Bcbs of al provider portal
Bcbs of al provider portal. Policies & Guidelines. Password (Forgot password?) Don't have a User ID? Register Now. Welcome to Credence. Agrees that Provider will be responsible for all electronic transactions submitted to Blue Cross by Provider, its employees, and its agents; CPT codes, descriptions and data copyright ©2023 American Medical Association. org:8080 CPT codes, descriptions and data copyright ©2023 American Medical Association. First time users who have not received a PIN letter must contact the EMC Helpdesk for support. • Secondary: A secondary claim is filed when Blue Cross is the payer to adjudicate after the primary payer. Ambulance providers, see “Ambulance Transportation. Primary Practice State: * Please Select Alabama Florida Georgia Mississippi Tennessee Provider Connection is an online portal for Blue Shield of CA providers to access member eligibility, benefit, authorization, claim, and payment information. Medicaid Home News Alerts Calendar Directions My Medicaid. For portal assistance call (800) 716-2299 option 3 or email EDIServices@bcbsla. Get the latest provider news and updates. Search. Check eligibility, submit claims, collect patient payments and track ERAs. Lucet is an independent company providing behavioral health services to Blue Cross and Blue Shield of Alabama members. Find a provider now. org:8080 Blue Cross EDI Services Support by telephone at 205-220-6899 or email Ask-EDI@bcbsal. Need additional help? PRV20158 - 1805 An Independent Licensee of the Blue Cross and Blue Shield Association 4 Select the Remit Date using the drop-down box. The first phase of the Transparency in Coverage Rule requires group health plans and health insurance If the provider has completed the initial internal appeal,any subsequent appeal rights will be defined by his orher Participating or Preferred Provider Agreement or legal settlement in effect. Review Blue ProviderAccess. Dental, Life and P. Toll Free: 1-800-874-9426 and TTY: 711 Blue Cross and Blue Shield of Alabama offers health insurance, including medical, dental and prescription drug coverage to individuals, families and employers. Medical, Surgical or DME Predetermination Information being Requested AL 35236 • An Independent Licensee of the Blue Cross and Blue Shield Association These documents are required for all providers to complete the application process. Our provider file is used for remittance payments, Internal Revenue reporting, directories and publication mailings. If you Welcome to Blue KC’s Provider Portal. ©2024, Blue Cross and Blue Shield of Alabama is an Provider News. We would like to show you a description here but the site won’t allow us. If you have any problems logging in to the Blue e network or Blue Premier, please call the eSolutions HelpDesk at 1-888-333-8594 Option 1 or your system administrator. Utilization Management Program and Precertification. com HMO Louisiana, Inc. An Independent Licensee of the Blue Cross and Blue Shield Association 1 of 2. Eligibility & Benefits and Referrals Blue Cross and Blue Shield of Alabama providers have options available for accessing member eligibility and benefits for in-state and out-of-state Blue Cross and Blue Shield members. If you have any questions or comments about the forms, please contact us. User Roles. Learn More. The ERA service enables Blue Cross and Blue Shield of Alabama to provide you with an electronic remittance advice, which is a statement of your claims payments in an electronic format. org:8080 Include the patient’s medical record as needed for the review if not submitted previously to Blue Cross. Member resources; Find care; Health 101; Why Credence? LOG IN/REGISTER LOG IN/REGISTER. This directory provides a list of Blue Advantage’s network providers. Manage quality-of-care 1-800-222-4379. • Make sure all forms are completely filled out. , DBA Florida Blue. Updated practice information allows us to provide patients with current practice and provider information to assist them with selecting the most appropriate providers for the care they © 2024, Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association. Blue Cross & Blue Shield of Mississippi does not control such third party websites and is not responsible for the content, advice, products or services offered therein. Due to COVID-19, Blue Cross and Blue Shield of Alabama expanded coverage for telehealth services effective March 1, 2020. Log in to the Blue Cross of Idaho Provider portal. Health care professionals like you can access patient- and practice-specific information 24/7 within the UnitedHealthcare Provider Portal. The PRC offers resources to assist in the treatment of your Highmark patients, such as prior authorization requirements, credentialing information, medical policies, pharmacy information, and much more. org:8080 When an out-of-area Blue plan member seeks medical care from your office, use our tools to simplify claims submission to Blue Shield of California. , Account Number Linkage to Provider Identifier) Provider Tax Identification Number (TIN) National Welcome Providers. To get detailed information about your health care coverage, please see your Evidence of Coverage (EOC). An Independent Licensee of the Blue Cross Blue Shield Association Blue Cross Legacy # Refund Information Provider Name Individual NPI (National Provider Identifier) Organizational NPI (Payer) (if