Box 2064 . Tricare Phone Number and Claim Address. 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. Looking to contact Magellan Rx Management? <> Click to skip to content, You are on secondary menu. The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies. 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. What should I do? DO NOT COMPLETE THIS FORM IF YOU ARE A MAGELLAN COMPLETE CARE MEMBER OR PROVIDER. Please provide the Tax Identification Number, NPI, and if applicable, Medicare Numbers for your provider when contacting Network Management. endobj You are responsible for verifying the member's coverage at the time of service. Box 660027 Magellan's Caroline Carney, MD, MSc, FAPM, CPHQ, recently co-chaired the National Quality Forum Committee with funding from the Centers for Medicare & Medicaid Services (CMS) to develop guidance for healthcare stakeholders to successfully implement the Opioids and Behavioral Health Measurement Framework and ultimately help combat the opioid crisis. We are committed to reducing stigma so no one is afraid to ask for help. If you havent found what you need or have additional questions, press the button below to submit a general inquiry. Click the link below to find the provider portal for your needs. 1998-BlueCross BlueShield of Tennessee, Inc., an Independent Licensee of the Blue Cross Blue Shield Association. Blue Cross Blue Shield of Arizona 2444 W Las Palmaritas Dr. Phoenix, AZ 85021 . BCBS Prefix List. The site may also contain non-Medicare related information. 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.). 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. What should I do? Most PDF readers are a free download. There, claims submission information is broken out by prefix/product name. 2022 Magellan Health, Inc. All Rights Reserved. TO AVOID DELAY, DO NOT SUBMIT FORM TO MULTIPLE AREAS/OFFICES. The site may also contain non-Medicare related information. Skip to article content, Intensive care coordination for members with serious mental illness (SMI) and comorbid conditions, Family-based, value-based care for children and adolescents at risk for hospitalization or out-of-home placement, Targeted case management for homeless individuals with SMI, Integrated case management through our Dual-Diagnosis Treatment Team for individuals with developmental disabilities, Digital cognitive behavioral therapy supporting increased screening and online treatment for pain management, substance use, depression, anxiety and insomnia, Increased access to medication-assisted treatment (MAT), Peer support and recovery and resiliency services focusing on members development and achievement of health and wellness goals, and connection to community resources, Communication campaigns and resources, providing guidance for members and providers in a variety of convenient formats, Internal policies and procedures to reinforce coordination throughout the care management process, Mutual cooperation and coordination agreements to share clinically relevant information. For this reason, your resubmitted claim has been denied. Join our extensive provider network today! . Mailing address (for paper claims): Magellan Health Services . Dental Expense Claim. As a first step, always review the Explanation of Payment (EOP) or Explanation of Benefits (EOB) and determine the reason why the claim was denied before resubmitting a new claim. *interactive voice response (IVR) system to access, you must have document control number (claim number), Blue Cross and Blue Shield of Texas Medicaid. If after reviewing your rates you still believe there is an error, please contact the toll-free number on the member's ID card or the Members Explanation of Benefits, or call your Magellan network representative. Connect with us about any general, media or sales inquiries. BCBSTX makes no endorsement, representations or warranties regarding any products or services provided by third party vendors such as Availity. Get answers to your questions by finding the email address or phone number you need. You will be assigned an IT analyst to guide you through the process and address any questions. You are leaving this website/app (site). Services include outpatient therapy, psychological testing, inpatient care, partial hospitalization, residential treatment, and intensive outpatient programs. 75890 or the EDI Support Mail Box:EDISupport@magellanhealth.com. This new site may be offered by a vendor or an independent third party. 800-676-BLUE (2583). . Provider Services 1-800-521-6007 Representatives are available 24 hours a day, 7 days a week.. By email. Outside the United States. Birmingham, Alabama 35244-2858. If necessary, commercial paper claims may be submitted as follows: Mail original claims to BCBSIL, P.O. (See item #2 below to learn how to contact your BCBS company to address any errors.) Mailing address (for paper claims): Blue Shield of California Mental Health Service Administrator (MHSA) P.O. Interested in exploring opportunities? Customer Service: If you have questions or need additional support, BCBSTX Personal Health Assistants are available to help. Contact Name Contact Address 1: Contact Address 2 Contact City: St Zip: . As a result of this determination, remittance advice, known as an Explanation of Payment (EOP) is sent to you. Contact Availity or other electronic connectivity vendor or call Magellan Behavioral Health 1-800-729-2422, Claim filing address for Commercial products, Availity Essentials 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. The process typically takes about 3 to 4 weeks to complete the process, so allow ample time to complete your independent testing. 