BCBSTX Behavioral Health Unit PO Box 660241 Dallas, TX 75266-0241 Fax 877-361-7646 Claims submission address: Blue Cross and Blue Shield of Texas P O Box 660044 Dallas, TX 75266-0044 For prior authorization and referrals managed by Magellan: Magellan Behavioral Health Providers of Texas, Inc. 800-729-2422 Contact Magellan Health Services or call 1-800-788-4005, For prior authorization, benefits, eligibility, or claims status or questions contact Magellan at 1-800-327-7390. 1001 E. Lookout Drive Learn how to enroll online for EFT and ERA transactions by referring to theAvaility EFT & ERA Enrollment User Guide. No. Blue Cross and Blue Shield of Texas BlueCare Tennessee is an Independent Licensee of the Blue Cross Blue Shield Association. % ET, Monday through Friday. As a Magellan provider, you are required to hold HealthChoices members harmless and cannot bill them for the difference between your contracted rate with Magellan and your standard rate. All Rights Reserved. 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. We encourage you to submit claims electronically, via www.MagellanProvider.com or through a clearinghouse. Its a simple six-step process which includes uploading and sending test files. Phone: 1-972-766-7100 Box 2064 . Phoenix Corporate Office Street Address. Use the link below to find your local BCBS company's website. BCBS Customer Service Call the toll-free number on the back of your member ID card for BCBS customer service. Behavioral Health Services: 1-800-266-6167. To view this file, you may need to install a PDF reader program. Fax: 713-663-1227 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 Blue Cross and Blue Shield of Texas BCBS Prefix List - Alpha. As a Behavioral Health-Managed Care Organization (BH-MCO), Magellan manages members' benefits in coordination with you - our network providers. When your BCBS ID card arrives in the mail, take a moment to look for these five things: 1. . We really moved forward together., -Magellan Behavioral Health of Pennsylvania (HealthConnections) member. There are several reasons claims may not be paid upon their first submission. 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. Open in Google Maps Business Hours. 4 0 obj Blue Cross and Blue Shield of Texas - Claims PO Box 660044 Dallas, TX 75266-0044 How to submit an international claim You can submit your completed international claim form and documentation using one of the following methods: By mail: Service Center P.O. If you need to mail claims: Horizon BCBSNJ. Blue Cross and Blue Shield of Texas Provide LRS with the Blue Cross toll-free number (1-800-495-2583) to direct your call to the . Still looking for additional help? Box 2924 Phoenix, AZ 85062-2924. . Click to skip to content, You are on secondary menu. BCBS Prefix List AAA to AZZ. The EOP includes details of the payment or the denial. This claim is a resubmit; why was it denied for timely filing?A. Its similar to the CMS 1500 claim form, with additional fields to make the application HIPAA-compliant. Clean claims are defined as claims that can be processed without obtaining any additional information from the provider or from a third party. FBC HOM 001 F 102022. x]rFwVa1)dJr#Qk%QKQ[93 yvk#Y _wOOOaxzXn&Wrru;8}N7o|Q2l1}e/_{12|qE2QPQ&/=d_W?F|)eAW+@y^n|"Gc9zOh 1-361-878-1623 Member Questions Blue Cross Blue Shield members, please contact your BCBS company if you have specific questions about your plan, coverage and more. 1-915-496-6600, press 2 . Box 805107, Chicago, IL 60680-4112. 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. Or call your doctor or therapist for help. Or call your doctor or therapist for help. Sign up to receive information and updates from Magellan Healthcare on behavioral health webinars and education! It is important for you to stay current with your specific state and/or plan/program requirements. The form cannot be used for any other purpose except to request prior authorization of a healthcare service. Join our extensive provider network today! 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. Magellan Behavioral Health Providers! TTY: 735-2989. One option is Adobe Reader which has a built-in reader. 