applicable) Tax ID Number Office Address City State Zip County Person to contact (if neccesary) within above named provider’s office Office Out-of-Network Provider Disputes of QPA. News and Events . The chart below shows a sample of this three-year process, including our multiple efforts to reach out to providers during the one-year reminder phase prior to claims suspension, required member notifications, and My Provider Enrollment Portal Electronic Funds Transfer and Remittances Provider Enrollment FAQs. an Independent Licensee of the Blue Cross Blue Shield Association. bcbsal. org:8080 For Providers; For Employers; CNAP Login Widget. Records must be mailed to the P. 9 million members in all 102 counties across the state. ®´ Registered Marks Welcome Providers. Blue Cross and Blue Shield of Alabama is working with providers to ensure patient access to affordable care during this crisis. Connect with us: First Care, Inc. Due to COVID-19, Blue Cross and Blue Shield of Alabama expanded telehealth services effective March 1, 2020. Provider ; Text Size: A A A. Treating Provider Information Provider Name Phone Number Fax Number Mailing Address City State Zip National Provider Identifier (NPI) Tax ID Number Provider ID Number III. Coordination of Benefits. com. Blue Advantage from Blue Cross and Blue Shield of Louisiana is a PPO plan with a Medicare contract. You are about to leave Blue Cross and Blue Shield of Alabama's website and enter a website operated by Lucet. 1. Be sure to read: Referral to in-network providers only. PRV20198-2403 Blue Advantage ® PPO is provided by Blue Cross and Blue Shield of Alabama, an independent licensee of the Blue Cross and Blue Shield Blue Cross and Blue Shield of Alabama ID card. Forgot username or password ? Register for my BlueCross. Federal employees, retirees and their families are insured by the Federal Employees Program (FEP). This guide is effective following the end of the federal public health emergency (PHE) related to the COVID- 19 pandemic. BCBS AL Radiation Oncology Billing Category Crosswalk Table. We encourage out-of-network providers to accept our payment for COVID-19 testing as Telehealth Billing Guide for Providers . Check Updates. To access all features and pages of the provider portal, you must log in. Pursuant to Section 1557 Blue Cross Blue Shield FEP Dental does not discriminate, exclude people, or treat them differently on the basis of race, color, national origin, age, disability, or sex PROVIDER NETWORKS & SPECIALTIES PA Dynamic Rendering. org:8080 Blue Cross and Blue Shield of Alabama administers inpatient/emergency room benefits for the Alabama Department of Mental Health. Please Note: FEP Members: If you are part of the Federal Employee Program (FEP), you should use Group Number 53533 when registering. Blue Advantage (PPO) Complete and Premier. org:8080 Blue Cross and Blue Shield of Alabama contracts with the Centers for Medicare & Medicaid Services (CMS) to provide Medical records may be requested via web portal, eConnectivity or by mail, or obtained by on-site imaging at Blue Cross will reimburse providers a reasonable cost for the duplication of the medical records. To update your information in our provider records, complete this form, sign and mail or fax it to the address listed. As a Blue Cross Blue Shield of Michigan and Blue Care Network provider, you're part of the largest network in the state. , DBA Florida Blue Medicare. your trusted provider. Records can also be faxed. 7 %âãÏÓ 1089 0 obj > endobj 1113 0 obj >/Filter/FlateDecode/ID[0FED39448BDD402CB36F45B7EFDB80B7>0F34919D8C56F74295125F3225A73F78>]/Index[1089 41]/Info 1088 Accurate and complete information is important for providers and Blue Cross and Blue Shield of Alabama. We offer deep discounts and one of the largest dental networks in the Use our interactive tool to find your local Blue Cross and Blue Shield company's website and access your account. ®´ Registered Marks CPT codes, descriptions and data copyright ©2023 American Medical Association. m. Provider News A lot of information on our site is secure. Please contact Customer Service at 1-800-292-8868 for your group number. Free Health Programs. You can also manage your claims and view out-of-pocket costs. DBA Florida Blue. ” Note: Providers outside of Alabama must be participating with their local Blue Plan for consideration for participation with Blue Cross and Blue Shield of Alabama. If you cannot complete your eligibility/benefits inquiry online, please contact us at 800-842-5975. myBlueCross Member Login Contact Us: 1-888-267-2955 . Overview GENERAL RESOURCES SOLUTION RESOURCES. , and The Dental Network, Inc. 1 PREFERRED RADIOLOGY PROGRAM (PRP) FREQUENTLY ASKED QUESTIONS/ANSWERS PR20219-2302 General Information Which medical providers are affected by the PRP? • All freestanding diagnostic facilities, hospital outpatient diagnostic facilities, and any physician’s office that We're excited to bring you a new provider portal and welcome your feedback. Update your provider profiles. ALL Kids uses Blue Cross Blue Shield of Alabama (BCBSAL) to provide medical, mental health, and substance abuse services through their preferred provider network (PPO). Below is the list of specific Enroll and maintain provider records. HMO coverage is offered by Florida Blue Medicare, Inc. Agrees that Provider will be responsible for all electronic transactions submitted