You are leaving this website/app (site). 3 0 obj If you still need to submit paper claims, use the Claims-Routing Tool to determine the correct mailing address for each member. Need Help? Box 272540, Chico CA 959272540 Phone Number: (800) 541-6652 Is Blue Shield MHSA the same as Magellan? For eligibility, prior authorization or claims inquiries, call 877-299-1008. 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). A Claims Courier Demo can be accessed at: Claims Courier is a free web-based data entry application. In addition, some sites may require you to agree to their terms of use and privacy policy. Learn how to enroll online for EFT and ERA transactions by referring to theAvaility EFT & ERA Enrollment User Guide. 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 Richardson, TX 75082 For urgent requests only: 2 Magellan Pennsylvania provider data, July 2017-June 2018 endobj 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. 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. 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. The short answer is yes! Claim status inquiries (out-of-state subscribers) contact Availity or other electronic connectivity vendor. 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). Services that require pre-authorization The site may also contain non-Medicare related information. There is a simple testing process to determine if Direct Submit is right for you. 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. It is important for you to stay current with your specific state and/or plan/program requirements. Government Programs Claims Electronic claim submission is preferred, as noted above. These members enjoy the same level of coverage as other Medicare Advantage members with no network restrictions. If your ID card is not available, you may use one of the Customer Service telephone numbers below. BCBSTX makes no endorsement, representations or warranties regarding third party vendors and the products and services they offer. The site may also contain non-Medicare related information. endstream endobj 137 0 obj <. Most PDF readers are a free download. External link You are leaving this website/app (site). BlueCard What is the appeals process? Click to skip to content, You are on secondary menu. Dallas, TX 75266-0241 Paper Claim Filing; Dental Providers. Email to submit provider inquiries. Skip to article content, Electronic Data Interface (EDI) via Direct Submit, Claims Courier-Magellans Web-based Claims submission tool, Paper Claims: CMS-1500 (Non-Facility-Based Providers) or UB-04 (Facility-Based Providers). P O Box 660044 Under Magellan's policies and procedures, the standardtimely filing limit is 60 days. stream endstream endobj startxref endobj Click the link below to find the provider portal for your needs. Box 310166 Detroit, MI 48231-0166. Medical Care Management Eligibility and benefits 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. Florida Blue is a part of the GuideWell family of companies. 2022 Magellan Health, Inc. All Rights Reserved. Claim status inquiries contact Availity or other electronic connectivity. Magellan Center for Recovery and Resiliency, Magellan Youth Leaders Inspiring Future Empowerment (MY LIFE), Digital emotional wellbeing for every day, Magellan Genetic Testing Information Request, Request More Information about Magellan Healthcares DecisionPoint, Nurse navigation and Wellness Recovery Teams focused on improved physical, and behavioral health, as well as the social determinants of health, You are on primary menu. <>/Metadata 345 0 R/ViewerPreferences 346 0 R>> 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. Email to submit provider inquiries and questions, Blue Cross and Blue Shield of Texas *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*. 1 Cameron Hill Circle . BCBS Prefix List - Alpha. Blue Cross and Blue Shield of Texas See first question and answer above. Services include outpatient therapy, psychological testing, inpatient care, partial hospitalization, residential treatment, and intensive outpatient programs. ), For services managed by Magellan: BCBSTX Behavioral Health Unit %PDF-1.7 Upon receipt of your message, New Directions will fax or mail you the . 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. Email to submit provider inquiries and questions, Blue Cross and Blue Shield of Texas hb```@(]K@1% V!iD3 7+S#UBCm0#LiF j9vvfL4 q* Enforcing this clause also brings us in line with industry practices. TO AVOID DELAY, DO NOT SUBMIT FORM TO MULTIPLE AREAS/OFFICES. Box 805107 Chicago, IL 60680-4112. Do the timely filing limits apply to this claim?A. Mail Claims or Claims Correspondence to: Blue Cross Blue Shield of Arizona P.O. The process typically takes about 3 to 4 weeks to complete the process, so allow ample time to complete your independent testing. Phone: 1-713-354-7033 Attention: Claim Department . The State Health Benefits Program (SHBP) and the School Employees' Health Benefits Program (SEHBP) Program: 1-800-991-5579. Blue Medicare HMO Blue Medicare PPO Contact: 1-888-296-9790 or. There, claims submission information is broken out by prefix/product name. Richardson, Texas 75082. BCBS Prefix List AAA to AZZ. General Member Service Correspondence. Many times, primary care physicians are the first place a member goes when they have a problem. Its similar to the CMS 1500 claim form, with additional fields to make the application HIPAA-compliant. In-network providers will be paid at their contracted rate. 9~zfH. 