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Provide LRS with the Blue Cross toll-free number (1-800-495-2583) to direct your call to the . 1999-2022 commercial_footer_copyright_magellan_link. Download information about our behavioral health solutions and public behavioral health overview. Box 710400, San Diego CA 921710400 Phone Number: (877) 263-9952 Blue Shield of CA: Payer ID: BS001 Claims Address: P.O. endstream endobj 137 0 obj <. Dallas, TX 75266-0044, Behavioral health services - claims status inquiries, For services managed by BCBSTX: Phoenix Corporate Office Street Address. 1001 E. Lookout Drive Medical Care Management Richardson, TX 75082 Magellan Healthcare Solutions for Complex Care Needs: Behavioral Health, Specialty Imaging, Automated Prior Authorization, Employee Assistance. 1 0 obj We encourage you to submit claims electronically, via www.MagellanProvider.com or through a clearinghouse. Not a Magellan provider yet? Services include outpatient therapy, psychological testing, inpatient care, partial hospitalization, residential treatment, and intensive outpatient programs. Email to submit provider inquiries and questions, Blue Cross and Blue Shield of Texas By telephone. Predetermination form and Email: RxNetworksDept@magellanhealth.com. Provider sends HIPAA transaction files directly to and receives responses from Magellan without a clearinghouse. Again, this can be a huge time-suck, calling and being transferred over and over. 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 HealthTrio Connect : Box 91059 Seattle, WA 98111-9159 *Washington Regence Blue Shield P. O. 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 1 0 obj Key Contact Information Eligibility and benefits contact Availity or other electronic connectivity vendor or call 1-800-442-4607*, Behavioral health services mental health and chemical dependency prior authorization and referrals (includes inpatient, residential treatment center (RTC) programs, partial hospitalization and outpatient behavioral health services) call 1-800-528-7264, Behavioral health services claims status inquiries contact Availity or other electronic connectivity vendor or call 1-800-442-4607*, Behavioral health services claim adjustments call 1-800-442-4607, Eligibility and benefits contact Availity or other electronic connectivity vendor or call 1-877-299-2377*, Claim status inquiries contact Availity or other electronic connectivity vendor, Medical Management Correspondence for the Health Insurance Marketplace for Blue Advantage HMO Members, Blue Cross Blue Shield of Texas Fax: 713-663-1227 Richardson, TX 75082-4144 endobj 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. ~_IV21b~Lj %PDF-1.7 Mailing address: 5660 University Parkway. General Member Service Correspondence. Box 52890 Bellevue, WA 98015- 2890 West Virginia Highmark BCBS of WV P.O. Magellans PCP toolkit represents Magellans commitment to promote integration of medical and behavioral health services toward the goal of better overall outcomes for patients. 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. If you are able to create an 837 file in a HIPAA compliant format, we. Email to submit provider inquiries, Blue Cross and Blue Shield of Texas (BCBSTX). 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). . Claim forms must be submitted to: Blue Cross and Blue Shield of Alabama. Winston-Salem, NC 27105. Richardson, Texas 75082. 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. Premera Blue Cross (WA/AK) P. O. For Emergency Situations, Always Call 911. endstream endobj startxref 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; . 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. 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). Box 629010 El Dorado Hills, CA 95762-9010. DO NOT COMPLETE THIS FORM IF YOU ARE A MAGELLAN COMPLETE CARE MEMBER OR PROVIDER. 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. Magellan was the first MBHO to have a program included in this publication. Box 272540, Chico CA 959272540 Phone Number: (800) 541-6652 Is Blue Shield MHSA the same as Magellan? Box 2048 Southeastern, PA 19399 Online: at www.bcbsglobalcore.com Under Magellan's policies and procedures, the standardtimely filing limit is 60 days. Instructions for submitting requests for predetermination P O Box 660044 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 All claims for covered services provided to HealthChoices Members must be submitted to and received by Magellan as follows: Within sixty (60) days from date of service for most levels of care except as provided below; Within sixty (60) days from date of discharge for 24/hr level of care; Within sixty (60) days of the last day of the month or the discharge date, whichever is earlier when billing monthly for longer treatment episodes of care at a 24/hr level facility; Within sixty (60) days of the claim settlement for third party claims. Corporate Address. Or call your doctor or therapist for help. 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). Within BCBSTX-branded Payer Spaces, select the Applications tab and click the BCBSTX Medicaid Provider Appeal Request Form. 4 0 obj endobj Richardson, TX 75082-4144 1998-BlueCross BlueShield of Tennessee, Inc., an Independent Licensee of the Blue Cross Blue Shield Association. Claim status inquiries contact Availity or other electronic connectivity. Phone: (800) 824-8839 Short-term claims for Blue Shield Life & Health Insurance Company Blue Shield Life & Health Insurance Company P.O. %PDF-1.5 % P.O. Magellan Behavioral Health Providers! TennCare Pharmacy Program 1-888-816-1680. Place of Service 23. Call 1-800-528-7264 or the phone number listed on the back of the member's/subscriber's ID card. Vision/Hearing Claim. Copyright 2022Health Care Service Corporation. <> Become an Anthem provider and join the nation's second- largest health plan-owned behavioral health company, serving more than 13 . <>/Metadata 345 0 R/ViewerPreferences 346 0 R>> Email to submit provider inquiries. We provide free eligibility and benefits verification as part of our billing . The form cannot be used for any other purpose except to request prior authorization of a healthcare service. For Texas-specific ABA resources,sign into this website. Do the timely filing limits apply to this claim?A. External link You are leaving this website/app (site). 1-361-878-1623 (See item #2 below to learn how to contact your BCBS company to address any errors.) Get answers to your questions by finding the email address or phone number you need. hbbd```b``A$ 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. 1-361-878-1623 Claims Address: P.O. HealthChoiceswill notmake payments if the full obligations of the primary insurer(s) are not met. As a Magellan network provider, what is my timely filing limit?A. BCBS Customer Service Call the toll-free number on the back of your member ID card for BCBS customer service. PDF File is in portable document format (PDF). Email to submit provider inquiries and questions, Golden Triangle (Beaumont, Orange, Port Arthur), Blue Cross and Blue Shield of Texas Box 211184 Eagan, MN 55121 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). EDI Support: Contact Magellans EDI Hotline for support and/or assistance:1-800-450-7281ext. Resubmissions must be submitted within 60 days from the date of denial. Behavioral health benefits are integrated into Anthem medical plans for a full spectrum of coordinated care for our members. This new site may be offered by a vendor or an independent third party. The site may also contain non-Medicare related information. Don't have your card? Please select the appropriate version of the form below based on the members you serve. Phone: 1-713-354-7033 To submit claims on Magellans website: Providers can submit claims using the Claims Courier application by signing in to the. *interactive voice response (IVR) system to access, you must have document control number (claim number), Blue Cross and Blue Shield of Texas Medicaid. AIM Specialty Health (AIM) is an operating subsidiary of Anthem and an independent third party vendor that is solely responsible for its products and services. Upon receipt of the completed form(s), Magellan will begin the prior authorization process. 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). 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 Health Coaching and Interventions: 1-800-672-7897 (toll free) Blue Cross and Blue Shield of North Carolina P.O. Fax: 1-713-663-1227 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.
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