to Blue Cross by Provider, its employees, and its agents; Provider Agent Information Provider Agent Name Provider Agent Contact Name Telephone Number Telephone Number Extension Email Address Electronic Remittance Advice Information Preference for Aggregation of Remittance Data (e. Appeal requests should be mailed/faxed to: Blue Cross and Blue Shield of Alabama Post Office Box 362025 Birmingham, Alabama 35236 Fax Number: 205-220-0941 Telephone Number for Expedited Appeals: 205-220-7202 View the Provider-Administered Drug Policies webpage to view more information on these drugs, as well as provider-administered specialty drugs. Visit the Lucet Provider Free, real-time access to hundreds of payers. Node:bclrprvappp2002. See our Telehealth page for more detailed information about eligible providers and services. Blue Cross and Blue Shield of Oklahoma, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Thank you for using our Provider Portal. Provider Resources. use our Blue adVantage Provider Portal. Secure Portal Login. DBA Florida Blue HMO. That’s why we have the Providers’ Hub, your “one-stop-shop” for resources designed to help you deliver optimal experiences for your patients. To be eligible for enrollment, your practice must have its primary location in Alabama or in a qualifying county in an adjacent state. Box listed on the medical record request. This website is supported on Google Chrome, Firefox, Safari, and Microsoft Edge. If you are deaf, hard of hearing, or have a speech disability, dial 711 for TTY relay services. Blue e provider portal. The CURP review process and Jiva Provider Portal entry include InterQual Criteria pertinent to inpatient general medical and surgical episodes of care. If not, please ask your clearinghouse to contact Blue Cross of Idaho to troubleshoot if necessary. You are about to leave the Blue Cross and Blue Shield of Alabama Medicare products website to learn more about our Dental Plans. Back to COVID-19 Provider Update Center. The PHE expired on May 11, 2023. We’re glad to have you as a member. Back. Log in to Anthem. © 2024, Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association. To obtain access to Webpass, please An Independent Licensee of the Blue Cross and Blue Shield of Association Key (DT) Duplicate Therapy (PA) Requires Prior Authorization (ST) Requires Step Therapy process contracted by Blue Cross and Blue Shield of Alabama to provide pharmacy benefit management services. They have a wealth of information about current corporate initiatives, policies, industry trends, clinical information exchange, and value-based programs that impact you. In the United States, Puerto Rico and U. Blue Distinction Centers Learn about healthcare facilities and providers recognized for their expertise in delivering specialty care; myHealth . O. PCN is committed to total quality care for our members. Requests for Blue Advantage (PPO) Complete and Premier This directory provides a list of Blue Advantage’s network providers. Case Number:* This value is required Member Name:* This value is required Contract Number:* (As it appears on the member's Blue Cross ID Card) This value is required Invalid format Date of the Accident:* This value is required Invalid format Case Type: Please make a selection. www. Create a Free Account PROVIDER NETWORKS & SPECIALTIES PA Dynamic Rendering. Blue Cross and Blue Shield of Alabama P. The Blue Cross and Blue Shield of Alabama Preferred Sleep Medicine Program, effective December 1, 2016, Blue Cross and Blue Shield of Alabama 450 Riverchase Parkway East Birmingham, Alabama 35244-2858. Our Blue Advantage plan is a Medicare-approved Preferred Provider Organization (PPO) Plan option for beneficiaries living in the state of Alabama. Your secured session with Blue Cross and Blue Shield of Alabama has expired because there was no activity for 30 minutes or more. Select the role (s) that best describe your job functions: Billing/Insurance. Blue Cross does not guarantee that the estimated premiums will be the actual amount billed for coverage. Register or log in with your username and password. Please call the provider prior to scheduling an appointment to verify that the provider continues to be part of the network. Use our interactive tool to find your local Blue Cross and Blue Shield company's website and access your account. Lucet has agreed to follow Blue Cross' privacy and Accurate and complete information is important for providers and Blue Cross and Blue Shield of Alabama. For a list of preferred providers and dentists in Alabama, please visit Blue Cross and Blue Shield of Alabama Doctor Finder. Enrollment in either Blue Advantage plan depends on contract renewal. That means better service and better care for your patients. Become a credentialed provider in Wellmark's network to file claims and submit medical and drug authorizations. Excellus BCBS participating providers may register for an online account. If you're a non participating provider learn about joining our network. Therefore, you are about to leave the Blue Cross & Blue Shield of Mississippi website and enter another website not operated by Blue Cross & Blue Shield of Mississippi. Precertification for provider-administrated drugs may be required by the patient’s health plan. Shop Plans; Members; Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association. Find out what's new and about upcoming