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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. Copyright 2022Health Care Service Corporation. PDF File is in portable document format (PDF). <>/Metadata 345 0 R/ViewerPreferences 346 0 R>> The EOP includes details of the payment or the denial. Copyright 2022Health Care Service Corporation. Magellan Healthcare is contracted to perform behavioral health managed care functions supporting members and participants for the following Blue Cross and Blue Shield of Texas HMO networks; Blue Advantage HMO SM, Blue Cross Medicare Advantage HMO SM, Blue Cross Medicare Advantage Dual Care (HMO SNP) SM and MyBlue Health SM. What is the appeals process? Looking to contact Magellan Rx Management? . Box 2048 Southeastern, PA 19399 Online: at www.bcbsglobalcore.com Will the timely filing standards be applied to claims I submitted prior to being a Magellan provider?A. One option is Adobe Reader which has a built-in reader. Contact us By mail. endobj TennCare Provider Services 1-800-852-2683. For this reason, your resubmitted claim has been denied. Magellans PCP toolkit represents Magellans commitment to promote integration of medical and behavioral health services toward the goal of better overall outcomes for patients. What should I do? 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. Predetermination form and PO Box 660241 Mailing address (for paper claims): Blue Shield of California Mental Health Service Administrator (MHSA) P.O. Maryland Heights, MO 63043 . Are you a member looking to access behavioral health or EAP services sponsored through your employer? Richardson, TX 75082-4144 4 0 obj The Subscriber Claim Summary includes the name of the health care provider who sent us the claim, the date of service, the type of service (lab, surgery, medical care, etc.) Email to submit provider inquiries. Tricare Phone Number and Claim Address. 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. DO NOT COMPLETE THIS FORM IF YOU ARE A MAGELLAN COMPLETE CARE MEMBER OR PROVIDER. There, claims submission information is broken out by prefix/product name. Paper Claims Address Independence Administrators P.O. P.O. Availity provides administrative services to BCBSTX. Richmond, VA 23242 It is important for you to stay current with your specific state and/or plan/program requirements. Houston, TX 77027-3279 Appeals address: Blue Cross and Blue Shield of Texas Attn: Complaints and Appeals Department PO Box 660717 Dallas, TX 75266-0717 Fax 1-855-235-1055 Email GPDTXMedicaidAG@bcbsnm.com Availity - Submit Claims Appeal Form Online Log into the Availity Provider Portal, select Payer Spaces from the top navigation menu and select BCBSTX. *interactive voice response (IVR) system to access, you must have document control number (claim number), Blue Cross and Blue Shield of Texas Medicaid. Read about our progress in the 2021 GuideWell Social Impact Report. Outside the United States. From February 15 to September 30, on weekends and holidays, you may be required to leave a message. Similar behavioral health programs are implemented across product lines but may differ by product. 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. Contact Availity or other electronic connectivity vendor or call 1-800-451-0287*, *interactive voice response (IVR) system to access, you must have full member's information (for example, member's ID, patients date of birth, etc. . Dental Blue Book eManual; Dental Blue News; Dental Enrollment and Credentialing; TTY: 735-2989. A. Paper Claim Filing; Dental Providers. Attn: Predetermination Dept. Dallas, TX 75266-0044, Behavioral health services - claims status inquiries, For services managed by BCBSTX: No. Complete the appropriate claim form - CMS-1500 forms are required for outpatient services and UB-04 forms are required for inpatient services. Q. Check member eligibility, submit and check claims and find important information and more on our provider portal. Fax to: 1-888-579-7935 External link You are leaving this website/app (site). Our approach addresses the most costly areas and most unique needs of health plans, fueling discovery of unmet clinical needs and driving innovation to improve health and financial outcomes. Federal Employee Program claims Blue Cross Blue Shield of Michigan P.O. Authorizations & Referrals submissions Braven Health: 1-888-444-0501. Most PDF readers are a free download. Need Help? Email: RxNetworksDept@magellanhealth.com. 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. This new site may be offered by a vendor or an independent third party. Out-of-network providers will be paid the Medicare-allowed amount less any member cost-sharing. Claim status inquiries contact Availity or other electronic connectivity. Magellan continuously looks at our processes and procedures to improve service and increase efficiencies. Participating physicians, professional providers, ancillary and facility providers may not seek payment from the member for claims submitted after the 95-day filing deadline. Make sure to send your claim form to the appropriate claims payer and specific address. Claims Address: P.O. Beaumont, TX 77702-1954 P. O. 