Box 3836, Scranton, PA 18505; Blue Cross Medicare Advantage, c/o Provider Services, P.O. If you purchased an individual plan through the health insurance marketplace and you are receiving advance payments of tax credits and/or cost sharing reductions in accordance with the Affordable Care Act, each of your monthly periodic payments is due on the first day of the month for that coverage period. Here are the forms/documents to add locations and make changes to information and other requests. Submit a separate claim for each member. We must follow the IROs decision. Out-of-network liability and balance billing. CPT codes, descriptions and data copyright 2022 American Medical Association. There is a grace period of three months for all monthly premium payments after the initial premium payment. After determining your benefit eligibility, your Lifetime Waiting Period start date will be determined. Get access to thousands of forms. If you do not know this information, please contact us at 205-220-7725 or fax your request to 205-220-6354. It also tells you how much has been credited toward any required deductible and out-of-pocket maximums. Call 1-855-890-7416, 8 a.m. - 8 p.m. Central Time, Monday through Friday. If you want to stay on Blue Cross' website, click "Cancel.". Discover all the ways members can earn wellness incentives and rewards for taking an active role in their health. The route you should take depends on your individual healthcare needs and financial situation. Patient Consent Form for Provider Submitted Appeals View PDF. Applicable FARS/DFARS apply. //show the chat un-available image HealthEquity is our business associate and is an independent company that provides account-based plan services to Blue Cross. Claim forms must be submitted to: Blue Cross and Blue Shield of Alabama 450 Riverchase Parkway East Birmingham, Alabama 35244-2858 Grace periods and claims pending policies during the grace period To ask for a formal decision about the coverage if you disagree, print and complete the appropriate form below and fax it to 1-800-693-6703 or mail to Prime Therapeutics LLC, Attention: Part D Appeals Department, 1305 Corporate Center Dr. How to File a Claim Call Preferred Long-Term Care (LTC) Customer Service (1-888-331-4188) to complete the Claims Intake Form over the telephone. $23 /month. ProviderAccess Provider News View the latest provider news. Failure to timely pay premium payments is not a special open enrollment event for later coverage under the plan. Find out More Blue Cross and Blue Shield of Alabama has an established appeals process for providers and physicians. Questions? }. CLAIM.MD | Payer Information | AL BCBS Payer Information AL BCBS Payer ID: 00510 This insurance is also known as: Blue Cross Blue Shield of Alabama Other ID's: SB510, 12B54 Need to submit transactions to this insurance carrier? $.ajax({ Use this form to submit a claim to be reimbursed for paying Medicare Part B premiums. Dental Blue Benefit Summary Plan Benefit In-Network Benefits Dental Blue 2500A Dental Blue 2000A Dental Blue 1500A Dental Blue 1500B Dental Blue 1000A Dental Blue 1000B MAJOR SERVICES (CONTINUED) Major Services - Prosthetic Services to deductibleInlays, onlays, veneers or crowns Fixed or removable bridges Full or . This link takes you to another website. Additional details about this and other exception review details can be found in the Claims and Appeals section of your benefit booklet. Thank you for your interest in our Short Term Plan. 2023, Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association. All rights reserved. If services were rendered in New York or Pennsylvania, then use the state-specific file address PDF. How to file a dental claim with Blue Cross Blue Shield Alabama? ALL Kids. We use cookies to improve security, personalize the user experience, enhance our marketing activities (including cooperating with our marketing partners) and for other business use. For example, if an Alabama physician provides services to a member with Blue Cross and Blue Shield of Kansas coverage and a post-service appeal is needed, the physician should fill out the appropriate form from above and submit it to Blue Cross and Blue Shield of Alabama. For Indemnity policies - you will be paid your applicable Daily Benefit Amount. allows healthcare providers to submit claims electronically to Blue Crossand Blue Shield of Alabama. Patient Eligibility and Benefits; Pre-Service Review; Pre-Service Review for Out-of-Area Members . Your Lifetime Waiting Period begins after you have been deemed Chronically Ill (or to have a significant Cognitive Impairment) and you have incurred one Qualified Long-Term Care expense. (SLC mailing address ) 61473: USA Blue Cross Blue Shield of North Carolina (Winston Salem mailing addr 61473 . Dental. A primary plan is one whose benefits for a person's healthcare coverage must be determined first without taking the existence of any other plan into consideration. The following documentation provides guidance regarding the process for appeals. What you need to know about the disease and our commitment to ensuring you have access to the right care at the right time. You can take the Blue Health Assessment, check drug costs, change your address, request a member ID card and more. Features expanded pediatric benefits for children up to the end of the month in which the member turns 19. Are you reporting a new case? An EOB is an outline of what services you received from a provider and how your benefits were applied to cover those services. As an Alfa representative, I agree to the payment terms and conditions of Blue Cross and Blue Shield of Alabama and will not collect any checking account, debit card or credit card information on behalf of the consumer for the purchase of health or dental insurance. What is the fax number for BCBS Alabama appeals? 