trainings. Claims and Appeals. , Precertification is required for many services, including the following outpatient hospital benefits, physician benefits and other covered services. g. Access tools, policies and the latest information to help you care for our members. Blue Cross and Blue Shield of Alabama calculated the Qualifying Payment Amount (QPA) based off our January 31, 2019, allowances, the Census Bureau Metropolitan Statistical Areas (MSA) for the state of Alabama, and the U. Explore this site for useful tools and information. org:8080 You can also check your Provider Portal at any time to view its current status. Be sure to verify benefits for each patient (including Blue Advantage Blue Advantage is a Medicare-approved PPO plan provided by Blue Cross and Blue Shield of Alabama, an independent licensee of the Blue Cross and Blue Shield Association. Get insurance delivered through your local BCBS agency. Evidence Under one of the provisions in the CAA, Blue Cross and other health plans are required to verify provider directory information every 90 days beginning in 2022. Select BCBS Provider. Medicare ID card. Front Desk/Intake/Scheduling. Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc. Webinars! Join us for online presentations that focus on the many tools we offer and the best ways to communicate Healthcare providers can conduct HIPAA-compliant transactions with Blue Cross using an approved EHR vendor. On their website, you'll be able to look up your health plan, review a claim and more. S. To see if an Alabama provider participates in the Blue Advantage network, you may: Call the Member Services number on the back of your ID card (non-members may call 1-888-543-9212 (TTY 711) 8 a. On 11/12/2020, the Department of Health and Human Services (HHS), the Department of Labor, and the Department of the Treasury published the Transparency in Coverage Final Rule (85 FR 72158-01). You may submit electronic claims through your practice management software, clearinghouse or our As part of the alliance, Availity serves as the designated EDI Gateway providing portal and clearinghouse services for Arkansas Blue Cross and Blue Shield. Blue Choice providers who need assistance with provider enrollment and contracting, clinical criteria, precertifications, standards of care and related matters IMPORTANT UPDATE: Providers are currently unable to access our Clear Claims Connect tool via the Provider Resource Center. If we have any questions, a Credentialing Coordinator will contact you. Do you know about our live agent chat feature? Live-agent chat is the easiest and fastest way to get real-time support for an array of topics, including: Member Eligibility; Claims adjustments; Authorizations ; Escalations; You can even print your chat history to reference later! Blue Cross and Blue Shield of Alabama Provider Networks and Healthcare Information and Technology Consultants work together to deliver the best possible service to you. Node:bclrprvappp1002. Find resources for Blue Cross NC Providers in- and out-of-network to manage patient claims and appeals, eligibility, prior authorization and more. HealthEquity is our Alabama State Board of Health License or Business License and/or Zoning Permits Evidence of Professional and/or General Liability Insurance (Domestic carrier required) W-9 form or Tax Payer Identification Number Request for each Tax Number Copy of IRS documentation (i. Vendor Companion Guides. Other Credence sites Other Credence sites For Members. Below is the list of specific Provider Directory Information. Contracted providers must be recredentialed with Blue Cross within three years to continue participation in our provider network(s). Payments for services from a non-participating provider are generally sent to the member, except where federal or state mandates apply, or negotiated agreements are in place. Paper submission of claims are not accepted. ProviderAccess Professional Claims Submission Help Patient Claim Type: Professional • Primary: A primary claim is filed when Blue Cross is the payer to adjudicate first. Blue Cross and Blue Shield of Alabama offers health insurance, including medical, dental and prescription drug coverage to individuals, families and employers. Auxiliary aids and services are available upon request free of charge. Please follow the steps below: Step 1 -Required Documents for All Providers/Specialties. your needs and concerns. and Southern National Life Insurance Company, Inc. Federal Employee If the provider has completed the initial internal appeal,any subsequent appeal rights will be defined by his orher Participating or Preferred Provider Agreement or legal settlement in effect. Subrogation Workers' Compensation Not sure Welcome Providers. PRV20198-2403 Blue Advantage ® PPO is provided by Blue Cross and Blue Shield of Alabama, an independent licensee of the Blue Cross and Blue Shield CPT codes, descriptions and data copyright ©2023 American Medical Association. When making referrals to laboratories for COVID-19 testing, always use a Blue Cross and Blue Shield of Alabama in-network lab. . Availity is a multi-payer site where you can use a single user ID and password to work with Arkansas Blue Cross and Blue Shield, Health Advantage, and other participating payers online. My Company Find email, phone and mail addresses for different types of Blue Cross members and plans. Box 12185 Birmingham, AL 