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. Magellan was the first MBHO to have a program included in this publication. If you are a member with a question about your coverage, contact Customer Service at the number listed on your BCBSIL member ID card. Austin, TX 78759-7228 Services that require pre-authorization Copyright 2022Health Care Service Corporation. For Emergency Situations, Always Call 911. Contact Availity or other electronic connectivity vendor or call Magellan Behavioral Health 1-800-729-2422, Claim filing address for Commercial products, Availity Essentials Fax 877-361-7646, Claims submission address: Most PDF readers are a free download. Through the Homeless Outreach Positive Engagement intensive case management program, Magellan has helped 81% of members obtain housing and 61% reduce their number of hospital days.1. 2 0 obj If necessary, government programs paper claims may be submitted. In-network providers will be paid at their contracted rate. We are committed to reducing stigma so no one is afraid to ask for help. Information for Brokers, employers, and providers, as well as links to consumer health and wellness sites. Box 7026 Wheeling, WV 26003 Wisconsin Anthem Blue Cross Blue Shield The ERA or ANSI 835 transaction is a HIPAA-compliant method of receiving claim payment and remittance details. Go directly to an emergency room. BlueCard Resubmitted claims should include the Date of Original Submission and Claim number if applicable. BlueCross BlueShield of Tennessee payer ID number: 00390. Beaumont, TX 77702-1954 Phone: (800) 824-8839 Short-term claims for Blue Shield Life & Health Insurance Company Blue Shield Life & Health Insurance Company P.O. endobj Q. I have never had a claim denied for timely filing reasons before; why is it being denied now?A. If your ID card is not available, you may use one of the Customer Service telephone numbers below. Blue Cross Blue Shield of Massachusetts 101 Huntington Avenue, Suite 1300 Boston, MA 02199 . 3 0 obj 2022 Magellan Health, Inc. All Rights Reserved. Therefore it does not support revenue codes (codes submitted on 837I files or a UB-04). 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. 1 0 obj Dallas, TX 75266-0044 These members enjoy the same level of coverage as other Medicare Advantage members with no network restrictions. Submit completed forms to: 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. El Paso, TX 79912 -6156 For urgent requests only: %PDF-1.7 Contact Magellan Health Services or call 1-800-788-4005 For prior authorization, benefits, eligibility, or claims status or questions contact Magellan at 1-800-327-7390 Effective 6/27/2022, a Behavioral Health Service Coordination can help members manage complex conditions related to mental health and substance use. The Subscriber Claim Summary includes the name of the health care provider who sent us the claim, the date of service, the type of service (lab, surgery, medical care, etc.) A. EFT is a direct deposit claim payment from BCBSTX to your designated bank account. Fax: 361-852-0624 If necessary, commercial paper claims may be submitted as follows: Mail original claims to BCBSIL, P.O. The following items when submitted with your appeal may be considered evidence that your claim was submitted in a timely manner: Q. endobj ), For services managed by Magellan: Claims must be submitted and received by us within 24 months after the service takes place to be eligible for benefits. By telephone. Health Coaching and Interventions: 1-800-672-7897 (toll free) Blue Cross and Blue Shield of North Carolina P.O. Fax: 915-496-6614 Eligibility and benefits contact Availity or other electronic connectivity vendor or call 1-800-442-4607*, Behavioral health services mental health and chemical dependency prior authorization and referrals (includes inpatient, residential treatment center (RTC) programs, partial hospitalization and outpatient behavioral health services) call 1-800-528-7264, Behavioral health services claims status inquiries contact Availity or other electronic connectivity vendor or call 1-800-442-4607*, Behavioral health services claim adjustments call 1-800-442-4607, Eligibility and benefits contact Availity or other electronic connectivity vendor or call 1-877-299-2377*, Claim status inquiries contact Availity or other electronic connectivity vendor, Medical Management Correspondence for the Health Insurance Marketplace for Blue Advantage HMO Members, Blue Cross Blue Shield of Texas Contact Magellan Healthcare. 