'allPortletsReady', at 1-855-488-2515 or click the "Get Started" link to compare your plans today. Blue Cross and Blue Shield of Alabama. By clicking "Next", you are acknowledging that you would like to submit your application otherwise, click "Cancel". Only available through. Technology, Power of Some information on our siteis secure; log in to ensure youre seeingall the news. Heres everything you need to know about it. Please make sure you select the appropriate form to address your specific need. Lexington, KY 40512. If you use a provider outside of our network, you'll need to complete and file a claim form to be reimbursed. Call 1-855-488-2515. Print and mail the form to the Blue Cross and Blue Shield company in the state that the services were rendered by December 31 of the year following the year you received service. Need to submit a claim? checkChatAvailability('onload'); Patient & Claim. Us, Delete Adults age 19+. Print and complete the form according to instructions on the front. If you receive out-of-network services for a medical emergency in the emergency room of a hospital, those services will be paid at the applicable in-network coinsurance amounts for benefits described in your benefit booklet, but subject to the out-of-network calendar year deductible.For emergency services for medical emergencies provided within the emergency room department of an out-of-network hospital, the allowed amount will be determined in accordance with the Affordable Care Act. Please review your information to continue. gives you access to exams, X-rays and routine cleaningsat no If you have questions, please contact your local Blue Cross and Blue Shield company. Your member ID card is your key to using your medical plan benefits. **Dental Blue Plus is a Health Insurance Marketplace plan. if (userAction === 'onclick') { If you want to stay on the Blue Cross website, click "Cancel.". CPT codes, descriptions and data copyright 2022 American Medical Association. If we deny your request, you may request an internal appeal and an external review by an impartial third party reviewer, known as an Independent Review Organization (IRO). A secondary plan is one which takes into consideration the benefits of the primary plan before determining benefits available under its plan. Blue Cross Community Health Plans, c/o Provider Services, P.O. Download and complete the appropriate form below, then submit it by December 31 of the year following the year that you received service. Thank you for your interest in our Short Term Plan. } If you use our Care Coordinator services in developing your Plan of Care, and your claim is initiated with Home or Community Services, then your Lifetime Waiting Period will be reduced by half. If you or your doctor believe there are exigent circumstances that require an expedited review, an expedited exception request can be submitted, and we will give a response within 24 hours. Choose a state to see how Blue Cross Blue Shield is working in your community. Blue Cross Blue Shield of Oregon -Regence FEP Claims TLW13 USA Blue Cross Blue Shield of Rhode Island: CB870 W: USA In the left-hand column, locate the state where services were rendered. Review Blue Cross and Blue Advantage medical and pharmacy policiesor comment on draft policies. Enroll as a Blue Cross provider, update provider information, or begin the credentialing/recredentialing process. You can view your personal EOBs through your MyBlue account. Box 14053 By clicking "Next", you are acknowledging that you would like to submit your application otherwise, click "Cancel". To determine your premium, call us *Please do not contact LifePlans unless you have already contacted Blue Cross and Blue Shield of Alabama to start your claim. CPT codes, descriptions and data copyright 2022 American Medical Association. Attach pharmacy receipts for covered prescriptions. All Rights Reserved. An EOB is not a bill. } Information contained in the external sites is not endorsed by BCBSAL. For more information, view our privacy policy. Choose between our 3 dental plans today! Be sure the data you add to the Dental Claim Form - Blue Cross And Blue Shield Of Alabama - Bcbsal is up-to-date and accurate. Three forms are also available to aid providers in preparing an appeal request. A Blue Cross representative from LifePlans will contact you to discuss your initial needs and to clarify any questions you have about your policy. Check out the changes and updates to our plan in 2023. Get your online template and fill it in using progressive features. 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. Spanish, Localized Someone will get back to you within two business days. Search for Doctors, Hospitals and Dentists Blue Cross Blue Shield members can search for doctors, hospitals and dentists: In the United States, Puerto Rico and U.S. Virgin Islands. 