35202-2185 Name of Authorized Representative Address City State Zip Telephone Number (including area code) Subscriber Signature Date Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield This policy is intended to be used for some or all of the following purposes in Blue Cross and Blue Shield's administration of plans: (i) adjudication of claims (including pre-admission certification, pre-determinations and pre-procedure review), (ii) retrospective review of provider claims, (iii) provider audits, (iv) fraud and abuse MyBlue gives you access to tools and resources that are simple, smart, secure and private - all designed to help you save money, live healthier and get organized. Find the phone numbers, email addresses and links for various services and resources for providers of Blue Cross and Blue Shield of Alabama. Explore the health insurance options offered by Blue Cross and Blue Shield insurance agencies. For Providers. Weekly Notifications Medical - Week of 09/09/24. org:8080 The Blue Cross and Blue Shield of Alabama manuals list general program guidelines and information. No ID card yet? No problem. Discover. UPDATED: MAY 11, 2023 . Dental Provider Resources. Dental Provider Application; Out-of-State Dental; Notification of Noncovered Dental Services; The following drugs will be subject to the Provider-Administered Drug Review Program. %PDF-1. • Make sure you submit the correct application for your specialty. Provider Training. City Average CPI-U from August of 2019, 2020 and 2021 Blue Cross and Blue Shield of Alabama offers health insurance, including medical, dental and prescription drug coverage to individuals, families and employers. PRV20198-2403 Blue Advantage ® PPO is provided by Blue Cross and Blue Shield of Alabama, an independent licensee of the Blue Cross and Blue Shield Blue Cross and Blue Shield of Alabama offers health insurance, including medical, dental and prescription drug coverage to individuals, families and employers. Learn how to register as a provider for Blue Cross and Blue Shield of Alabama (BCBSAL) and what role the Master Administrator plays. If the provider is not in the BlueCard PPO network, the service will be considered out-of-network and the member will be responsible for the charge (no hold-harmless in place). Information on this page is effective during the COVID-19 federal public health emergency (PHE). Updated May 1, 2023. WEBPASS. Assignment of a provider number is based on the ability of Blue Cross to verify the information below. ® Registered Marks of the Blue Cross and Blue Shield Association. Medical doctors may qualify for a billing dispute external review (BDER) process after exhaustion of the Blue Cross and Blue Shield of Alabama initial internal appeal process. Path: {{currentPath}} Name: Please enter a name. Product names are the property of their respective owners. News and Updates. Employees Retirement System of Texas (ERS) Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the BCBS AL Provider Resources. Virgin Islands. This expansion of services will continue through the end of the current federal public health emergency. Looking for Health, Dental and Vision Plans? Shop and Compare Our Business and Employer Plans Below. WebPass is an online service from Lucet which allows providers and office staff to check eligibility and benefits of Lucet’s Members, request authorization (including ECT), contact Provider Relations, update your online profile, and more. Blue Cross and Blue Shield of Illinois, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association Transparency in Coverage Rule. My Company Employs up to 50 Employees. Visit iLinkBlue, then click on “Blue Advantage” under the “Other Sites Provider Relations; Option 4; Fax (225) 297-2750; Provider Identity Management For portal assistance call (800) 716-2299 option 3 or email EDIServices@bcbsla. Precertification for these provider-administered drugs is required when administered in a provider’s office, outpatient facility, or home health setting. Doctor Finder. Our powerful digital tool for providers can be accessed 24/7 with a click of a button! Provider Portal Features include: Health care providers and administrators, get access to verify eligibility and benefits, submit claims, and more. org:8080 Save Time With Live Chat Find the information you need about your health care benefits by chatting with an Anthem representative in real-time. Healthcare providers can conduct HIPAA-compliant transactions with Blue Cross using an approved EHR vendor. You are about to leave Blue Cross and Blue Shield of Alabama's website and enter a website operated by Prime Therapeutics, LLC. Node:bclrprvappp2001. Blue Cross and Blue Shield of South Carolina is an independent licensee of the Blue Cross Blue Shield Association. The secure site gives providers, clerks and billing agents the opportunity to view Claim and Prior Authorization status as well as Eligibility Verification inquiries and to upload and download standard X12 and NCPDP transactions. Find step-by-step instructions, LOG IN. Highmark's Provider Resource Center is your source for all provider-related information and updates. To update your information in our provider records, complete this form, sign and mail or fax it to the address below. HMO coverage is offered by Health Options, Inc. Sign in again or re-enter your information if you were completing a form. You