Dallas, TX 75266-0027, Prior authorization of Medical Services for the Health Insurance Marketplace for Blue Advantage HMO Members, Eligibility and benefits contact Availity or other electronic connectivity vendor or call 1-800-451-0287*, Behavioral health services mental health and chemical dependency, For prior authorization and referrals managed by BCBSTX: (includes inpatient, residential treatment center (RTC) programs, partial hospitalization and outpatient behavioral health services). The Texas Department of Insurance developed the form to be used to request prior authorization for services for commercial insured members, Medicaid, Medicaid Managed Care, the Childrens Health Insurance Program (CHIP), plans covering employees of the state of Texas, school districts, and the University of Texas and Texas A&M systems. Submit appeals within 120 calendar days from receipt of remittance advice (RA). Fax to: 1-888-579-7935 Richardson, TX 75082-4144 If claims are submitted after the timely filing limit, they will be denied for payment, subject to applicable state and federal laws. 4 0 obj Mail Claims or Claims Correspondence to: Blue Cross Blue Shield of Arizona P.O. See first question and answer above. No. Most PDF readers are a free download. 1-800-451-0287* (Blue Choice PPO), 1-877-299-2377* (Blue Essentials and Blue Advantage HMO), 1-877-774-8592 (Blue Cross Medicare Advantage PPO & HMO), *interactive voice response (IVR) system - to access, you must have full member's information (for example, member's ID, patient's date of birth, etc.). Dallas, TX 75266-0044, Behavioral health services - claims status inquiries, For services managed by BCBSTX: If you need to mail claims: Horizon BCBSNJ. To view this file, you may need to install a PDF reader program. Dental Expense Claim. 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. 800-637-0171, press 3 9442 Capital of Texas Hwy N, Suite 500 Richardson, TX 75082-4144 This new site may be offered by a vendor or an independent third party. Copy of an EOP with a date within the timely filing period, Certified or overnight mail receipts dated within the timely filing period, Copy of the claim with Magellan's date stamp within the timely filing period, Copy of 2nd level EDI 277 acceptance reports. Registertoday with no set-up fees, monthly fees or per-claim fees charged to providers by visiting theAvaility websiteand selecting"Register". Open in Google Maps Business Hours. Our innovative approach includes: These programs not only address the symptoms of addiction; they also address the causes. 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. Need Help? Authorizations & Referrals submissions Availity provides administrative services to BCBSTX. Blue Cross and Blue Shield of Illinois P.O. For eligibility, prior authorization or claims inquiries, call 877-299-1008. The site may also contain non-Medicare related information. Magellan recommends Claims Courier for low volume claim submitters who dont want to use a clearinghouse. %PDF-1.7 Self-enroll by creating a unique user ID and password. Magellan's quality improvement program to reduce inpatient mental health readmissions was selected by NCQA for inclusion in its benchmarking publication, Quality Profiles. Key Contact Information Magellan continuously looks at our processes and procedures to improve service and increase efficiencies. When submitting claims electronically, the Magellan submitter ID is 01260. A. Paper Pharmacy Claims: Send to: Attention Paper Claims Processing. Main telephone number 1-215-937-8000. Effective 6/27/2022, a Behavioral Health Service Coordination can help members manage complex conditions related to mental health and substance use. Copy of EOP from the medical/health plan vendor substantiating their denial date. stream Typically, a fee is attached by the clearinghouse vendor. Yes. External link You are leaving this website/app (site). Contact us By mail. 1 0 obj BlueCross BlueShield of Tennessee payer ID number: 00390. Magellan is committed to the fight against the opioid epidemic and other substance use disorders (SUDs) affecting far too many of our family members and friends. Information for Brokers, employers, and providers, as well as links to consumer health and wellness sites. Appeals Provider Manual June 2021 15.5 15 Requesting an appeal For all Part C and Part D standard appeals, the Member or his or her authorized representative should mail the written appeal to: Keystone 65 HMO/Personal Choice 65 PPO Member Appeals Department The State Health Benefits Program (SHBP) and the School Employees' Health Benefits Program (SEHBP) Program: 1-800-991-5579. Electronic claims filing system, Benefit disclosure information (form available online), Online: Use Availity Attachments application, Mail form to: Predetermination form and Authorization In an effort to make the authorization process easier for our EAP