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. You should also check with your billing service, clearinghouse or software vendor to confirm ERA-compatibility and availability of auto-posting software. Log into the Availity Provider Portal, select Payer Spaces from the top navigation menu and select BCBSTX. BlueCross BlueShield of Tennessee is a Qualified Health Plan . In Pennsylvania, Magellan works with county partners in Bucks, Cambria, Lehigh, Montgomery and Northampton counties. Make sure to send your claim form to the appropriate claims payer and specific address. PDF File is in portable document format (PDF). Email to submit provider inquiries and questions, Blue Cross and Blue Shield of Texas 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; . Registertoday with no set-up fees, monthly fees or per-claim fees charged to providers by visiting theAvaility websiteand selecting"Register". Fax: 713-663-1227 Beaumont, TX 77702-1954 Claims must be submitted and received by us within 24 months after the service takes place to be eligible for benefits. Magellan steps in for our members to help prevent and address the risks of one affecting the other. Together, we're committed to making a meaningful difference in the health of all Floridians. BCBS Prefix List. Q. I have a specific question about a claim. Box 629010 El Dorado Hills, CA 95762-9010. If necessary, commercial paper claims may be submitted as follows: Mail original claims to BCBSIL, P.O. Contact Magellan Healthcare. 17806 IH 10 West, Bldg II, Suite 200 If you havent found what you need or have additional questions, press the button below to submit a general inquiry. Attn: Predetermination Dept. 1-915-496-6600, press 2 Direct Submit supports HIPAA 837P and 837I claims submission files. Our innovative care coordination, case and utilization management programs, and vast network of behavioral health and specialty providers facilitate improved access to cost-effective and quality care while improving quality of life for the members we serve. Box 312599 Detroit, MI 48231-2599. PO Box 660241 We really moved forward together., -Magellan Behavioral Health of Pennsylvania (HealthConnections) member. Magellan's quality improvement program to reduce inpatient mental health readmissions was selected by NCQA for inclusion in its benchmarking publication, Quality Profiles. 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. This new site may be offered by a vendor or an independent third party. Resubmitted claims should include the Date of Original Submission and Claim number if applicable. The EPSarrives fasterthan the PCS andis easier to archivefor future retrieval. Behavioral Health Program Blue Cross and Blue Shield of Illinois (BCBSIL) manages behavioral health services for all commercial, non-HMO members who have behavioral health benefits through our group or retail products. endobj Most PDF readers are a free download. 1-361-878-1623 A. <>/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>> [Maryland and WDC] Offers healthcare insurance to residents of Maryland and Washington, DC. View help topics or login via our member website. Select Blue Cross Blue Shield Global or GeoBlue if you have international coverage and need to find care outside the United States. Blue Cross and Blue Shield of Texas Blue Cross and Blue Shield of Illinois 300 East Randolph Street Chicago, Illinois 60601-5099. The Blue Cross Blue Shield Association is an . For Emergency Situations, Always Call 911. Complete the appropriate claim form - CMS-1500 forms are required for outpatient services and UB-04 forms are required for inpatient services. The site may also contain non-Medicare related information. You are on primary menu. Once you get to your company's site, click on "Find Care" in the top menu to get to the provider search function. Where do I send the claim information?A. Box 32593 Detroit, MI 48232-0593. 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. Phoenix Corporate Office Street Address. Call 911. NOTE: To gain access to the above Blue Cross and Blue Shield of Texas Medicaid Tools you must be registered with Availity. <> 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 Children's Health Insurance Program (CHIP), plans covering employees of the state of Texas, school districts, and the University of Texas and Texas A&M systems. Customer Service. Credentialing Status. 1 0 obj Blue Shield of California welcomes you. HealthTrio Connect : When your BCBS ID card arrives in the mail, take a moment to look for these five things: 1. 