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 Claim forms must be submitted to: Blue Cross and Blue Shield of Alabama. 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). For the latest information on flexibilities and extensions due to COVID-19, refer to theTexas Medicaid & Healthcare PartnershipandTexas Health and Human Services Commissionwebsites. 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. 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 Box 272540, Chico CA 959272540 Phone Number: (800) 541-6652 Is Blue Shield MHSA the same as Magellan? Claims Address. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. 1-361-878-1623 (out-of-state subscribers) Under Magellan's policies and procedures, the standardtimely filing limit is 60 days. Does this timely filing limit apply to all claims for all members (e.g., COB, Medicare, etc.)?A. Magellan Behavior Health Services coordinates all behavioral health (mental health and chemical dependency) services for Medicaid (STAR), CHIP, and STAR Kids members. Availity provides administrative services to BCBSTX. 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. It is important that you review all EOPs promptly. Utilization Management/Medical Management/Case Management. To view this file, you may need to install a PDF reader program. PO Box 660044 Dallas, TX 75266-0044 Fax: (325) 794-2926 Claims, medical and mental health: Send Claims Form to: Blue Cross and Blue Shield of Texas PO Box 660044 Dallas, TX 75266-0044 Learn more about submitting claims. Claims submission address: Blue Cross and Blue Shield of Texas P O Box 660044 Dallas, TX 75266-0044. Provider sends HIPAA transaction files directly to and receives responses from Magellan without a clearinghouse. endobj Q. I have proof that I submitted the claim within the timely filing limits. Email to submit provider inquiries and questions, Blue Cross and Blue Shield of Texas General Information: 1-972-766-6900. Blue Cross and Blue Shield of Illinois 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 <> If you still need to submit paper claims, use the Claims-Routing Tool to determine the correct mailing address for each member. 800-676-BLUE (2583). NOTE: To gain access to the above Blue Cross and Blue Shield of Texas Medicaid Tools you must be registered with Availity. Box 7355 . PO Box 660044. Box 52890 Bellevue, WA 98015- 2890 West Virginia Highmark BCBS of WV P.O. A. Phone Numbers for Providers. Provider Services 1-800-521-6007 Representatives are available 24 hours a day, 7 days a week.. By email. 2 Magellan Pennsylvania provider data, July 2017-June 2018 Richardson, TX 75082 Fax: 1-800-424-5881. Pharmacy claim submission and Pro- DUR questions ; 24 hours / 7 days a week; Magellan Rx Management Pharmacy Call Center: 1-800-424-5725. The site may also contain non-Medicare related information. Phone: (800) 824-8839 Short-term claims for Blue Shield Life & Health Insurance Company Blue Shield Life & Health Insurance Company P.O. *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*. APPEALS . 1-361-878-1623 Availity EFT & ERA Enrollment User Guide. These members enjoy the same level of coverage as other Medicare Advantage members with no network restrictions. <>/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>> Blue Cross and Blue Shield of Illinois 300 East Randolph Street Chicago, Illinois 60601-5099. Magellan was the first MBHO to have a program included in this publication. When submitting claims electronically, the Magellan submitter ID is 01260. 9442 Capital of Texas Hwy N, Suite 500 Bundling Rationale (Claims filed before Aug. 25, 2017) BlueCross BlueShield of Tennessee uses a clinical editing database. Email to submit provider inquiries and questions, Blue Cross and Blue Shield of Texas PDF File is in portable document format (PDF). 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. If after reviewing your rates you still believe there is an error, please contact the toll-free number on the member's ID card or the Members Explanation of Benefits, or call your Magellan network representative. 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. Behavioral Health Services: 1-800-266-6167. Claims Submitting Claims Claims will continue to go directly to BlueCross. The easiest way to determine your current rates is to review the current rate sheet for your Magellan or affiliate company agreement. Please note: as these requirements can be subject to change, thegrid may not contain a complete list of exceptions. We provide free eligibility and benefits verification as part of our billing . BCBS Prefix List AAA to AZZ. The following address should be used for claims related to outer counties: Outer County Claims - Lehigh, Lancaster, Northampton, and Berks County Claims Receipt Center P.O. Horizon Behavioral Health. 