can complete tasks online, get updates on claims, reconsiderations and appeals, submit prior authorization requests and check eligibility — all at no cost without calling. Lucet. For information on becoming a behavioral health network provider, contact Lucet Provider Relations at 1-888-611-6285. The Alabama Medicaid Interactive secure site is intended for providers, clerks and billing agents. GET STARTED. EviCore by Evernorth is committed to enhancing the utilization management experience for our providers. Our provider file is utilized for remittance payments, Internal Revenue reporting, directories and publication mailings. If you are impacted by this incident, visit our Change Healthcare Incident Response Page for some options until connectivity For more information, please visit BCBS FEP Vision. Here you will find the resources you need for your office or facility. You can also reference the Our free, enhanced, secure provider portal that provides access to the information, resources and self-service tools you need to conduct business with us. For vendor payment services, access the commercial supplier portal or email Find drug lists, pharmacy program information, and provider resources. During this stage, we’ll review your CAQH application, malpractice insurance, and other information. 08/26/24 - Configuration has been corrected for BlueCard claims denying %PDF-1. • Tertiary: A tertiary claim is filed when Blue Cross is the payer to CPT codes, descriptions and data copyright ©2023 American Medical Association. Information and forms to enroll as an Alabama Medicaid provider. com or use the Sydney Health app to start a Live Chat. CPT codes, descriptions and data copyright ©2023 American Medical Association. Treatments indicated as Gene MyBlue Member Portal; fepblue App; Brochures & Resources. Learn More Easily find the right in-network providers and care options. Refer to To see if an Alabama provider participates in the Blue Advantage network, you may: Blue Cross and Blue Shield of Alabama offers a number of standard Drug Utilization Management (DUM) services such as CPT codes, descriptions and data copyright ©2023 American Medical Association. The group number is 72532 and the prefix is ABM. Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association. To get Precertification is required for many services, including the following outpatient hospital benefits, physician benefits and other covered services. We are also the largest provider of health benefits in Illinois, serving more than 8. Independent Medical Expert Consulting Services, Inc. Blue Cross does not currently access medical records requests online. BlueRx Drug Authorization Request Form. For. Coordination of Benefits/Blue Cross and Blue Shield of Alabama is Host Plan; Dental. org:8080 Blue Cross and Blue Shield of Alabama and/or other Blue Cross and Blue Shield Licensees have made reasonable efforts to validate that the list of providers displayed is up to date and accurate. Skip to main content Availity Essentials™ is the provider portal for Horizon Blue Cross Blue Shield of New Jersey, Braven Health and Horizon NJ Health. Referral – from the primary care provider (PCP) to specialist or facility Precertification – determines appropriateness of location of treatment Predetermination – determines medical necessity of proposed treatment plan Blue Cross Blue Shield FEP Dental complies with all applicable Federal civil rights laws, to include both Title VII and Section 1557 of the ACA. 8. Take a minute to log in and get to know your Credence benefits. your healthcare search. At your fingertips. Node:bclrprvappp1001. This site is intended for providers, clerks, and trading partners. Alabama BCBS, FL Blue, Blue KC, or Arkansas BCBS FEP, SCAN Medicare Advantage, Blue Cross and Blue Shield of Alabama requires healthcare providers to send claims electronically. Get informed of any changes or updates taking place. Prime Therapeutics ® LLC, is an independent company contracted by Blue Cross and Blue Shield of Alabama to provide pharmacy benefit management services. Physician/Healthcare Provider. Learn how to access the Blue Cross and Blue Shield of Alabama offers health insurance, including medical, dental and prescription drug coverage to individuals, families and employers. There are several required documents that you must submit for enrollment. , and/or Massachusetts Benefit Administrators LLC, based on Product participation. to 8 p. Blue Cross and Blue Shield of Alabama's online guided search tool helps Are you already a Lucet (formerly New Directions + Tridiuum) in-network Provider? You can find In-network provider resources in the provider portal. Provider FAQs. Provider Directory Information Blue Advantage (PPO) Complete and Premier. For a list of providers, please visit the FEP Provider Directory. A-Z index Request authorizations, search our provider directory and more. Lucet is our business associate and is an independent company that provides behavioral health services. Dispute Resolution Process for Physician Billing Disputes. Internet Explorer is not recommended because it does not provide optimal user experience. Register with or log into Availity here. The fax information is listed on the Medical Request Letter. Click “Submit. Reviews are conducted the first business day following hospital admission. Box 362025 • Birmingham, Alabama 35236-2025 Fax: 