Enter a location and search by doctor or hospital name, health condition, or specialty. Note: Current three-character, alpha-only prefixes will not be affected by this change. PDF BCBSAZ/TPA Co-Administered Group Plans - AZBlue Member ID cards with no prefix Some member ID cards may not have a prefix. We update BCBS prefix list data on daily basis to provide latest BCBS prefix home plan information. Codes may chan ge, and this list may be updated throughout the year. What is the difference between BCBS alpha prefix and BCBS alpha numeric prefix? for medical policies and prior authorization requests . How To Identify Blue Cross Blue Shield Member? There are three variants; a typed, drawn or uploaded signature. PDF Traditional Coverage - BCBSIL endstream endobj startxref 8772287268 Mail Administrator P.O. Coverage Period: 01/01/2021 - 12/31/2021 . Account Specific Prefix are assigned by BCBS to national accounts. Additionally, the following services require Prior Authorization regardless of place of service or level of care: To submit a prior authorization request you may also fax or mail your request. 1268 0 obj <>stream Search for doctors near you and in your network. Decide on what kind of signature to create. It is used to identify and track the healthcare coverage and benefits for that specific member. ;MTK First Character Z assigned to the BCBS Plan. eviCore healthcare (eviCore) is an independent specialty medical benefits management company that provides utilization management services for BCBSIL. We have a track record of providing quality medical billing services to multiple healthcare organizations and specialty providers across USA. BCBS prefix is a three character prefixes followed by the id number except for the following products and programs. 15456 0 obj <>stream Do not create one or use the BCBS prefix from another member ID card. endstream endobj startxref Secondly, it ensures that you have the most up-to-date information about each and every BCBS prefix home plan because we update the BCBS prefix list on daily basis. Prefix ZGP identifies Blue Cross Blue Shield of Texas PPO Product. Benefits Administration Corporation, Inc. (BACI) 9411 Philadelphia RD. Prior authorization requirements are specific to each patients policy type and the procedure(s) being rendered. The policy number is usually provided to the policyholder, who is the individual or entity that holds the insurance policy. View Medicare information Radiology utilization for Arkansas Blue Cross FEP Working or retired, we'll help you every step of the way to find the right plan. Few times, BCBS plan members doesnt have prefix mentioned on their BCBS Insurance card. We've provided the following resources to help you understand Anthem's prior authorization process and obtain authorization for your patients when it's required. By using this directory, you can ensure that you have the most up-to-date information about BCBS home plans and make more informed decisions about choosing right insurance plan. Prior Authorization for Some Commercial Members Will Transition from eviCore to AIM, Effective Jan. 1, 2021 This notice was posted Oct. 1, 2020, to alert you of a utilization management vendor change. 1229 0 obj <> endobj BCBS Alpha Prefix List from PAA to PZZ Updated 2023 Three-Character Prefixes. BCBS Prefix will not only have numbers and the . DIGNITY HEALTH YAVAPAI REGIONAL MEDICAL CENTER AND BLUE CROSS BLUE SHIELD OF ARIZONA REACH AGREEMENT, FIESTA BOWL AND BLUE CROSS BLUE SHIELD OF ARIZONA OPEN APPLICATIONS FOR FOURTH ANNUAL EMPOWERING DIVERSITY SCHOLARSHIP, PCMH PROGRAM DELIVERS HEALTHIER PATIENTS AND HAPPIER PROVIDERS. By knowing the details of BCBS home plan, including BCBS insurance plan benefits, coverage options, and costs, you can make better decisions about your healthcare needs. PDF Provider Quick Reference Guide - CareFirst These prefixes may include alpha and numerical characters. Check any internal documents you may have and update any references of "alpha prefix" to "prefix". Policy number is a unique number, which is provided to their insured person by respective insurances in order for identification purposes and also for billing the healthcare claims. Due to the exceeding number of BCBS insurance members, Alpha-Only Prefix member IDs exhausted. Services that require precertification - IBX Yes, Policy number same as member ID number and also known as subscriber ID number. Wheelchairs - Mobility Assistive Equipment (Manual & Power) & Scooters - Wheelchair Purchase only -Motorized) Wheelchair: E1050, E1060, E1070, E1083, E1084, E1085 . 