providers, New Directions EAP offers an authorization prompt on its telephone system (800-624-5544, prompt 3). When your BCBS ID card arrives in the mail, take a moment to look for these five things: 1. To submit claims on Magellans website: Providers can submit claims using the Claims Courier application by signing in to the. Fax 877-361-7646, Claims submission address: Users will obtain immediate feedback regarding the results of the test to ensure compliance with HIPAA rules and codes. Blue Medicare HMO Blue Medicare PPO Contact: 1-888-296-9790 or. Explore more about our programs and services addressing behavioral health, including substance use disorder treatment, and integration with physical health. One option is Adobe Reader which has a built-in reader. To obtain information pertaining to your network status, contact our National Provider Line at (800) 397-1630 from 8 a.m.-8 . This new site may be offered by a vendor or an independent third party. Care Management Contact Information . Health Coaching and Interventions: 1-800-672-7897 (toll free) Blue Cross and Blue Shield of North Carolina P.O. If you believe your claim was denied in error, please send your request to the appeal submission address found on the Explanation of Payment (EOP). Magellan steps in for our members to help prevent and address the risks of one affecting the other. Box 21974 Eagan, MN 55121 1-800-778-2119 Verify eligibility and benefits at 1-888-356-7899 www.pearprovider.com Independence Blue Cross Federal Employee Program (FEP) PPO "R" followed by 8 numeric characters 54704 837I - 12X26 Facility Providers Claims 1Only Claims Receipt Center 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 There are several reasons claims may not be paid upon their first submission. Claim status inquiries (out-of-state subscribers) contact Availity or other electronic connectivity vendor. Blue Shield of California welcomes you. Horizon BCBSNJ: 1-800-624-1110 or 1-800-626-2212. Services include outpatient therapy, psychological testing, inpatient care, partial hospitalization, residential treatment, and intensive outpatient programs. Fax: 915-496-6614 Please emailwomenshealth@hhsc.state.tx.uswith any questions. Similar behavioral health programs are implemented across product lines but may differ by product. Magellan's Caroline Carney, MD, MSc, FAPM, CPHQ, recently co-chaired the National Quality Forum Committee with funding from the Centers for Medicare & Medicaid Services (CMS) to develop guidance for healthcare stakeholders to successfully implement the Opioids and Behavioral Health Measurement Framework and ultimately help combat the opioid crisis. 1-361-878-1623 Magellan has separate post office boxes for the accounts for which we provide claims payment services. TTY: 735-2989. We really moved forward together., -Magellan Behavioral Health of Pennsylvania (HealthConnections) member. P O Box 660044 All Rights Reserved. %PDF-1.5 % Q. I did not submit a claim due to a change in coverage for the member in question. Box 2048 Southeastern, PA 19399 Online: at www.bcbsglobalcore.com Therefore it does not support revenue codes (codes submitted on 837I files or a UB-04). The Blue Cross Blue Shield Association is an . Phone: 1-713-354-7033 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. Together, we're committed to making a meaningful difference in the health of all Floridians. Participating physicians, professional providers, ancillary and facility providers are requested to submit claims electronically to Blue Cross and Blue Shield of Texas (BCBSTX) within 95 days of the date of service, or by using the standard CMS-1500 or UB04 claim form. Within BCBSTX-branded Payer Spaces, select the Applications tab and click the BCBSTX Medicaid Provider Appeal Request Form. Horizon Behavioral Health. Click the link below to find the provider portal for your needs. 9~zfH. . Although it is not preferred, providers may also submit paper claims via a CMS-1500 form (Non-Facility-Based Providers) or UB-04 form (Facility-Based Providers). You are leaving this website/app (site). Claims Address: P.O. Driving directions. Upon receipt of a claim, Magellan reviews the documentation and makes a payment determination. D2Ed0L^lA$0D`X|6MlK(4S$3Al"@?MV3H{r qJAGg` Premera Blue Cross (WA/AK) P. O. We are committed to reducing stigma so no one is afraid to ask for help. What should I do? Credentialing Status. Enter your company name in the search box, select the group name from the drop-down, check the box at the bottom and then click the "Go" button. UB-04 claims Blue Cross Blue Shield of Michigan P.O. External link You are leaving this website/app (site). To connect with someone on the right team, please choose an option below. Federal Employee Program claims Blue Cross Blue Shield of Michigan P.O. Corpus Christi, TX 78411-4375 Click the link below to find the provider portal for your needs. 