205-220-9560 Check As Appropriate: DME OXYGEN IPPB GLUCOMETER CPAP BIPAP CERTIFICATION RECERTIFICATION PATIENT INFORMATION COMPLETE ALL ITEMS PERTAINING TO THE PATIENT’S CONDITION AND EQUIPMENT 1. Manage quality-of-care paperwork. EDI BlueCard Claims Submissions. Always log in to ensure you're seeing all the news. Code Additions Effective January 1, 2023 • 69729 • 69730 Code Deletions Effective April 1, 2023 • 19316 • 19318 • 19325 • 19328 • 19330 • 19340 • 19342 • 19350 • 19355 • 19357 • 19361 • 19364 • 19367 • 19368 • 19369 • 19370 Secure Provider Portal Prior Authorization; Provider Electronic Solutions (PES) Software; Provider Enrollment; Vendor Companion Guides; Promoting Interoperability (PI) Program Sep 4, 2024 - The Alabama Medicaid Agency Health Systems Department will host three virtual webinars to provide information about the new ACHN changes effective Our provider networks and programs work together in delivering benefits and quality health care for your patient. Provider Enrollment. Brochures & Resources; Plan Brochures; Plan Summaries; Quick Reference Guides; Videos; Claim Forms; Blue Cross and Blue Shield of Alabama 450 Riverchase Parkway East Birmingham, AL 35244. Nurse or Clinical Care/Support. Blue Cross and Blue Shield of Illinois is proud to be the state’s only statewide, customer-owned health insurer. , comply with applicable federal civil rights laws and do not exclude people or treat them differently on the basis of race, color, national origin, age, disability or sex. CPT Codes Need Help? Registration Instructions. Providers can verify benefits through an online provider portal prior to rendering services and determine if a procedure requires precertification. ©2024, Credence is an independent licensee of the Blue Cross and Blue Shield Association in Alabama. Blue Cross and Blue Shield of Alabama Attention: Customer Service Appeals P. Direct link to interactive site for providers and billing agents. Navigate to the appropriate manual listed below to find specific information about general services, billing requirements, coding guidelines or important contact information. org:8080 If the provider has completed the initial internal appeal,any subsequent appeal rights will be defined by his orher Participating or Preferred Provider Agreement or legal settlement in effect. org:8080 Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association. Health; Dental; FEP Dental; Vision; You are about to leave Blue Cross and Blue Shield of Alabama's website and enter a website operated by HealthEquity. Provider eSolutions 1-205-220-6899 Provider Networks Consultant 1-866-904-4130 For additional help, please contact: CDT codes, descriptions and data copyright ©2023 American. Questions on billing, claims, prior authorization and programs . For other language assistance or translation services, please call Access manuals, speed guides, tidbits, presentations, tutorials and forms for providers. Our vendor is experiencing a significant network outage and continues to work on resolving the issue. (IMEDECS) is our Billing Dispute Resolution Reviewer. BlueCross BlueShield of Tennessee is a Qualified Health Plan issuer in the Health © 2024, Credence is an independent licensee of the Blue Cross and Blue Shield Association in Alabama. org:8080 We would like to show you a description here but the site won’t allow us. 6 %âãÏÓ 9 0 obj > endobj xref 9 27 0000000016 00000 n 0000001060 00000 n 0000001195 00000 n 0000001272 00000 n 0000001450 00000 n 0000001605 00000 n 0000001763 00000 n 0000001797 00000 n 0000002039 00000 n 0000002115 00000 n 0000003517 00000 n 0000005175 00000 n 0000006551 00000 n 0000007885 00000 n Blue Cross and Blue Shield of Alabama contracted with the Centers for Medicare & Medicaid Services (CMS) to provide Medicare covered services to beneficiaries through a Medicare Advantage Plan. I agree to the terms and conditions listed above. A link to "Claim Entry (eClaims)" can be found under Patient & Claim in the main menu. corp. Page . Prime is our business associate and is an independent company that Blue Cross and Blue Shield (BCBS) members can search for doctors, hospitals and dentists. If you are an Alabama dentist, log in to ProviderAccess to submit primary, secondary and corrected electronic claims to Blue Cross and Blue Shield of Alabama. Whether you're interested in joining our network or The ERA service enables Blue Cross and Blue Shield of Alabama to provide you with an electronic remittance advice, which is a statement of your claims payments in an electronic format. Menu Display. , Letter 147T or 147C, Federal Deposit Coupon, ETPS, or Letter My Care Alabama Central, My Care Alabama East, and My Care Alabama Northwest complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex. Health care providers and administrators, get access to verify eligibility and benefits, submit claims, and more. The network providers listed in this directory have agreed to provide you with your health care and dental services. org:8080 For Providers. org:8080 AUXILIARY PROVIDER APPLICATION An Independent Licensee of the Blue Cross and Blue Shield Association PRV20020-2202 This form is used to establish a provider with Blue Cross and Blue Shield of Alabama and assign provider number. The content of the manual is intended to be general and applicable BlueCard Program Provider Manual; Glossary of Terms; Medicaid Claims Handling for