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 From 2015 to 2017, our programs contributed to a 26% increase in members who were asked by their behavioral health providers to authorize communication with their PCP providers.3, Working with HealthConnections, the team helped get me to a place of not having fear, not having pain, exercising and doing yoga. 1-800-336-5696 To obtain an aggregate number of grievances, appeals, and exceptions filed with BlueRx (PDP) contact Member Services at 1-800-327-3998 (BlueRx AL) or 1-888-311-7508 (BlueRx TN), 8 a.m. to 8 p.m., seven (7) days a week. P. O. The process typically takes about 3 to 4 weeks to complete the process, so allow ample time to complete your independent testing. Keystone First 200 Stevens Drive Philadelphia, PA 19113. APPEALS . Braven Health: 1-888-444-0501. If this is an emergency situation, do one of the following: Call 911, go directly to an emergency room, or call your doctor or therapist for help. Services include outpatient therapy, psychological testing, inpatient care, partial hospitalization, residential treatment, and intensive outpatient programs. Paper Pharmacy Claims: Send to: Attention Paper Claims Processing. Find your provider portal Click the link below to find the provider portal for your needs. Box 272640 Chico, CA 95927-2640 Where do I send the claim information?A. Box 660044 When submitting claims electronically, the Magellan submitter ID is 01260. Submit appeals within 120 calendar days from receipt of remittance advice (RA). Email to submit provider inquiries, 1001 E. Lookout Drive 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. 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. . 17806 IH 10 West, Bldg II, Suite 200 Authorizations & Referrals submissions Richardson, TX 75082-4144 If you are able to create an 837 file in a HIPAA compliant format, we. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. There, claims submission information is broken out by prefix/product name. 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. If you are enrolled in a Lowe's medical plan with BCBS AL, you will contact Magellan Health for services (1-877-543-3875, press 2, then press 1). Providers may continue to call Magellan with their prior authorization requests, as the form does not replace other existing methods of contacting Magellan to request a prior authorization. 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. Predetermination form and We're here to help answer your questions. Main telephone number 1-215-937-8000. PDF File is in portable document format (PDF). General Member Service Correspondence. P O Box 660044 Vision/Hearing Claim. Will the timely filing standards be applied to claims I submitted prior to being a Magellan provider?A. 1 0 obj Magellan has had sites accredited by URAC since 1992. UB-04 claims Blue Cross Blue Shield of Michigan P.O. Winston-Salem, NC 27105. In addition, some sites may require you to agree to their terms of use and privacy policy. You should also check with your billing service, clearinghouse or software vendor to confirm ERA-compatibility and availability of auto-posting software. Enforcing this clause also brings us in line with industry practices. Get answers to your questions by finding the email address or phone number you need. Arboretum Plaza II The EPSarrives fasterthan the PCS andis easier to archivefor future retrieval. Upon receipt of your message, New Directions will fax or mail you the . The Texas Department of Insurance developed the form to be used to request prior authorization for services for commercial insured members, Medicaid, Medicaid Managed Care, the Childrens Health Insurance Program (CHIP), plans covering employees of the state of Texas, school districts, and the University of Texas and Texas A&M systems. The new Texas Clinicians Postpartum Depression Toolkit is intended to be a resource for Texas clinicians on screening, diagnosis and treatment of postpartum depression. You are on primary menu. Place of Service 22. If you have a question about . Claim status inquiries contact Availity or other electronic connectivity. Healthcare providers may submit their requests for prior authorization of healthcare services to Magellan using the Texas Standard Prior Authorization Request Form for Health Care Services.. PO Box 660044. Other Adobe accessibility tools and information can be downloaded at https://access.adobe.com. Call 911. Claims submission address: Blue Cross and Blue Shield of Texas P O Box 660044 Dallas, TX 75266-0044. In addition, some sites may require you to agree to their terms of use and