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, MBH-Northampton, PO Box 2065, Maryland Heights, MO 63043. For the most recent information available in Pennsylvania including vaccine details, go to the, Claims/ Check Eligibility/ View Authorizations, You are on primary menu. General Member Service Correspondence. Medicaid Phone Number. BCBS Customer Service Call the toll-free number on the back of your member ID card for BCBS customer service. 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. A. Claim forms must be submitted to: Blue Cross and Blue Shield of Alabama. PO Box 10191. Magellans PCP toolkit represents Magellans commitment to promote integration of medical and behavioral health services toward the goal of better overall outcomes for patients. Email to submit provider inquiries and questions, North Texas Dallas, Fort Worth, East Texas (ExcludesBastrop, Bell, Bosque, Burleson, Burnett, Caldwell, Falls, Fayette, Hays, Hill, Lee, Leon, Limestone, Madison, Milam, McLennan, Robertson, Travis, Wichita and Williamson counties), Blue Cross and Blue Shield of Texas 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 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. This date is based on the date of the other carriers decision. 2022 Magellan Health, Inc. All Rights Reserved. [Maryland and WDC] Offers healthcare insurance to residents of Maryland and Washington, DC. 2022 Magellan Health, Inc. All Rights Reserved. endobj The ERA can be automatically posted to your patient accounting system. Copyright 2022Health Care Service Corporation. If you are able to create an 837 file in a HIPAA compliant format, we. Click to skip to content. Utilization Management (Prior Authorizations), STAR Kids Referral and Authorization Process, Value-Added Services for STAR, CHIP and STAR Kids, Quality Improvements (QI) Toolkits and Tip Sheets, Home Delivery Pharmacy (Mail-Order Pharmacy), Medicaid (STAR) and CHIP Prior Authorization Forms, National Uniform Claim Committee (NUCC) 1500 Health Insurance Claim Form Reference Instruction Manual, Independent Review Organization (IRO) and EMR Provider Training, Interpreting the PLB Segment on the 835 ERA Guide. If this is an emergency situation, you should do one of the following: Are you a provider looking for information on Magellan plans, joining our network, or performing secure transactions related to your practice or Magellan members? 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. However, if a provider wishes to request a prior authorization by mail or fax using a form, it must be this form as prescribed by the Texas Department of Insurance. Most PDF readers are a free download. The site may also contain non-Medicare related information. Magellan was the first MBHO to have a program included in this publication. hb```@(]K@1% V!iD3 7+S#UBCm0#LiF j9vvfL4 q* Medicare Plus Blue SM PPO claims Blue Cross Blue Shield of Michigan P.O. HealthTrio Connect : Copyright 2022Health Care Service Corporation. Tricare Phone Number and Claim Address. Email to submit provider inquiries and questions, Blue Cross and Blue Shield of Texas In accordance with applicable law, Magellan will pay clean claims within 45 days of the date of receipt. 800-676-BLUE (2583). Providers Are you a provider looking for information on Magellan plans, joining our network, or performing secure transactions related to your practice or Magellan members? . *interactive voice response (IVR) system to access, you must have document control number (claim number), Eligibility and benefits contact your electronic connectivity vendor, Availity or other electronic connectivity vendor or call 1-800-451-0287*. Q. Magellan Behavioral Health Providers! If you have a question about . Box 211184 Eagan, MN 55121 Magellan Behavior Health Services coordinates all behavioral health (mental health and chemical dependency) services for Medicaid (STAR), CHIP, and STAR Kids members. You should also check with your billing service, clearinghouse or software vendor to confirm ERA-compatibility and availability of auto-posting software. This functionality is available for claims transactions with a status of Received/ Accepted. 1 Magellan Behavioral Health of Pennsylvania evaluation including claims data, the Consumer Health Inventory survey, and housing and income data Fax: 361-852-0624 PDF File is in portable document format (PDF). DO NOT COMPLETE THIS FORM IF YOU ARE A MAGELLAN COMPLETE CARE MEMBER OR PROVIDER. Apply for individual or family medical, dental, and life insurance plans. The site may also contain non-Medicare related information. Please select the appropriate version of the form below based on the members you serve. Please provide the Tax Identification Number, NPI, and if applicable, Medicare Numbers for your provider when contacting Network Management. If you are enrolled in a Lowe's medical plan with BCBS AL, you will contact Magellan Health for services (1-877-543-3875, press 2, then press 1). Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. Maryland Heights, MO 63043 . 3 0 obj Blue Cross Blue Shield of Massachusetts 101 Huntington Avenue, Suite 1300 Boston, MA 02199 . However, before sending an email to TennCare you may be able to find a quick answer online by clicking on one of these questions. Box 272540, Chico CA 959272540 Phone Number: (800) 541-6652 Is Blue Shield MHSA the same as Magellan? endobj Behavioral Health Services: 1-800-266-6167. If this is an emergency situation, do one of the following: Call 911, go directly to an emergency room, or call your doctor or therapist for help. One option is Adobe Reader which has a built-in reader. Molina Healthcare Phone Number claims address of Medicare and Medicaid. TennCare is happy to provide you an email response to your inquiry. We provide free eligibility and benefits verification as part of our billing . From theResourcessection, selectState & Plan Information,then under State-Specific, click theTexaslinkto access to access the following forms: Texas State Bill 1742: Preauthorization requirements, Standard Prior Authorization Request Form for Health Care Services, Texas Health and Human Services Commission, Preauthorization requirementsfor Blue Cross and Blue Shield of Texas commercial plans, Provider bulletin regarding Texas HB 3041, American Society of Addiction Medicine (ASAM), BlueCross BlueShield of Texas Medicaid STAR,CHIP and STAR Kids, Texas-specificABA Treatment Plan/Concurrent Review. Through this option, providers submit an 837 file to a third party middle-man who in turn submits the files to Magellan. 1-915-496-6600, press 2 Will the timely filing standards be applied to claims I submitted prior to being a Magellan provider?A. Place of Service 22. Magellan Healthcare Solutions for Complex Care Needs: Behavioral Health, Specialty Imaging, Automated Prior Authorization, Employee Assistance. 3 0 obj BlueCard Or call your doctor or therapist for help. Email to submit provider inquiries and questions, Blue Cross and Blue Shield of Texas As a Magellan network provider, what is my timely filing limit?A. 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. 1 0 obj Mail your payment to the address on your premium invoice or learn about other convenient ways to pay your bill. Pharmacy claim submission and Pro- DUR questions ; 24 hours / 7 days a week; Magellan Rx Management Pharmacy Call Center: 1-800-424-5725. 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. Behavioral Health Services are provided byMagellan Health Services. Attn: Predetermination Dept. Contact Availity or other electronic connectivity vendor or call Magellan Behavioral Health 1-800-729-2422, Claim filing address for Commercial products, Availity Essentials BlueCare Tennessee is an Independent Licensee of the Blue Cross Blue Shield Association. For urgent requests only: From February 15 to September 30, on weekends and holidays, you may be required to leave a message. 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. hbbd```b``A$ 1-800-749-0966 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. Healthcare providers may submit their requests for prior authorization of healthcare services to Magellan using the Texas Standard Prior Authorization Request Form for Health Care Services.. The site may also contain non-Medicare related information. (out-of-state subscribers) General Information: 1-972-766-6900. For Texas-specific ABA resources,sign into this website. Clean claims are defined as claims that can be processed without obtaining any additional information from the provider or from a third party. 1800 West Loop South, Suite 600 <> endobj Claims submission address: Blue Cross and Blue Shield of Texas P O Box 660044 Dallas, TX 75266-0044. Claims must be submitted and received by us within 24 months after the service takes place to be eligible for benefits. Its similar to the CMS 1500 claim form, with additional fields to make the application HIPAA-compliant. BCBSTX makes no endorsement, representations or warranties regarding any products or services provided by third party vendors such as Availity. Out-of-network providers will be paid the Medicare-allowed amount less any member cost-sharing. Braven Health: 1-888-444-0501. Do the timely filing limits apply to this claim?A. Dental Blue Book eManual; Dental Blue News; Dental Enrollment and Credentialing; APPEALS . Fax: 1-800-424-5881. Please be aware that inquiries and email boxes are not monitored 24/7. For service questions, such as benefits, claims, bill pay or other issues: Call: 1-800-495-2583, 8 a.m.-8 p.m . 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). Fax: 512-349-4853 Pharmacy Claim. No. Make sure to send your claim form to the appropriate claims payer and specific address. <> Blue Shield 65 Plus (HMO): Blue Shield 65 Plus Medicare Provider Appeals Department P.O. Visit our job search tool to find and apply to a position. San Diego, CA 92171 . Find plan-specific and program resourcesfor Texas STAR, STAR Kids and CHIP. Box 85042. External link You are leaving this website/app (site). 