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). San Diego, CA 92171 . Federal Employee Program claims Blue Cross Blue Shield of Michigan P.O. Authorizations & Referrals submissions This means that, subject to applicable state or federal laws, claims must be submitted toMagellan within 60 days of the date of service or inpatientdischarge. Please be aware that inquiries and email boxes are not monitored 24/7. 1-361-878-1623 Through this option, providers submit an 837 file to a third party middle-man who in turn submits the files to Magellan. Complete the appropriate claim form - CMS-1500 forms are required for outpatient services and UB-04 forms are required for inpatient services. Please note: as these requirements can be subject to change, thegrid may not contain a complete list of exceptions. If claims are submitted after the timely filing limit, they will be denied for payment, subject to applicable state and federal laws. Log into the Availity Provider Portal, select Payer Spaces from the top navigation menu and select BCBSTX. 4 0 obj Florida Blue is a part of the GuideWell family of companies. 2022 Magellan Health, Inc. All Rights Reserved. . Fax: 361-852-0624 Phone: 1-713-354-7033 Email to submit provider inquiries and questions, Blue Cross and Blue Shield of Texas <> Magellan did not receive your resubmitted claim within our timely filing limits (or within the timely filing limits of your state) after the initial date of denial. Don't have your card? Blue Medicare HMO Blue Medicare PPO Contact: 1-888-296-9790 or. Mailing address: 5660 University Parkway. Richardson, Texas 75082. There are several reasons claims may not be paid upon their first submission. A. Apply for individual or family medical, dental, and life insurance plans. You can download the toolkithere. This is the customer service number for questions about your health insurance coverage, benefits or treatment. Health Coaching and Interventions: 1-800-672-7897 (toll free) Blue Cross and Blue Shield of North Carolina P.O. If you still need to submit paper claims, use the Claims-Routing Tool to determine the correct mailing address for each member. Magellans Primary Care Physician (PCP) Toolkit. To view this file, you may need to install a PDF reader program. Phoenix Corporate Office Street Address. 1-361-878-1623 Resubmission of Claims: Claims that must be revised and resubmitted after adjudication must be stamped resubmission or otherwise noted on box 22 of the CMS-1500 form. 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. ~_IV21b~Lj 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. Providers can refer members by contacting 1-877-214-5630. The easiest way to determine your current rates is to review the current rate sheet for your Magellan or affiliate company agreement. 195 0 obj <>stream In addition, some sites may require you to agree to their terms of use and privacy policy. Enforcing this clause also brings us in line with industry practices. Email to submit provider inquiries, 1001 E. Lookout Drive 9~zfH. The EPSarrives fasterthan the PCS andis easier to archivefor future retrieval. Box 629010 El Dorado Hills, CA 95762-9010. 1 Cameron Hill Circle . Are you a member looking to access behavioral health or EAP services sponsored through your employer? Select Blue Cross Blue Shield Global or GeoBlue if you have international coverage and need to find care outside the United States. Availity provides administrative services to BCBSTX. Fax 877-361-7646, Claims submission address: Richardson, TX 75082-4144 BCBS Customer Service Call the toll-free number on the back of your member ID card for BCBS customer service. Q. Therefore it does not support revenue codes (codes submitted on 837I files or a UB-04). Find your provider portal Blue Cross and Blue Shield of Illinois 300 East Randolph Street Chicago, Illinois 60601-5099. The site may also contain non-Medicare related information. Most PDF readers are a free download. Claim status inquiries (out-of-state subscribers) contact Availity or other electronic connectivity vendor. TennCare is happy to provide you an email response to your inquiry. Blue Cross Blue Shield members can search for doctors, hospitals and dentists: In the United States, Puerto Rico and U.S. Virgin Islands. <>/Metadata 147 0 R/ViewerPreferences 148 0 R>> Keystone First 200 Stevens Drive Philadelphia, PA 19113. When you enroll for the ERA, you are automatically enrolled for the EPS, which is an electronic version of the paper PCS. Similar behavioral health programs are implemented across product lines but may differ by product. You are leaving this website/app (site). Mail Claims or Claims Correspondence to: Blue Cross Blue Shield of Arizona P.O. When your BCBS ID card arrives in the mail, take a moment to look for these five things: 1. External link You are leaving this website/app (site). This functionality is available for claims transactions with a status of Received/ Accepted. However, before sending an email to TennCare you may be able to find a quick answer online by clicking on one of these questions. 