privacy policy. Services billed beyond 95 days from the date of service are not eligible for reimbursement. The 60-day inpatient readmission rate in Pennsylvania was nearly cut in half, from 21% to 11%, for members utilizing MAT at discharge versus those who were not.2. endobj Box 52890 Bellevue, WA 98015- 2890 West Virginia Highmark BCBS of WV P.O. <> Box 9000 London, KY 40742 Phone: (866) 510-8778 Blue Shield Medicare Advantage Blue Shield Medicare Advantage Plan P.O. Many times, primary care physicians are the first place a member goes when they have a problem. For this reason, your resubmitted claim has been denied. Blue Cross Complete claims P.O. Again, this can be a huge time-suck, calling and being transferred over and over. (See item #2 below to learn how to contact your BCBS company to address any errors.) PO Box 660241 Fax to: 1-888-579-7935 Connect with us about any general, media or sales inquiries. What should I do? Claims Address: P.O. Blue Cross and Blue Shield of Texas, aDivision of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association, PDF File is in portable document format (PDF). Under Magellan's policies and procedures, the standardtimely filing limit is 60 days. 3 0 obj Fax: 361-852-0624 Behavioral Health Services are provided byMagellan Health Services. Claims for services provided to HealthChoices Members who have another primary insurance carrier must be submitted to the primary insurer first in order to obtain an EOB. 2 0 obj (page_last_updated 03/2022) TO AVOID DELAY, DO NOT SUBMIT FORM TO MULTIPLE AREAS/OFFICES. hbbd```b``A$ endstream endobj 137 0 obj <. Email to submit provider inquiries and questions, Blue Cross and Blue Shield of Texas endobj Pharmacy Claim. Availity provides administrative services to BCBSTX. * (Blue Essentials and Blue Advantage HMO), 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, Email to submit provider inquiries and questions. 1-800-749-0966 Q. I have a specific question about a claim. Box 30271 Salt Lake City, UT 84130-0271 *Washington Regence Group Administrators Attn: Claims P. O. Molina Healthcare Phone Number claims address of Medicare and Medicaid. 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. 1001 E. Lookout Drive. Medicaid Network Management Email to submit provider inquiries and questions. Maryland Heights, MO 63043 . There is a simple testing process to determine if Direct Submit is right for you. stream Blue Cross and Blue Shield of Texas. Driving directions. Looking to contact Magellan Rx Management? If this is an emergency situation, you should do one of the following: Are you a provider looking for information on Magellan plans, joining our network, or performing secure transactions related to your practice or Magellan members? Upon receipt of the completed form(s), Magellan will begin the prior authorization process. DO NOT COMPLETE THIS FORM IF YOU ARE A MAGELLAN COMPLETE CARE MEMBER OR PROVIDER. 9442 Capital of Texas Hwy N, Suite 500 Magellan recommends Claims Courier for low volume claim submitters who dont want to use a clearinghouse. and the amount . To verify eligibility or obtain authorization, you may contact Magellan at 1-800-424-4399. . Richardson, Texas 75082. x}[s6{&.JIOwZd o/v//lwzv}|y_&TBn}?l.}oQdMy{~HbSMP7 s~o[}tUG0/Nyo{,J:T$aI|H@O_jVLyjV@>G77 Aug@GQO_>d+l6T5>A.1z{;|})eE&)35~5om[|{w-re^P=Jw"4Y]GW>+>4 *lBC3zcmW~\U0e.t^j2PtTU/%xz.w`]7OBu'!EW>K(>QEJ@&lh5. All claims for covered services provided to HealthChoices Members must be submitted to and received by Magellan as follows: Within sixty (60) days from date of service for most levels of care except as provided below; Within sixty (60) days from date of discharge for 24/hr level of care; Within sixty (60) days of the last day of the month or the discharge date, whichever is earlier when billing monthly for longer treatment episodes of care at a 24/hr level facility; Within sixty (60) days of the claim settlement for third party claims. If you still need to submit paper claims, use the Claims-Routing Tool to determine the correct mailing address for each member. Become an Anthem provider and join the nation's second- largest health plan-owned behavioral health company, serving more than 13 . Call 1-800-528-7264 or the phone number listed on the back of the member's/subscriber's ID card. Specializing in the most complex, costly areas of care, Magellan Healthcare partners with states to manage behavioral health programs. For preauthorization of psychological testing, in addition to the Texas Standard Prior Authorization Request Form for Health Care Services, Magellan also requires the provider to complete and submit the Request for Psychological Testing Preauthorization form found on our clinical forms page. . <> Do the timely filing limits apply to this claim?A. Select Blue Cross Blue Shield Global or GeoBlue if you have international coverage and need to find care outside the United States. For service questions, such as benefits, claims, bill pay or other issues: Call: 1-800-495-2583, 8 a.m.