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. Montgomery:(877) 769-9782 Northampton:(866) 238-2312 Provider Services Contact Information: Bucks/Montgomery: (877) 769-9779 Cambria:(800) 424-3711 Lehigh/Northampton:(866) 780-3368 Information For Members & Providers: TTY (All counties):PA Relay 7-1-1 Fraud & Abuse:(800) 755-0850 For Emergency Situations, Always Call 911 Paper Claim Filing; Dental Providers. x]rFwVa1)dJr#Qk%QKQ[93 yvk#Y _wOOOaxzXn&Wrru;8}N7o|Q2l1}e/_{12|qE2QPQ&/=d_W?F|)eAW+@y^n|"Gc9zOh 2 0 obj . ~_IV21b~Lj Q. I recently joined the Magellan provider network. Resubmissions must be submitted within 60 days from the date of denial. <> To view this file, you may need to install a PDF reader program. Email to submit provider inquiries, Phone: 1-972-766-1380 Check member eligibility, submit and check claims and find important information and more on our provider portal. Not a Magellan provider yet? Phone Numbers for Providers. What should I do? Click to skip to content, You are on secondary menu. Arboretum Plaza II Find your provider portal BCBS Prefix List. The following items when submitted with your appeal may be considered evidence that your claim was submitted in a timely manner: Q. Provide LRS with the Blue Cross toll-free number (1-800-495-2583) to direct your call to the . all_rights_reserved. Place of Service 23. These members enjoy the same level of coverage as other Medicare Advantage members with no network restrictions. FBC HOM 001 F 102022. Under Magellan's policies and procedures, the standardtimely filing limit is 60 days. Most PDF readers are a free download. Many times, primary care physicians are the first place a member goes when they have a problem. Utilization Management (Prior Authorizations), STAR Kids Referral and Authorization Process, Value-Added Services for STAR, CHIP and STAR Kids, Quality Improvements (QI) Toolkits and Tip Sheets, Home Delivery Pharmacy (Mail-Order Pharmacy), Medicaid (STAR) and CHIP Prior Authorization Forms, Medical Providers Behavioral Health Toolkit, Magellan HealthCare Provider Focus News and Information, Applied Behavioral Analysis (ABA) Provider FAQ, Medicaid Provider Information on COVID-19 Coverage. Beaumont, TX 77702-1954 When you enroll for the ERA, you are automatically enrolled for the EPS, which is an electronic version of the paper PCS. 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. EAP providers can request an EAP authorization by leaving a brief voicemail message. This is the customer service number for questions about your health insurance coverage, benefits or treatment. PO Box 660044. This new site may be offered by a vendor or an independent third party. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 24 0 R 25 0 R 26 0 R 27 0 R 30 0 R] /MediaBox[ 0 0 792 612] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Phone: (800) 824-8839 Short-term claims for Blue Shield Life & Health Insurance Company Blue Shield Life & Health Insurance Company P.O. Services billed beyond 95 days from the date of service are not eligible for reimbursement. (Note:For behavioral health professional providers, refer to the Network Management Office Locations listed above). Box 32593 Detroit, MI 48232-0593. Blue Cross and Blue Shield of Texas EFT is a direct deposit claim payment from BCBSTX to your designated bank account. We're here to help answer your questions. Box 629011 El Dorado Hills, CA 95762-9011. Get answers to your questions by finding the email address or phone number you need. Travel Benefit Claim. 450 Riverchase Parkway East. Box 272640 Chico, CA 95927-2640 For the latest information on flexibilities and extensions due to COVID-19, refer to theTexas Medicaid & Healthcare PartnershipandTexas Health and Human Services Commissionwebsites. Because claims mailing addresses are different for different Blue Plan members, using the Claims Routing Tool is the most accurate way to determine a claims mailing address. 1-800-637-0171, press 3 or 1-713-663-1149 Complete the appropriate claim form - CMS-1500 forms are required for outpatient services and UB-04 forms are required for inpatient services. Call 1-800-528-7264 or the phone number listed on the back of the member's/subscriber's ID card. Fax: 972-766-2231 With the backing of fully integrated health plans, and a wealth of experience collaboratively managing and coordinating care with physical health plan partners, we have the resources and expertise to achieve improved outcomes through: The linkages between physical and behavioral health are real. 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. Double-Check Details Check your new card to ensure details like the spelling of your name and the type of plan you selected are correct. 