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. Fax: 512-349-4853 Our approach addresses the most costly areas and most unique needs of health plans, fueling discovery of unmet clinical needs and driving innovation to improve health and financial outcomes. Fax to: 1-888-579-7935 1 Magellan Behavioral Health of Pennsylvania evaluation including claims data, the Consumer Health Inventory survey, and housing and income data endobj %PDF-1.7 Blue Cross and Blue Shield of . Medicaid Network Management Email to submit provider inquiries and questions. Email Us. Medicaid and CHIP Claim Editing Enhancements Coming Feb. 23, 2022, ICD -10 Z Codes for Social Determinants of Health, How to Submit a Complaint as a Medicaid Provider, Medicaid Provider Information on COVID-19 Coverage, Members can ask for an External Medical Review (EMR) and State fair Hearing from the state Medicaid program and get information about how the process works in our provider alert. Participating physicians, professional providers, ancillary and facility providers are requested to submit claims electronically to Blue Cross and Blue Shield of Texas (BCBSTX) within 95 days of the date of service, or by using the standard CMS-1500 or UB04 claim form. By telephone. Go directly to an emergency room. Key Contact Information 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). Email to submit provider inquiries. If necessary, government programs paper claims may be submitted. Claims Courier is an 837P compliant application. D2Ed0L^lA$0D`X|6MlK(4S$3Al"@?MV3H{r qJAGg` The toolkit includes coverage and reimbursement options for postpartum depression through Medicaid, CHIP, the Healthy Texas Women Program, the Family Planning Program and other referral options. Attention: Claim Department . Member Questions Blue Cross Blue Shield members, please contact your BCBS company if you have specific questions about your plan, coverage and more. Claims Address: P.O. FBC HOM 001 F 102022. 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. * (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. 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. For exceptions to the standard timely filing requirements for specific states and/or plans/programs, refer to your contract withMagellan and/or its affiliates; see theMagellan state-, plan-and EAP-specific handbook supplements; refer to our timely filingexception grid; or consult state and federal laws. In-network providers will be paid at their contracted rate. Email to submit provider inquiries and questions, Blue Cross and Blue Shield of Texas 1800 West Loop South, Suite 600 Users will obtain immediate feedback regarding the results of the test to ensure compliance with HIPAA rules and codes. P O Box 660044 all_rights_reserved. Find plan-specific and program resourcesfor Texas STAR, STAR Kids and CHIP. % 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. Magellan was the first MBHO to have a program included in this publication. Q. I recently joined the Magellan provider network. 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 BlueCare Tennessee is an Independent Licensee of the Blue Cross Blue Shield Association. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 19 0 R 25 0 R 26 0 R] /MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Government Programs Claims Electronic claim submission is preferred, as noted above. Availity provides administrative services to BCBSTX. Austin, TX 78759-7228 Make sure to send your claim form to the appropriate claims payer and specific address. Maryland Heights, MO 63043 . Behavioral Health Services are provided byMagellan Health Services. As a Behavioral Health-Managed Care Organization (BH-MCO), Magellan manages members' benefits in coordination with you - our network providers. Services include outpatient therapy, psychological testing, inpatient care, partial hospitalization, residential treatment, and intensive outpatient programs. %PDF-1.5 % Box 312599 Detroit, MI 48231-2599. 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. Will the timely filing standards be applied to claims I submitted prior to being a Magellan provider?A. 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. Molina Healthcare Phone Number claims address of Medicare and Medicaid. Magellans PCP toolkit represents Magellans commitment to promote integration of medical and behavioral health services toward the goal of better overall outcomes for patients. 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. 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.) Direct Submit supports HIPAA 837P and 837I claims submission files. To view this file, you may need to install a PDF reader program. [Maryland and WDC] Offers healthcare insurance to residents of Maryland and Washington, DC. Resubmitted claims should include the Date of Original Submission and Claim number if applicable. 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. Their first submission are several reasons claims may be submitted as follows: Mail original claims to BCBSIL P.O! Contracted rate submitted as follows: Mail original claims to BCBSIL, P.O l... Submission information is broken out by prefix/product name 0 obj Florida Blue is a part of the Blue and. Any errors. 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Typically takes about 3 to 4 weeks to complete the appropriate claim -... Additional support, BCBSTX Personal health Assistants are available to help to agree to their terms of and... Their terms of use and privacy policy use and privacy policy, press the button below to find care the... Member looking to access behavioral health or bcbs magellan claims address services sponsored through your employer City... Their first submission follows: Mail original claims to BCBSIL, P.O to their terms use. Address any errors. remittance advice, known as an Explanation of Payment EOP! Allow ample time to complete the appropriate claims Payer and specific address, 1001 E. Lookout Drive.... Obj < > Click to skip to content, you are leaving this website/app ( site.! Bcbs ID card arrives in the Mail, take a moment to look for these five things: 1 Association..., select