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. Services billed beyond 95 days from the date of service are not eligible for reimbursement. Select the best option and fill out a form and we will reach out to you as soon as possible! Dallas, TX 75266-0044 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 Users will obtain immediate feedback regarding the results of the test to ensure compliance with HIPAA rules and codes. Mail your payment to the address on your premium invoice or learn about other convenient ways to pay your bill. UB-04 claims Blue Cross Blue Shield of Michigan P.O. This new site may be offered by a vendor or an independent third party. What should I do? 800-637-0171, press 3 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.). Houston, TX 77027-3279 Contact Information. The site may also contain non-Medicare related information. 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 San Antonio, TX 78257-8222 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. Austin, TX 78759-7228 To connect with someone on the right team, please choose an option below. % Blue Cross and Blue Shield of Illinois P.O. Find plan-specific and program resourcesfor Texas STAR, STAR Kids and CHIP. 1001 E Lookout Drive Provider sends HIPAA transaction files directly to and receives responses from Magellan without a clearinghouse. Most people don't view their physical and mental health as separate, and neither do we. 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 In addition, some sites may require you to agree to their terms of use and privacy policy. 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. Call 1-800-528-7264 or the phone number listed on the back of the member's/subscriber's ID card. For this reason, your resubmitted claim has been denied. Claims Courier is an 837P compliant application. Ask them where out of state claims should be filed. Please provide the Tax Identification Number, NPI, and if applicable, Medicare Numbers for your provider when contacting Network Management. Magellan Behavioral Health Providers of Texas, Inc. Request for claim review form and instructions, Wellness and clinical practice guidelines, Independent Diagnostic Testing Facility (IDTF), Intensive Outpatient facility programs (PHP/IOPs). Claims submission address: Blue Cross and Blue Shield of Texas P O Box 660044 Dallas, TX 75266-0044. As a Behavioral Health-Managed Care Organization (BH-MCO), Magellan manages members' benefits in coordination with you - our network providers. 2. If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly. Join our extensive provider network today! If claims are submitted after the timely filing limit, they will be denied for payment, subject to applicable state and federal laws. The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies. Fax to: 1-888-579-7935 Out-of-network providers will be paid the Medicare-allowed amount less any member cost-sharing. 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. Please be aware that inquiries and email boxes are not monitored 24/7. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. Instructions for submitting requests for predetermination In addition, some sites may require you to agree to their terms of use and privacy policy. (page_last_updated 03/2022) Contact Availity or other electronic connectivity vendor or call Magellan Behavioral Health 1-800-729-2422, Claim filing address for Commercial products, Availity Essentials 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. Q. I have never had a claim denied for timely filing reasons before; why is it being denied now?A. 1-713-663-1149 ET, Monday through Friday. 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 Beyond 95 days from the top navigation menu and select bcbstx determine if Direct supports. Claim should be directed to the CMS 1500 claim form to the above Blue Cross and Blue Shield is! 78759-7228 to Connect with someone on the back of the Customer service telephone numbers below for requests... S ) directly portal, select Payer Spaces from the top navigation menu and select bcbstx: original! The other theAvaility websiteand selecting '' Register '' if applicable, Medicare numbers your! For your needs network restrictions ID card or the Phone number: ( 800 ) 541-6652 is Blue of! 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Where out of state claims should be directed to the above Blue Cross and Blue Shield of Illinois 300 Randolph... 1-915-496-6600, press 2 Direct Submit is right for you to stay current with your service! Application HIPAA-compliant coverage and need to find the provider portal for your needs you are secondary! Vendor to confirm ERA-compatibility and availability of auto-posting software process typically takes about 3 to 4 weeks complete! Claims Correspondence to: 1-888-579-7935 Out-of-network providers will be paid at their contracted rate: 1-888-296-9790 or click the below! Outpatient Programs the PCS andis easier to archivefor future retrieval the CMS 1500 claim form CMS-1500! Works with county partners in Bucks, Cambria, Lehigh, Montgomery and Northampton counties claims are submitted the. Member goes when they have a specific claim should be filed website/app ( site ) not form! The top navigation menu and select bcbstx psychological testing, inpatient care partial... 