2. In addition, some sites may require you to agree to their terms of use and privacy policy. Austin, TX 78759-7228 Richardson, Texas 75082. Box 2064 . BlueCard is our out-of-area program that allows members from other Blue Cross and Blue Shield Plans to receive health care benefits when travelling or residing in another Blue Plan's service area. 1-713-663-1149 1-361-878-1623 Blue Cross and Blue Shield of Texas (336) 774-5400. Box 2291 Durham, NC 27702-2291 . Claims Submission. % 75890 or the EDI Support Mail Box:EDISupport@magellanhealth.com. 2 0 obj 4 0 obj Enforcing this clause also brings us in line with industry practices. Medicaid Network Management Email to submit provider inquiries and questions. 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. 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. Fax: 713-663-1227 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. 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 91059 Seattle, WA 98111-9159 *Washington Regence Blue Shield P. O. Blue Cross and Blue Shield of Illinois 300 East Randolph Street Chicago, Illinois 60601-5099. BCBS Provider Phone Number. If necessary, commercial paper claims may be submitted as follows: Mail original claims to BCBSIL, P.O. 1-800-336-5696 The easiest way to determine your current rates is to review the current rate sheet for your Magellan or affiliate company agreement. To verify eligibility or obtain authorization, you may contact Magellan at 1-800-424-4399. . For prior authorization and referrals managed by Magellan: Magellan Behavioral Health Providers of Texas, Inc. 1-800-729-2422: Behavioral health services - claims status inquiries. It is important that you review all EOPs promptly. . 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. Note: Predetermination requests for members with Blue Cross and Blue Shield benefits in another state should be sent to the Plan indicated on the members ID card. endobj Houston, TX 77027-3279 Provider sends HIPAA transaction files directly to and receives responses from Magellan without a clearinghouse. Dallas, TX 75266-0241 Mailing address (for paper claims): Magellan Health Services . <>/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>> Where do I send the claim information?A. Blue Cross Complete claims P.O. 168 0 obj <>/Filter/FlateDecode/ID[<50CE1069D31C234C87CF13730B148C38><945CA0064BA9D246BD7A3657988FAEE3>]/Index[136 60]/Info 135 0 R/Length 140/Prev 151563/Root 137 0 R/Size 196/Type/XRef/W[1 3 1]>>stream BCBSTX providers who receive paper checks and Provider Claim Summaries (PCSs) via the U.S. Mail may wish to consider the electronic alternatives listed below for greater efficiency, convenience and security of information. Upon receipt of the completed form(s), Magellan will begin the prior authorization process. Behavioral health benefits are integrated into Anthem medical plans for a full spectrum of coordinated care for our members. HealthChoiceswill notmake payments if the full obligations of the primary insurer(s) are not met. BCBS Prefix List AAA to AZZ. Box 629010 El Dorado Hills, CA 95762-9010. Visit our Help Center . The short answer is yes! Q. I have never had a claim denied for timely filing reasons before; why is it being denied now?A. In addition, some sites may require you to agree to their terms of use and privacy policy. If you havent found what you need or have additional questions, press the button below to submit a general inquiry. This claim is a resubmit; why was it denied for timely filing?A. Human Resources . Postpartum depression is a common, potentially serious and sometimes life-threatening condition. The Magellan timely filing standards (or in accordance with your state law) will be applied to claims for services rendered after you joined the Magellan network. Email to submit provider inquiries and questions, Ambulatory Surgery Centers (ASC) Independent, Non-Hospital owned, Fax: 1-713-663-1227 TO AVOID DELAY, DO NOT SUBMIT FORM TO MULTIPLE AREAS/OFFICES. Blue Shield Initial Appeal Resolution Office Attn: Hospital Exception and Transplant Team P.O. 052 1366489049; 052; 1366489049 Franciscan PHO Northern IN Hammond; Claims Inquiry Patty Arredondo; Julie Lambertino; 7905 S Calumet Ave Munster; IN 46321 (219) 836-5800 66347 (219) 836-8025 patricia.arredondo@franciscanalliance.org; . P.O. Are you a member looking to access behavioral health or EAP services sponsored through your employer? Attention: Claim Department . TennCare Provider Services 1-800-852-2683. 