find Care" in the top menu to get to the provider search function. Health Coaching and Interventions: 1-800-672-7897 (toll free) Blue Cross and Blue Shield of North Carolina P.O. Bundling Rationale (Claims filed before Aug. 25, 2017) BlueCross BlueShield of Tennessee uses a clinical editing database. The ERA can be automatically posted to your patient accounting system. Box 272640 Chico, Ca 95927-2640 Phone: (800) 541-6652 Fax: (818) 228-5014 1 Magellan Behavioral Health of Pennsylvania evaluation including claims data, the Consumer Health Inventory survey, and housing and income data PDF Magellan Complete Care Provider Quick Guide Payers with unique claim filing rules - SimplePractice Support Blue Cross Blue Shield of Illinois is the location of the claims processing center and customer service center. Medicaid Phone Number. Fax: 361-852-0624 endobj 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. 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. In addition, some sites may require you to agree to their terms of use and privacy policy. Email to submit provider inquiries. * (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. Apply for individual or family medical, dental, and life insurance plans. A. 9~zfH. Read about our progress in the 2021 GuideWell Social Impact Report. Claim forms must be submitted to: Blue Cross and Blue Shield of Alabama. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. We are committed to reducing stigma so no one is afraid to ask for help. Magellan employs many methods to identify members with complex needs to match them with the appropriate level of specialized case management services, including: Our team provides the compassionate extra support individuals need to overcome significant behavioral health and life challenges. Box 2048 Southeastern, PA 19399 Online: at www.bcbsglobalcore.com endobj Email to submit provider inquiries, Phone: 1-972-766-1380 Box 272540, Chico CA 959272540 Phone Number: (800) 541-6652 Is Blue Shield MHSA the same as Magellan? 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. 3 0 obj Join our extensive provider network today! <> Join Blue Cross and Blue Shield companies and leading voices from NAMI, Business Group on Health and Morgan, Lewis & Bockius LLP as they come together to discuss strategies for addressing pandemic-amplified behavioral health challengesparticularly as vaccines are rolling out and more focus on hybrid work models are set to spur workplace changes that can impact employee behavioral health. Customer Service: If you have questions or need additional support, BCBSTX Personal Health Assistants are available to help. Box 211184 Eagan, MN 55121 In Texas, Magellan uses the American Society of Addiction Medicine (ASAM) criteria as the basis for the utilization reviews of substance use disorder cases. Attention: Claim Department . Don't have your card? This date is based on the date of the other carriers decision. Box 2924 Phoenix, AZ 85062-2924. . Not a Magellan provider yet? This new site may be offered by a vendor or an independent third party. When you enroll for the ERA, you are automatically enrolled for the EPS, which is an electronic version of the paper PCS. Claim status inquiries contact Availity or other electronic connectivity. %PDF-1.7 Ask them where out of state claims should be filed. P O Box 660044 1-800-749-0966 For exceptions to the standard timely filing requirements for specific states and/or plans/programs, refer to your contract withMagellan and/or its affiliates; see theMagellan state-, plan-and EAP-specific handbook supplements; refer to our timely filingexception grid; or consult state and federal laws. Providers may continue to call Magellan with their prior authorization requests, as the form does not replace other existing methods of contacting Magellan to request a prior authorization. General Member Service Correspondence. Through the Homeless Outreach Positive Engagement intensive case management program, Magellan has helped 81% of members obtain housing and 61% reduce their number of hospital days.1. Services billed beyond 95 days from the date of service are not eligible for reimbursement. 800-637-0171, press 3 To connect with someone on the right team, please choose an option below. Note: For the requests below, utilize the indicated links: All other inquiries submit an email by selecting the office closest to your location and provide the Tax Identification Number, NPI, and if applicable, Medicare Numbers for your provider when contacting Network Management. Clean claims are defined as claims that can be processed without obtaining any additional information from the provider or from a third party. By telephone. If you are a member with a question about your coverage, contact Customer Service at the number listed on your BCBSIL member ID card. Driving directions. Copyright 2022Health Care Service Corporation. You should also check with your billing service, clearinghouse or software vendor to confirm ERA-compatibility and availability of auto-posting software. Fax: 1-800-424-5881. (page_last_updated 03/2022) Therefore it does not support revenue codes (codes submitted on 837I files or a UB-04). Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association. To obtain information pertaining to your network status, contact our National Provider Line at (800) 397-1630 from 8 a.m.-8 . 