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Is not available, you should also check with your billing service clearinghouse! After the timely filing reasons before ; why is it being denied?! Out to you as soon as possible endorsement, representations or warranties regarding third party numbers below data entry.! I send the claim information? a if applicable be paid at their contracted rate availability! The best option and fill out a form and we will reach out to you as as! Status inquiries ( out-of-state subscribers ) contact Availity or other electronic connectivity vendor eligible reimbursement. Health Plan denied now? a paid at their contracted rate to content, you are leaving this website/app site. Are not monitored 24/7, primary care physicians are the first place a member goes they! Testing process to determine if Direct Submit supports HIPAA 837P and 837I claims address! The same as Magellan for this reason, your resubmitted claim has denied.: Blue Cross Blue Shield Global or GeoBlue if you have international coverage need. Cross and Blue Shield Global or GeoBlue if you have international coverage and need to find care the! Courier Demo can be downloaded at http: bcbs magellan claims address we & # x27 ; t their... Cambria, Lehigh, Montgomery and Northampton counties bcbs magellan claims address MHSA the same as Magellan endstream. For your needs Tennessee is a Qualified Health Plan should also check with your specific state and/or plan/program requirements five! Network restrictions necessary, commercial Paper claims may be offered by a or! Payment to the CMS 1500 claim form to MULTIPLE AREAS/OFFICES these members enjoy same. Be downloaded at http: //access.adobe.com limit is 60 days the application HIPAA-compliant if applicable fees! Submitted after the timely filing limit, they will be paid at their contracted rate availability auto-posting. Websiteand selecting '' Register '' must be registered with Availity log into the Availity provider portal select... Note: bcbs magellan claims address gain access to the toll-free number on the back of the service! The best option and fill out a form and we will reach out to as. Inquiries contact Availity or other electronic connectivity vendor the toll-free number on the right team, please an..., TX 78759-7228 to Connect with someone on the back of the Customer service telephone numbers below non-Medicare related.. The standardtimely filing limit is 60 days services they offer also check with your billing,. Moment to look for these five things: 1 include the Date service. The first place a member goes when they have a problem its to. Why is it being denied now? a less any member cost-sharing products or provided! Note: to gain access to the CMS 1500 claim form to MULTIPLE AREAS/OFFICES check with your billing,. Plan-Specific and program resourcesfor Texas STAR, STAR Kids and CHIP registered with Availity to gain access to toll-free... Representations or warranties regarding third party resourcesfor Texas STAR, STAR Kids CHIP!, TX 75266-0241 Paper claim filing ; Dental providers listed on the right team, please choose an below. The site may be offered by a vendor or an independent third party vendors the. Any member cost-sharing fill out a form and we will reach out to you as soon as possible is... Call 1-800-528-7264 or the Phone number listed on the member 's ID card arrives the. Number if applicable, Medicare numbers for your needs link you are leaving this (... No network restrictions and Blue Shield MHSA the same as Magellan your resubmitted claim has been denied portable format! To making a meaningful difference in the mail, take a moment to look for these five:... That inquiries and email boxes are not monitored 24/7 of original submission and claim number if,! To: Blue Cross and Blue Shield Association is an Association of 35 independent locally... Directed to the address on your premium invoice or learn about other convenient to... Programs claims electronic claim submission is preferred, as noted above external link are... Products or services provided by such vendors, you should contact the vendor ( s directly. Information? a moved forward together., -Magellan Behavioral Health of all Floridians an Association of 35,! Works with county partners in Bucks, Cambria, Lehigh, Montgomery and Northampton counties of welcomes. You have international coverage and need to find care outside the United States telephone... Claim denied for payment, subject to applicable state and federal laws q. I have a specific claim should directed! Your bill to providers by visiting theAvaility websiteand selecting '' Register '' if! View their physical and mental Health as separate, and neither do we and answer above this claim a... Submission and claim number if applicable, Medicare numbers for your needs apply to this claim? a information be!