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). Blue Cross Blue Shield of Arizona 2444 W Las Palmaritas Dr. Phoenix, AZ 85021 . If necessary, commercial paper claims may be submitted as follows: Mail original claims to BCBSIL, P.O. To verify eligibility or obtain authorization, you may contact Magellan at 1-800-424-4399. . Contact Name Contact Address 1: Contact Address 2 Contact City: St Zip: . 1001 E. Lookout Drive Enforcing this clause also brings us in line with industry practices. Where do I send the claim information?A. Please provide the Tax Identification Number, NPI, and if applicable, Medicare Numbers for your provider when contacting Network Management. The Blue Cross Blue Shield Association is an . In-network providers will be paid at their contracted rate. Eligibility and benefits P.O. D2Ed0L^lA$0D`X|6MlK(4S$3Al"@?MV3H{r qJAGg` 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. Customer Service: If you have questions or need additional support, BCBSTX Personal Health Assistants are available to help. Within BCBSTX-branded Payer Spaces, select the Applications tab and click the BCBSTX Medicaid Provider Appeal Request Form. Magellan Behavioral Health Providers! Questions related to a specific claim should be directed to the toll-free number on the member's ID card or the Explanation of Benefits. 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. Mailing Address, Customer Service and Claims Contact Information Line of Business Customer Service/ Telephone Number Address Blue Shield of CA (BSC)/ MHSA 1-877-263-9952 1-800-424-6064 1-800-424-5999, option 3 Claims Mailing Address Blue Shield of California Mental Health Service Administrator (MHSA) P O Box 710400 San Diego, CA 92171 To view this file, you may need to install a PDF reader program. 2615 Calder St, Suite 700 1998-BlueCross BlueShield of Tennessee, Inc., an Independent Licensee of the Blue Cross Blue Shield Association. Box 710400 . If necessary, government programs paper claims may be submitted. 1001 E Lookout Drive BCBSTX makes no endorsement, representations or warranties regarding any products or services provided by third party vendors such as Availity. 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). Submit appeals within 120 calendar days from receipt of remittance advice (RA). Again, this can be a huge time-suck, calling and being transferred over and over. 114 Mesa Park Dr. Suite #300 Box 85042. Together, we're committed to making a meaningful difference in the health of all Floridians. . 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. We really moved forward together., -Magellan Behavioral Health of Pennsylvania (HealthConnections) member. To help > the EOP includes details of the payment or the Explanation of.. These requirements can be a huge time-suck, calling and being transferred over and.! Texas P O Box 660044 dallas, TX 75266-0044, behavioral health programs are implemented across product but. Covid-19 bcbs magellan claims address refer to theTexas Medicaid & Healthcare PartnershipandTexas health and Human services.... Claim within the timely filing limits go directly to BlueCross at their contracted rate: 1-972-766-6900 us!, NPI, and if applicable, Medicare, etc. ) a... Your resubmitted claim has been denied to: 1-888-579-7935 External link you are a COMPLETE... Eligibility or obtain authorization, you may need to install a PDF reader.. Services - claims status inquiries contact Availity or other electronic connectivity Suite 700 1998-BlueCross BlueShield of Tennessee,,... Tx 75082 fax: 1-800-424-5881 you review all EOPs promptly amount less any cost-sharing! In-Network providers will be paid at their contracted rate to help address: Blue Blue. Tab and click the BCBSTX Medicaid provider Appeal Request form to leave a message Box 660044,!, Inc., an independent third party your claim form - CMS-1500 forms are required for outpatient services UB-04... Health of all Floridians claims claims will continue to go directly to BlueCross week.. by email (! Hours a day, 7 days a week ; Magellan Rx Management pharmacy Center. Extensions due to COVID-19, refer to theTexas Medicaid & Healthcare PartnershipandTexas health and Human Commissionwebsites... Similar behavioral health programs are implemented across product lines but may differ product... Difference in the health of all Floridians 2017-June 2018 Richardson, TX 75082:... Service and increase efficiencies health programs are implemented across product lines but may differ by product etc )! 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