El Paso, TX 79912 -6156 Self-enroll by creating a unique user ID and password. Email to submit provider inquiries and questions, Blue Cross and Blue Shield of Texas Magellan steps in for our members to help prevent and address the risks of one affecting the other. Contact Magellan Healthcare. Mailing Address, Customer Service and Claims Contact Information Line of Business Customer Service/ Telephone Number Address Blue Shield of CA (BSC)/ MHSA 1-877-263-9952 1-800-424-6064 1-800-424-5999, option 3 Claims Mailing Address Blue Shield of California Mental Health Service Administrator (MHSA) P O Box 710400 San Diego, CA 92171 Medicaid Network Management Email to submit provider inquiries and questions. * (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. Join our extensive provider network today! Medicare Plus Blue SM PPO claims Blue Cross Blue Shield of Michigan P.O. . . 1800 West Loop South, Suite 600 FBC HOM 001 F 102022. 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. Fax: 713-663-1227 Ask them where out of state claims should be filed. Email to submit provider inquiries and questions, North Texas Dallas, Fort Worth, East Texas (ExcludesBastrop, Bell, Bosque, Burleson, Burnett, Caldwell, Falls, Fayette, Hays, Hill, Lee, Leon, Limestone, Madison, Milam, McLennan, Robertson, Travis, Wichita and Williamson counties), Blue Cross and Blue Shield of Texas This date is based on the date of the other carriers decision. *interactive voice response (IVR) system to access, you must have document control number (claim number), Blue Cross and Blue Shield of Texas Medicaid. Behavioral health benefits are integrated into Anthem medical plans for a full spectrum of coordinated care for our members. Are you a member looking to access behavioral health or EAP services sponsored through your employer? All Rights Reserved. Contact Us. 114 Mesa Park Dr. Suite #300 For eligibility, prior authorization or claims inquiries, call 877-299-1008. 1-915-496-6600, press 2 In Pennsylvania, Magellan works with county partners in Bucks, Cambria, Lehigh, Montgomery and Northampton counties. 4 0 obj Behavioral Health Services: 1-800-266-6167. Availity provides administrative services to BCBSTX. Attention: Claim Department . Registertoday with no set-up fees, monthly fees or per-claim fees charged to providers by visiting theAvaility websiteand selecting"Register". <> Magellan was the first MBHO to have a program included in this publication. Contact Availity or other electronic connectivity vendor or call 1-800-451-0287*, *interactive voice response (IVR) system to access, you must have full member's information (for example, member's ID, patients date of birth, etc. P.O. In Texas, Magellan uses the American Society of Addiction Medicine (ASAM) criteria as the basis for the utilization reviews of substance use disorder cases. A. Fax: 361-852-0624 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. Through this option, providers submit an 837 file to a third party middle-man who in turn submits the files to Magellan. Join Blue Cross and Blue Shield companies and leading voices from NAMI, Business Group on Health and Morgan, Lewis & Bockius LLP as they come together to discuss strategies for addressing pandemic-amplified behavioral health challengesparticularly as vaccines are rolling out and more focus on hybrid work models are set to spur workplace changes that can impact employee behavioral health. ), For services managed by Magellan: Fax to: 1-888-579-7935 There, claims submission information is broken out by prefix/product name. The EOP includes details of the payment or the denial. P.O. Fax: 361-852-0624 Secure Provider Web Portal (Electronic Verification System - EVS) Online Provider Enrollment (OPE) Online Prior Authorization (PA) system Online Claims Submission Online Provider Claim Appeals Audio Response System (ARS) (800-942-6511) Real time CAQH/CORE EDI eligibility and claim verification Provider PASRR Nevada Medicaid COVID-19 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. Sign up to receive information and updates from Magellan Healthcare on behavioral health webinars and education! For urgent requests only: One option is Adobe Reader which has a built-in reader. 1-713-663-1149 In addition, some sites may require you to agree to their terms of use and privacy policy. 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. Does this timely filing limit apply to all claims for all members (e.g., COB, Medicare, etc.)?A. A. Contact Information. Email to submit provider inquiries, Phone: 1-972-766-1380 TennCare is happy to provide you an email response to your inquiry. If necessary, commercial paper claims may be submitted as follows: Mail original claims to BCBSIL, P.O. Contact Name Contact Address 1: Contact Address 2 Contact City: St Zip: . The following address should be used for claims related to outer counties: Outer County Claims - Lehigh, Lancaster, Northampton, and Berks County Claims Receipt Center P.O. endobj 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 process typically takes about 3 to 4 weeks to complete the process, so allow ample time to complete your independent testing. Box 710400, San Diego CA 921710400 Phone Number: (877) 263-9952 Blue Shield of CA: Payer ID: BS001 Claims Address: P.O. 1 Cameron Hill Circle . Blue Cross Blue Shield members can search for doctors, hospitals and dentists: In the United States, Puerto Rico and U.S. Virgin Islands. Please be aware that inquiries and email boxes are not monitored 24/7. 4444 Corona, Suite 148 Participating physicians, professional providers, ancillary and facility providers may not seek payment from the member for claims submitted after the 95-day filing deadline. Molina Healthcare Phone Number claims address of Medicare and Medicaid. General Information: 1-972-766-6900. 1001 E. Lookout Drive 2 Magellan Pennsylvania provider data, July 2017-June 2018 Paper Claims Address Independence Administrators P.O. Dallas, TX 75266-0241 In-network providers will be paid at their contracted rate. 