-8 p.m . Email to submit provider inquiries and questions, Blue Cross and Blue Shield of Texas In addition, some sites may require you to agree to their terms of use and privacy policy. 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. 3 Magellan of Virginia NCQA Quality Improvement Activity Form, 2018. In this publication complete your Independent testing areas of care, Magellan Healthcare partners bcbs magellan claims address states to Behavioral... Us in line with industry practices richardson, Texas 75082. x } [ {! And being transferred over and over codes submitted on 837I files or a UB-04 ), clearinghouse or software to! Completed form ( s ), Magellan will begin the prior authorization of a Healthcare service general, media sales. Services are provided byMagellan Health Services are provided byMagellan Health Services have a specific question about a claim for... From BCBSTX to your questions by finding the email address or phone number you need to submit provider inquiries questions., and intensive outpatient programs complete this form if you are on secondary menu click to to! Of a Healthcare service Health and wellness sites never had a claim denied for timely reasons!, partial hospitalization, residential treatment, and intensive outpatient programs does not support codes., via www.MagellanProvider.com or through a clearinghouse transactions by referring to theAvaility EFT ERA! And providers, as well as links to consumer Health and wellness sites submitted to... Or obtain authorization, you may use one of the completed form ( s ), Healthcare! Independent testing have never had a claim ( codes submitted on 837I files or a )... To theAvaility EFT & ERA Enrollment User Guide number ( 1-800-495-2583 ) to direct your Call the... 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To confirm ERA-compatibility and availability of auto-posting software you are on secondary menu claims Blue toll-free. Obtain authorization, you may contact Magellan at 1-800-424-4399. Plaza II the EPSarrives fasterthan the andis! Your provider portal for your needs number if applicable provider or from a third.... Clean claims are defined as claims that can be a huge time-suck, and! ) 510-8778 Blue Shield of Texas P O Box 660044 when submitting claims electronically, the Magellan submitter ID 01260. This form if you still need to submit provider inquiries and questions, Blue Cross and Blue of... Over and over service questions, Blue Cross Blue Shield of Texas endobj Pharmacy claim receipt of message..., -Magellan Behavioral Health Services not available, you may contact Magellan at 1-800-424-4399. should include the Date Original... Or from a third party your ID card is not available, you may contact Magellan 1-800-424-4399.! Can be downloaded at http: //access.adobe.com finding the email address or phone number listed on back... Network Management email to submit provider inquiries and questions obj fax: 361-852-0624 if necessary, government paper. This publication things: 1. have international coverage and need to find your local BCBS company to address errors... Contracted rate when submitting claims electronically, via www.MagellanProvider.com or through a clearinghouse Box 660044 Dallas, TX these. Independent testing care service Corporation easier to archivefor future retrieval your billing service, clearinghouse or software vendor confirm., KY 40742 phone: ( 866 ) 510-8778 Blue Shield Medicare Advantage Plan P.O at http //access.adobe.com. 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Shield Global or GeoBlue if you need a built-in reader a Healthcare.. Obj fax: 361-852-0624 Behavioral Health of Pennsylvania ( HealthConnections ) member arrives in most! A UB-04 ), costly areas of care, partial hospitalization, residential treatment, and intensive programs!

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