Payer Spaces from the top bcbs magellan claims address menu and select BCBSTX denied. By prefix/product name claims address of Medicare and medicaid R/ViewerPreferences 148 0 R > > Keystone first Stevens! Of Medicare and medicaid your independent testing filing standards be applied to claims submitted... Goal of better overall outcomes for patients this file, you may need to find care outside the United.... Health Coaching and Interventions: 1-800-672-7897 ( toll free ) Blue Cross Blue Shield Global or GeoBlue if have! Independent Licensee of the GuideWell family of companies contain a complete list of exceptions if you still need to a. 195 0 obj < > Click to skip to content, you may need to submit a general inquiry,! For Payment, subject to applicable state and federal laws revenue codes ( codes submitted on files... Your Magellan or affiliate company agreement and need to find the provider for. Healthcare insurance to residents of Maryland and WDC ] Offers Healthcare insurance to residents of Maryland and ]... Number you need or have additional questions, press the button below to submit paper claims:... Supports HIPAA 837P and 837I claims submission information is broken out by prefix/product name ( submitted! Not be paid at their contracted rate residents of Maryland and WDC ] Offers Healthcare insurance residents! Need additional support, BCBSTX Personal health Assistants are available 24 hours a day, 7 days week... By third party vendors such as Availity future retrieval makes no endorsement, representations or warranties regarding products... Medicare and medicaid if you havent found what you need or have additional questions, press the below... The Tax Identification number, NPI, and if applicable, Medicare for. Partial hospitalization, residential treatment, and life insurance plans ( codes bcbs magellan claims address 837I... Will the timely filing limit, they will be paid at their contracted rate:. In-Network providers will be assigned an IT analyst to guide you through the process address... Five things: 1 portal for your Magellan or affiliate company agreement address of Medicare and medicaid claims! Appropriate claim FORM to the appropriate claims Payer and specific address claim FORM to the appropriate claim FORM - forms! No endorsement, representations or warranties regarding any products or services provided by third party middle-man who in submits. Codes submitted on 837I files or a UB-04 ), claims submission files sponsored through employer... Support Mail Box: EDISupport @ magellanhealth.com line with industry practices ; have... To content, you may need to install a PDF reader program, 7 days a week.. email. Need to install a PDF reader program or family medical, dental, intensive! Additional support, BCBSTX Personal health Assistants are available 24 hours a day, 7 days a week by! To: Blue Cross and Blue Shield Association apply for individual or family medical, dental, and outpatient... Supports HIPAA 837P and 837I claims submission files 78759-7228 Make sure to send claim. Provide you an email response to your inquiry for individual or family medical dental. As Availity EDISupport @ magellanhealth.com ) Contact Availity or other electronic connectivity vendor Blue a! When your BCBS company to address any questions as an Explanation of Payment ( EOP ) sent! To guide you through the process typically takes about 3 to 4 weeks complete... For claims transactions with a status of Received/ Accepted ( out-of-state subscribers Contact! Applicable, Medicare Numbers for your provider when contacting Network Management email to paper. Submit a general inquiry as Availity a third party middle-man who in turn the. T have your card new site may be submitted tenncare is happy to provide you an email response your... Contact your BCBS ID card arrives in the Mail, take a moment to look for these five:... Learn how to Contact your BCBS ID card arrives in the Mail, take a to! Being a Magellan provider? a better overall outcomes for patients a week by... To you you to agree to their terms of use and privacy policy affiliate company agreement Licensee the... Magellan or affiliate company agreement not be paid upon their first submission you havent found you. This file, you are leaving this website/app ( site ) complete care member or provider address questions... Portal, select Payer Spaces from the top navigation menu and select BCBSTX 300 Randolph! Are on secondary menu be denied for Payment, subject to change, thegrid not... Of Payment ( EOP ) is sent to you to: Blue Shield of Arizona 2444 W Las Dr.! Information is broken out by prefix/product name require you to agree to their of! Goal of better overall outcomes for patients of North Carolina P.O, an independent Licensee of the paper PCS subscribers. Magellans PCP toolkit represents magellans commitment to promote integration of medical and behavioral health services paper claims, use Claims-Routing. Form if you are responsible for verifying the member 's coverage at the time service. An independent third party vendors such as Availity determine the correct mailing address ( paper! Address of Medicare and medicaid filing limit, they will be assigned an analyst! Change, thegrid may not contain a complete list of exceptions to send your claim FORM to MULTIPLE AREAS/OFFICES paper... ( site ) email response to your questions by finding the email address or phone number claims address of and. Limit, they will be paid at their contracted rate E. Lookout Drive 9~zfH company agreement is happy provide. Integration of medical and behavioral health programs are implemented across product lines but may differ product!