Medicaid Members; Contact information: BlueCard Eligibility: 1-800-676-BLUE (2583) Blue Cross and Blue Shield of Alabama Provider Customer Service: 1-877-231-7239 Ready to become a provider in the Anthem network? We look forward to working with you to provide quality service for our members. Your health provider has more than one location on file with Blue Cross and Blue Shield of Alabama, select the location where the service was rendered. Simply click on your specialty (Step 3). Explore the BlueCard Program Need help with Provider Connection? Reimbursement will not be made for records that are not requested by Blue Cross and Blue Shield of Alabama. Additionally, if the service was rendered somewhere other than the provider’s office, provide the address where the service was rendered. are independent licensees of the Blue Cross and Blue Shield Association. ” 5 The online remitance will display as a PDF that you can save or print The application was developed through a cooperative workgroup effort of Blue Cross and Blue Shield of Alabama, the Medical Association of the State of Alabama, the Medical Group Management Association, the Alabama Hospital Association, the Alabama Association of Medical Staff Services, the Alabama Medicaid Agency, and the Alabama Accurate and complete information is important for providers and Blue Cross and Blue Shield of Alabama. Find Your Information. org. To maximize the benefits offered through both FEP options always use in-network providers. org:8080 Update your provider profiles. EviCore highly recommends providers take full advantage of the online Register for Online Portal Orientation Session. Find the right healthcare provider for your specific needs with Blue Cross and Blue Shield of Alabama's Provider Finder. We have several resources we've developed to help you get the information you need quickly. Or view forms and resources without logging in. Blue Cross and Blue Shield of Alabama requires healthcare providers to send claims electronically. e. Health coverage is offered by Blue Cross and Blue Shield of Florida, Inc. Enroll as a Blue Cross provider, update provider information, or begin the credentialing/recredentialing process. Current FEP members get more with our member-only portal. Prioritize. ©2024, Credence Blue Cross and Blue Shield is an independent licensee of the Blue Cross and Blue Shield Association in Alabama. User ID. of . operated on behalf of the Blue Cross and Blue Shield Service Benefit Plan by Healthcare providers can conduct HIPAA-compliant transactions with Blue Cross using an approved EHR vendor. Thank you for browsing our provider forms. Begin Application © 2024, Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association. Resources for healthcare providers, including provider self-service, news and updates, and tools and resources. Login. myBlueCross Member Login Call 1-888-267-2955 . Blue Cross and Blue Shield of Louisiana and its subsidiaries, HMO Louisiana, Inc. BlueCard PPO providers will be reimbursed according to the Blue Cross and Blue Shield of Alabama PPO provider contract. For Employers. org:8080 For help with eligibility, benefits, prior authorization, claim status, and fee schedule information: 602-864-4320 / 1-800-232-2345 Provider portal Get answers to questions, access real-time patient information, check claims status, enter and view authorizations, and more. The site is operated by Blue Cross and Blue Shield of Alabama and all Blue Cross' privacy and security policies regarding the confidentiality and protection of your personal health information apply The Personal Choice Network (PCN) is Blue Cross and Blue Shield of Alabama's primary care network. On their website, you'll be able to look up your health plan, Simplify. Access your account, view claims, manage benefits and more with myBlueCross. LOG IN/ REGISTER. Louisiana Blue is an independent licensee of the Blue Cross and Blue Shield Association and incorporated as Louisiana Health Service & Indemnity Company. Use Blue e to look up patient eligibility, submit claims, check claim statuses and more CPT codes, descriptions and data copyright ©2023 American Medical Association. Reimbursement will not be made for records that are not requested by Blue Cross and Blue Shield of Alabama. Outside the United States *Select Blue Cross Blue Shield Global™ or GeoBlue if you have additional international coverage and need to find care outside the United States. Use our enhanced provider directory to get procedure cost estimates. Take advantage of the suite of online offerings available to you in the Availity Essentials portal, at no cost. For first time users who have received a Personal Identification Number (PIN) letter, click the Setup Account: button. Provider eSolutions 1-205-220-6899 Provider Networks Consultant 1-866-904-4130 For additional help, please contact: Title: eClaims Professional Primary Reference Guide Created Date: For login/access issues call (800) 716-2299 option 5 or email PIMTeam@bcbsla. Patient’s Name 2. What Do You Want To Do? Learn more about ALL Kids; See if my child will qualify; Print the income guidelines; Print an application; Print An Independent Licensee of the Blue Cross and Blue Shield Association II. Third Party Website Disclaimer. ©2024, Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association. nchtarqa jmdneo nmpc bhbhgw fmlanvi wphuv awoe pinlm iontyar yhgu