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. Medical Care Management Its similar to the CMS 1500 claim form, with additional fields to make the application HIPAA-compliant. BCBSTX Behavioral Health Unit PO Box 660241 Dallas, TX 75266-0241 Fax 877-361-7646 Claims submission address: Blue Cross and Blue Shield of Texas P O Box 660044 Dallas, TX 75266-0044 For prior authorization and referrals managed by Magellan: Magellan Behavioral Health Providers of Texas, Inc. 800-729-2422 PO Box 10191. When submitting claims electronically, the Magellan submitter ID is 01260. Predetermination form and Services include outpatient therapy, psychological testing, inpatient care, partial hospitalization, residential treatment, and intensive outpatient programs. Medicaid and CHIP Claim Editing Enhancements Coming Feb. 23, 2022, ICD -10 Z Codes for Social Determinants of Health, How to Submit a Complaint as a Medicaid Provider, Medicaid Provider Information on COVID-19 Coverage, Members can ask for an External Medical Review (EMR) and State fair Hearing from the state Medicaid program and get information about how the process works in our provider alert. Resubmissions on Claims Courier (MBH Website): changes/ corrections are allowed to Place of Service, Billed Amount, or Number of Units Only (all other corrections must be submitted via paper claim). You can download the toolkithere. Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSTX. Mailing address (for paper claims): Magellan Health Services . Richardson, Texas 75082. Please send your claims for imaging procedures to the following address: BlueAdvantage Operations 1 Cameron Hill Suite 0002 Chattanooga TN 37402-0002 Please continue to use EDI claims submission. Skip to article content, Intensive care coordination for members with serious mental illness (SMI) and comorbid conditions, Family-based, value-based care for children and adolescents at risk for hospitalization or out-of-home placement, Targeted case management for homeless individuals with SMI, Integrated case management through our Dual-Diagnosis Treatment Team for individuals with developmental disabilities, Digital cognitive behavioral therapy supporting increased screening and online treatment for pain management, substance use, depression, anxiety and insomnia, Increased access to medication-assisted treatment (MAT), Peer support and recovery and resiliency services focusing on members development and achievement of health and wellness goals, and connection to community resources, Communication campaigns and resources, providing guidance for members and providers in a variety of convenient formats, Internal policies and procedures to reinforce coordination throughout the care management process, Mutual cooperation and coordination agreements to share clinically relevant information. Box 30271 Salt Lake City, UT 84130-0271 *Washington Regence Group Administrators Attn: Claims P. O. Still looking for additional help? Similar behavioral health programs are implemented across product lines but may differ by product. From 2015 to 2017, our programs contributed to a 26% increase in members who were asked by their behavioral health providers to authorize communication with their PCP providers.3, Working with HealthConnections, the team helped get me to a place of not having fear, not having pain, exercising and doing yoga. Magellan did not receive your resubmitted claim within our timely filing limits (or within the timely filing limits of your state) after the initial date of denial. Box 7355 . Call 1-800-528-7264 or the phone number listed on the back of the member's/subscriber's ID card. TennCare is happy to provide you an email response to your inquiry. Blue Cross Blue Shield of Arizona 2444 W Las Palmaritas Dr. Phoenix, AZ 85021 . Many times, primary care physicians are the first place a member goes when they have a problem. NOTE: To gain access to the above Blue Cross and Blue Shield of Texas Medicaid Tools you must be registered with Availity. If necessary, commercial paper claims may be submitted as follows: Mail original claims to BCBSIL, P.O. Make sure to send your claim form to the appropriate claims payer and specific address. One option is Adobe Reader which has a built-in reader. <> Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association. BlueCross BlueShield of Tennessee is a Qualified Health Plan . Main telephone number 1-215-937-8000. See first question and answer above. Or call your doctor or therapist for help. Place of Service 23. Find My BCBS Company Florida Blue is a part of the GuideWell family of companies. [Maryland and WDC] Offers healthcare insurance to residents of Maryland and Washington, DC. Vision/Hearing Claim. You may direct any questions about the form to Magellan at the phone number on the form. Preauthorization requirementsfor Blue Cross and Blue Shield of Texas commercial plans(PDF), Magellan'sannual preauthorization reportfor BCBSTX commercial plans (PDF), Provider bulletin regarding Texas HB 3041 (PDF). Fax: 512-349-4853 Blue Cross and Blue Shield of Texas Vendor to confirm ERA-compatibility and availability of auto-posting software claims that can be downloaded at http //access.adobe.com! Life insurance plans BCBSIL, P.O your claim form to the above Cross. Assistants are available to help as noted above should also check with your billing,. Id is 01260 is Adobe Reader which has a built-in Reader is a Qualified Health.! Programs claims electronic claim submission is preferred, as noted above Administrators Attn: claims P. O may! 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