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. 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. Claims must be submitted and received by us within 24 months after the service takes place to be eligible for benefits. General Member Service Correspondence. Claim forms must be submitted to: Blue Cross and Blue Shield of Alabama. Q. Richardson, TX 75082 This functionality is available for claims transactions with a status of Received/ Accepted. Richardson, TX 75082-4144 Services billed beyond 95 days from the date of service are not eligible for reimbursement. 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.) EFT is a direct deposit claim payment from BCBSTX to your designated bank account. BlueCare Tennessee is an Independent Licensee of the Blue Cross Blue Shield Association. TennCare Provider Services 1-800-852-2683. Submit completed forms to: Fax: 972-766-2231 DO NOT COMPLETE THIS FORM IF YOU ARE A MAGELLAN COMPLETE CARE MEMBER OR PROVIDER. Dallas, TX 75266-0044 Fax: 1-800-424-5881. APPEALS . 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. 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.). Box 805107, Chicago, IL 60680-4112. and the amount . Services that require pre-authorization Q. Services include outpatient therapy, psychological testing, inpatient care, partial hospitalization, residential treatment, and intensive outpatient programs. Box 310166 Detroit, MI 48231-0166. Fax: 713-663-1227 Dallas, TX 75266-0027, Prior authorization of Medical Services for the Health Insurance Marketplace for Blue Advantage HMO Members, Eligibility and benefits contact Availity or other electronic connectivity vendor or call 1-800-451-0287*, Behavioral health services mental health and chemical dependency, For prior authorization and referrals managed by BCBSTX: (includes inpatient, residential treatment center (RTC) programs, partial hospitalization and outpatient behavioral health services). Other Adobe accessibility tools and information can be downloaded at https://access.adobe.com. <> BCBS Prefix List - Alpha. Claims Submitting Claims Claims will continue to go directly to BlueCross. PO Box 10191. Note: For the requests below, utilize the indicated links: All other inquiries submit an email by selecting the office closest to your location and provide the Tax Identification Number, NPI, and if applicable, Medicare Numbers for your provider when contacting Network Management. You are responsible for verifying the member's coverage at the time of service. You should also check with your billing service, clearinghouse or software vendor to confirm ERA-compatibility and availability of auto-posting software. NOTE: To gain access to the above Blue Cross and Blue Shield of Texas Medicaid Tools you must be registered with Availity. 1-800-637-0171, press 3 or 1-713-663-1149 Richardson, TX 75082-4144 Not a Magellan provider yet? Click the link below to find the provider portal for your needs. To obtain information pertaining to your network status, contact our National Provider Line at (800) 397-1630 from 8 a.m.-8 . Email to submit provider inquiries and questions, Austinand Central TX (Bastrop, Bell, Bosque, Burleson, Burnett, Caldwell, Falls, Fayette, Hays, Hill, Lee, Leon, Limestone, Madison, Milam, McLennan, Robertson, Travis, Williamson counties), Blue Cross and Blue Shield of Texas Maryland Heights, MO 63043 . 2. endstream endobj startxref Fax 877-361-7646, Claims submission address: EAP providers can request an EAP authorization by leaving a brief voicemail message. BlueCross BlueShield of Tennessee is a Qualified Health Plan . Mailing address 1901 Market Street Philadelphia, PA 19103-1480 Email Complete the Provider Communications Email Sign-up Form to receive email updates with the latest information, including Partners in Health UpdateSM. To connect with someone on the right team, please choose an option below. No. 0 Where do I send the claim information?A. Blue Shield of California welcomes you. Email to submit provider inquiries and questions, Blue Cross and Blue Shield of Texas [Maryland and WDC] Offers healthcare insurance to residents of Maryland and Washington, DC. To view this file, you may need to install a PDF reader program. This new site may be offered by a vendor or an independent third party. Effective 6/27/2022, a Behavioral Health Service Coordination can help members manage complex conditions related to mental health and substance use. Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Claim status inquiries contact Availity or other electronic connectivity. For the most recent information available in Pennsylvania including vaccine details, go to the, Claims/ Check Eligibility/ View Authorizations, You are on primary menu. By telephone. If your ID card is not available, you may use one of the Customer Service telephone numbers below. In Pennsylvania, Magellan works with county partners in Bucks, Cambria, Lehigh, Montgomery and counties... 75082-4144 not a Magellan complete care member or provider click the link below to find the portal. A PDF reader program 2 Magellan Pennsylvania provider data, July 2017-June paper. Option below status of Received/ Accepted Administrators P.O billed beyond 95 days from date... Treatment, and intensive outpatient programs, Lehigh, Montgomery and Northampton counties which a. After the service takes place to be eligible for benefits the first MBHO have. 800 ) 397-1630 from 8 a.m.-8 include outpatient therapy, psychological testing, inpatient,! Mbho to have a program included in this publication Magellan complete care member or provider inpatient care, hospitalization... 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And Medicaid behavioral health or EAP services sponsored through your employer link below to find the portal. Up to receive information and updates from Magellan Healthcare on behavioral health benefits are integrated into Anthem medical for...
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