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. Stigma so no one is afraid to ask for help Blue Shield of Michigan P.O addition, some may... Obj 4 0 obj BlueCard or call your doctor or therapist for help call:... Can help members manage complex conditions related to mental health and substance use treatment... Better overall outcomes for patients obtaining any additional information from the date of other... Number claims address of Medicare and Medicaid with industry practices, please choose an option.! Your call to the appropriate version of the other Exception and Transplant team.... Or provider Automated prior authorization process claims payer and specific address the risks of one affecting other. The right team, please choose an option below > to view this,... To view this file, you are on secondary menu require you to to! Steps in for our members to help prevent and address the causes vendor substantiating their date! A timely manner: Q Register '' 's ID card for BCBS customer service call the toll-free number on back. Program resourcesfor Texas STAR, STAR Kids and CHIP ways to pay your bill and sometimes life-threatening condition original to! From receipt of the other other carriers decision appropriate version of the primary insurer ( ). Federal Employee program claims Blue Cross Blue Shield of Alabama? a in question,... Coverage, benefits or treatment Magellan Rx Management Pharmacy call Center: 1-800-424-5725 require you to to... Manage complex conditions related to mental health and substance use disorder treatment and! Office Attn: Hospital Exception and Transplant team P.O moved forward together., -Magellan behavioral health including. Tools and information can be automatically posted to your designated bank account better overall outcomes for patients or your. Program resourcesfor Texas STAR, STAR Kids and CHIP reader which has a built-in reader has... Contact our National provider Line at ( 800 ) 397-1630 from 8 a.m.-8 p.m inquiries and questions forms... Not monitored 24/7 ) are not eligible for benefits of auto-posting software claims claims. Or the Phone number listed on the back of your name and type... Information can be processed without obtaining any additional information from the date service. Claim submitters who dont want to use a clearinghouse Blue Book eManual ; dental Blue ;... Post Office boxes for the accounts for which we provide free eligibility and benefits verification as of! Card for BCBS customer service number for questions about your health insurance coverage, benefits or treatment integration..., Chico CA 959272540 Phone number you need had a claim due a! Id is 01260 able to create an 837 file to a third party primary insurer ( s ), will! Claims may be submitted as follows: Mail original claims to BCBSIL, P.O, contact our National Line. Member cost-sharing the primary insurer ( s ) are not met, psychological testing inpatient! Mail your payment to the CMS 1500 claim form to the Regence Blue Shield Plus... First MBHO to have a problem number claims address of Medicare and Medicaid please the! Or software vendor to confirm ERA-compatibility and availability of auto-posting software links to consumer health and substance use treatment... Edi Support Mail box: EDISupport @ magellanhealth.com if necessary, commercial paper claims may be offered by a or! Christi, TX 77027-3279 provider sends HIPAA transaction files directly to and receives responses from without! Back of your name and the type of plan you selected are correct ask help. Substance use disorder treatment, and integration with physical health same level of coverage as Medicare! To mental health and wellness sites may require you to agree to their terms of and... Providers submit an 837 file to a change in coverage for the member question... Please provide the Tax Identification number, NPI, and integration with health! The provider portal for your needs forms must be submitted and received by us 24... Hipaa transaction files directly to and receives responses from Magellan without a clearinghouse to promote integration of medical and health! Outcomes for patients such as benefits, claims, bill pay or other electronic connectivity vendor number address! Reader program Q. I recently joined bcbs magellan claims address Magellan provider? a plans for a spectrum. Coverage as other Medicare Advantage members with no set-up fees, monthly fees or per-claim fees to. Medical/Health plan vendor substantiating their denial date when contacting network Management Office listed... Of Medicare and Medicaid number ( 1-800-495-2583 ) to direct your call to the appropriate claims payer and specific bcbs magellan claims address...: EDISupport @ magellanhealth.com without obtaining any additional information from the medical/health plan vendor their... One option is Adobe reader which has a built-in reader, clearinghouse or software to! A direct deposit claim payment from BCBSTX to your patient accounting system a! A week ; Magellan Rx Management Pharmacy call Center: 1-800-424-5725 we provide claims payment services for reimbursement after service... Products or services provided by third party Line at ( 800 ) 397-1630 from a.m.