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, Blue Cross Blue Shield of Texas provider website. BCBSIL makes no endorsement, representations or warranties regarding any products or services provided by third party vendors such as eviCore, AIM or Availity. Final Remarks about BCBS Prefix Lookup Directory. BCBS Alpha Prefix Its a three letter alpha prefix followed by id number. BCBS Prefix can be classified as follows: BCBS Alpha Prefix - It's a three letter alpha prefix followed by id number. 1 of 7. hbbd```b``A$ endstream endobj startxref BCBS prefix lookup directory is a valuable resource for anyone who is looking for right Blue Cross Blue Shield home plan. In that case claim may be denied as Submit the claim to the correct address / Member ID not found. endstream endobj 15364 0 obj <>>>/EncryptMetadata false/Filter/Standard/Length 128/O(a;uY[7y\\ Y)/P -1036/R 4/StmF/StdCF/StrF/StdCF/U(ZgYX: )/V 4>> endobj 15365 0 obj <>/Metadata 280 0 R/PageLayout/OneColumn/Pages 15351 0 R/StructTreeRoot 2939 0 R/Type/Catalog>> endobj 15366 0 obj <>/Font<>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 15367 0 obj <>stream So the next time you need to identify accurate BCBS prefix home plan, remember to use the BCBS prefix list lookup finder. Amerihealth Caritas Directory Healthcare, Health Insurance in United States of America, Place of Service Codes List Medical Billing, Empire Blue-Cross Blue-Shield of New York, Anthem Blue-Cross Blue-Shield of Kentucky, Maryland/District of Columbia/Northern Virginia, Highmark Blue-Cross Blue-Shield of Pennsylvania, Anthem Blue-Cross Blue-Shield of Connecticut, Anthem Blue-Cross Blue-Shield of Colorado, Anthem Blue-Cross Blue-Shield of New Hampshire, Anthem Blue-Cross Blue-Shield of Missouri, Blue-Cross Blue-Shield of Western New York, Independence Blue-Cross of Philadelphia and Southeastern Pennsylvania, Anthem Blue-Cross Blue-Shield of Virginia, Excellus Blue-Cross Blue-Shield of New York, Anthem Blue-Cross Blue-Shield of Wisconsin, Highmark Blue-Cross Blue-Shield of West Virginia, Horizon Blue-Cross Blue-Shield of New Jersey, Highmark Blue-Cross Blue-Shield of Delaware. This new site may be offered by a vendor or an independent third party. Does policy number same as member ID number? Born in Texas, USA. For Example: ABC, AQT, TXX, TEA, A2B, 2AB, 2A2, PAS, ZGP, XXU etc. endstream endobj 1230 0 obj <. The purpose of this list is to assist WA and AK providers to determine plan [PDF] CareFirst Third Party Administrator (TPA)/Network Lease Accounts Prefix. There are two types of BCBS prefixes which are mentioned below: Plan Specific prefix are assigned by BCBS to each plan. Amerihealth Caritas Directory Healthcare, Health Insurance in United States of America, Place of Service Codes List Medical Billing. The following summary and related prior authorization lists were posted on the Support Materials (Commercial) page the Utilization Management section of our Provider website as of Jan. 1, 2021: Commercial Communications We have the right plan for you to keep you and your family covered. Third, it can help you make more informed decisions to choose right insurance plan and benefits. If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly. For Example: ABC, AQT, TXX, TEA, A2B, 2AB, 2A2, PAS, ZGP, XXU etc. This article offers an overview of 2021 prior authorization support materials and related communications that may apply for some of our non-HMO commercial and government programs members, effective Jan. 1, 2021. %PDF-1.5 % Our Health Choice plans are available to Arizonans who qualify for Medicaid. %PDF-1.6 % BCBS Prefix will not only have numbers and the digits 0 and 1. BCBS Prefix List - Alpha Lookup by State 2022 - Finder BCBS Alpha Numeric Prefix - It's a three letter Alpha numeric prefix followed by id number. %PDF-1.6 % Prior Authorization List for Blue Shield Effective April 1, 2023 BCBS Alpha Numeric Prefix Its a three letter Alpha numeric prefix followed by id number. For Federal Employee Program (FEP) precertification requirements, please see the separate FEP precertification list. We make it easy for you to offer the healthcare coverage that delivers for your business. B}hJu`n+Z9>)2B~feo,TV [ZI^ylRr8DGo;ckrA;X2SjUlW]$4_vN(Tvh6#moc0!pbJ;oW)A'oR&bH=`1K}P(u3gD9:#1!m2saW1SD5/p2 'Su &x@`N.e#U(Fne]4;$"o*k;$~gn-Sd"mjdTY2R*I:w8w3;fpCfQH& BCBS of Illinois (IL) PAK. hb```I! Benefits will be determined once a claim is received and will be based upon, among other things, the members eligibility and the terms of the members certificate of coverage applicable on the date services were rendered. Each BCBS alpha numeric prefix represents different BCBS home plan. 2021 Commercial Prior Authorization Requirements Summary (Updated December 2020) This document provides an overview of services/care categories for which prior authorization may be required for some commercial, non-HMO Blue Cross and Blue Shield of Illinois (BCBSIL) members.
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bcbs prefix list 2021 pdf