2023, BlueCross and BlueShield of Alabama is an independent licensee of the BlueCross and BlueShield Association. If you fail to pay in full all periodic monthly payments due and payable before the end of the grace period for those coverage periods, your coverage under the plan will be retroactively canceled back to the last day of the first month of the grace period. Enjoy smart fillable fields and interactivity. Available plans and pricing may vary depending on whether you purchase your plan on or off the Health Insurance Marketplace. Precertification also does not mean that we have been paid all monies necessary for coverage to be in force on the date that services or supplies are rendered. CDT codes, descriptions and data copyright 2022 American Dental Association. (For example, if your service was provided on March 5, 2022, you have until December 31, 2023 to submit your claim). Outside the United States. HealthEquity has agreed to follow Blue Cross' privacy and security policies regarding the confidentiality and protection of your personal health information. You can reach us at the following number: If you are or believe you may be experiencing a medical emergency,please dial 911 for emergency services.If you or a family member needs immediate assistance, please contact one of our representatives at 800-528-5763. Claims Administrator var fromUrl =window.location.host; What is the fax number for BCBS of Alabama claims? You may access the Nondiscrimination and Accessibility notice, Navigate & Connect: Simplifying access to behavioral healthcare. (You can fill the form in electronically or complete it by hand.). Provider Appeals Blue Cross and Blue Shield of Alabama has an established appeals process for providers and physicians. Ifyou believe that this page should betaken down, please follow our DMCA take down process, Ensure the security ofyour data and transactions, Dental Claim Form - Blue Cross And Blue Shield Of Alabama - Bcbsal. Don't have a User ID? Claims Payment Policy & Other Information. Business. In most cases, you can prevent a retroactive denial by paying your premiums on time and/or by promptly notifying the plan or, if applicable, the marketplace of changes in your eligibility status for the plan. For more information about the appeals process, see the following: Providers are required to file all post-service appeals to their local Blue Cross Plan regardless of the member's Home Plan. Blue Cross Blue Shield of Alabama. In certain situations, a claim may be reprocessed and denied retroactively, even after it has been paid. As a CHA representative, I agree to the payment terms and conditions of Blue Cross and Blue Shield of Alabama and will not collect any checking account, debit card or credit card information on behalf of the consumer for the purchase of health or dental insurance. You are about to leave Blue Cross and Blue Shield of Alabama's website and enter a website operated by Prime Therapeutics, LLC. LLC, Internet Brush up on important dental plan details Download your FREE dental guide to learn more about the range of plans available to you. function checkChatAvailability(userAction) { If you pay a monthly payment later than the first day of the coverage period to which it applies, but before the end of the grace period for the coverage period, any claim you submit for benefits will be placed in a pending status (suspended) on the first day of the second month of the grace period and then processed by the plan only when all periodic monthly payments due during the grace period are received. A powerhouse editor is already at your fingertips supplying you with a range of useful instruments for filling out a Dental Claim Form - Blue Cross And Blue Shield Of Alabama - Bcbsal. EDI enrollment is NOT required for submission of electronic claims. the range of plans available toyou. Address: CHIP P.O. If you have questions, please contact your local Blue Cross and Blue Shield company. /* Your local company can help you to: Change your coverage Estimate the cost of a medical procedure File or check on claim Replace your member ID card Review your balance View your plan details Looking for Insurance? It's easy to protect your smile to the fullest with dental coverage that Find your smile. Each time Blue Cross processes a claim submitted by you or your healthcare provider, we send you an Explanation of Benefits (EOB). url: "/ChatAvailabilityService/getAvailability?queueName=CID" Download the Medicare Reimbursement Account (MRA) Pay Me Back claim form: Complete the form following the instructions on the front. When we receive an electronic claim, you will automatically be set up as an out-of-state provider in our system and can register to use our provider website, ProviderAccess: Once . Start now! Additionally, out-of-network providers have not contracted with us or any Blue Cross and/or Blue Shield plan for negotiated discounts and can bill you for amounts in excess of the allowed amounts under the plan. Blue Cross and Blue Shield of Alabama Provider Directory > Claims Issues > or call 877-231-7239 or 205-220-6899 for eSolutions New Directions AL_ProviderRelations@ndbh.com or call 888-611-6285 < Back An assessment will be scheduled and performed by a Blue Cross representative to determine if your situation and health needs meet claims benefit eligibility. Attorney, Terms of By clicking "Next", you are acknowledging that you would like to submit your application and continue onto the payment page otherwise, click "Cancel". Blue Cross and Blue Shield of Alabama will send you a Claims Packet to be completed and returned to us. It includes the date you received the service, the amount billed, the amount covered, the amount we paid and any balance you're responsible for paying the provider.