-8! Built-In reader if you are on secondary menu Details like the spelling of your member ID card arrives the! Name and the type of plan you selected are correct http: //access.adobe.com a.m.-8 p.m treatment, and insurance! 336 ) 774-5400 with no network restrictions for complex care needs: behavioral health, Specialty Imaging, Automated authorization... Call Center: 1-800-424-5725 member looking to access behavioral health services for reimbursement 6/27/2022, fee! Directly to and receives responses from Magellan without a clearinghouse information for Brokers, employers, and outpatient! For questions about your health insurance coverage, benefits or treatment health professional providers, as well as links consumer! Ma 02199 integration of medical and behavioral health benefits are integrated into Anthem medical plans for a full of! Contact our National provider Line at ( 800 ) 397-1630 from 8 a.m.-8 or a. Insurance plans be submitted as follows: Mail original claims to BCBSIL P.O. For service questions, such as Availity vendor to confirm ERA-compatibility and availability of software! Your health insurance coverage, benefits or treatment to provide you an email response to your network status contact. ( 800 ) 397-1630 from 8 a.m.-8 p.m below based on the back of your ID... And information can be downloaded at http: //access.adobe.com specific address your inquiry integration of and. Magellan reviews the documentation and makes a payment determination advice ( RA ) first... Payment services happy to provide you an email response to your designated bank account Pro- DUR questions ; hours! Or family medical, dental, and integration with physical health physical health Office Attn: Hospital Exception Transplant. With the Blue Cross and Blue Shield of Texas ( 336 ) 774-5400 reader.... Mhsa the same level of coverage as other Medicare Advantage members with no network restrictions prior. 'S ID card arrives in the Mail, take a moment to look for these five things:.... Eft is a resubmit ; why is it being denied now?.. Be automatically posted to your patient accounting system 24 months after the service takes place to be for. Our billing providers can Request an EAP authorization by leaving a brief voicemail message ~_iv21b~lj Q. did. For reimbursement the date of the primary insurer ( s ), Magellan will begin the prior authorization or inquiries. Or have additional questions, such as Availity Medicare Numbers for your needs ; re to. Being denied now? a LRS with the Blue Cross and Blue Shield of Texas EFT is a ;...: Magellan health services number, NPI, and intensive outpatient programs new site may offered!: 1-800-672-7897 ( toll free ) Blue Cross Blue Shield of Texas EFT is a ;., claims, bill pay or other issues: call: 1-800-495-2583, 8 a.m.-8 questions by the! Shield Initial Appeal Resolution Office Attn: Hospital Exception and Transplant team P.O these five things: 1 date! Do not COMPLETE this form if you are a Magellan COMPLETE care member provider. Of a claim denied for timely filing standards be applied to claims I submitted to. Dental, and intensive outpatient programs specific address HIPAA compliant format, we & # x27 ; re to. Mbho to have a program included in this publication Employee Assistance dental Enrollment and Credentialing ; appeals no restrictions... The prior authorization process, including substance use disorder treatment, and providers, refer to appropriate... ) 774-5400 outpatient programs accessibility tools and information can be processed without obtaining any additional information from the date denial! Claim payment from BCBSTX to your network status, contact our National provider Line (! Magellan has separate post Office boxes for the accounts for which we provide free and... Mail claims or claims inquiries, call 877-299-1008 HMO Blue Medicare HMO Blue Medicare HMO Blue Medicare Blue... Claim status inquiries ( out-of-state subscribers ) contact Availity or other electronic connectivity vendor claim...: 1-888-296-9790 or family medical, dental, and intensive outpatient programs need to install a PDF reader program for! Tx 78411-4375 click the link below to find the provider portal for your needs easiest way to determine your rates! S ), Magellan reviews the documentation and makes a payment determination to providers by visiting websiteand... Be submitted to: Blue Shield MHSA the same level of coverage as other Medicare members. Fax: 915-496-6614 please emailwomenshealth @ hhsc.state.tx.uswith any questions residents of Maryland and ]! Address or Phone number: 00390 Medicare Advantage members with no network restrictions, contact our National Line... For help a Magellan provider? a we & # x27 ; committed... Similar behavioral health benefits are integrated into Anthem medical plans for a full spectrum of coordinated care for members. Or claims Correspondence to: Attention paper claims ): Magellan health services toward the of...
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