bcbs magellan claims address

In addition, some sites may require you to agree to their terms of use and privacy policy. stream endstream endobj startxref 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. 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. This is the customer service number for questions about your health insurance coverage, benefits or treatment. 450 Riverchase Parkway East. Its similar to the CMS 1500 claim form, with additional fields to make the application HIPAA-compliant. The process typically takes about 3 to 4 weeks to complete the process, so allow ample time to complete your independent testing. Select the best option and fill out a form and we will reach out to you as soon as possible! General Information: 1-972-766-6900. BlueCare Tennessee is an Independent Licensee of the Blue Cross Blue Shield Association. BCBS Customer Service Call the toll-free number on the back of your member ID card for BCBS customer service. %%EOF You should also check with your billing service, clearinghouse or software vendor to confirm ERA-compatibility and availability of auto-posting software. For Emergency Situations, Always Call 911. A. Instructions for submitting requests for predetermination 1-361-878-1623 Austin, TX 78759-7228 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). Skip to article content, Electronic Data Interface (EDI) via Direct Submit, Claims Courier-Magellans Web-based Claims submission tool, Paper Claims: CMS-1500 (Non-Facility-Based Providers) or UB-04 (Facility-Based Providers). Federal Employee Program claims Blue Cross Blue Shield of Michigan P.O. Registertoday with no set-up fees, monthly fees or per-claim fees charged to providers by visiting theAvaility websiteand selecting"Register". Pharmacy Claim. The easiest way to determine your current rates is to review the current rate sheet for your Magellan or affiliate company agreement. Magellan Behavioral Health Providers! Government Programs Claims Electronic claim submission is preferred, as noted above. As a Behavioral Health-Managed Care Organization (BH-MCO), Magellan manages members' benefits in coordination with you - our network providers. Resubmissions must be submitted within 60 days from the date of denial. Box 52890 Bellevue, WA 98015- 2890 West Virginia Highmark BCBS of WV P.O. Q. I have never had a claim denied for timely filing reasons before; why is it being denied now?A. ~_IV21b~Lj 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. 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? Blue Cross and Blue Shield of Texas Therefore it does not support revenue codes (codes submitted on 837I files or a UB-04). 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). Questions related to a specific claim should be directed to the toll-free number on the member's ID card or the Explanation of Benefits. 2. From theResourcessection, selectState & Plan Information,then under State-Specific, click theTexaslinkto access to access the following forms: Texas State Bill 1742: Preauthorization requirements, Standard Prior Authorization Request Form for Health Care Services, Texas Health and Human Services Commission, Preauthorization requirementsfor Blue Cross and Blue Shield of Texas commercial plans, Provider bulletin regarding Texas HB 3041, American Society of Addiction Medicine (ASAM), BlueCross BlueShield of Texas Medicaid STAR,CHIP and STAR Kids, Texas-specificABA Treatment Plan/Concurrent Review. Fax: 361-852-0624 In-network providers will be paid at their contracted rate. and the amount . PO Box 10191. There is a simple testing process to determine if Direct Submit is right for you. Magellan Healthcare Solutions for Complex Care Needs: Behavioral Health, Specialty Imaging, Automated Prior Authorization, Employee Assistance. Behavioral Health Program Blue Cross and Blue Shield of Illinois (BCBSIL) manages behavioral health services for all commercial, non-HMO members who have behavioral health benefits through our group or retail products. BCBSTX makes no endorsement, representations or warranties regarding third party vendors and the products and services they offer. [Maryland and WDC] Offers healthcare insurance to residents of Maryland and Washington, DC. Clean claims are defined as claims that can be processed without obtaining any additional information from the provider or from a third party. Please emailwomenshealth@hhsc.state.tx.uswith any questions. 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). Blue Shield Initial Appeal Resolution Office Attn: Hospital Exception and Transplant Team P.O. Note: Predetermination requests for members with Blue Cross and Blue Shield benefits in another state should be sent to the Plan indicated on the members ID card. Phone Numbers for Providers. Are you a member looking to access behavioral health or EAP services sponsored through your employer? 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. Q. Dallas, TX 75266-0044 Mail Claims or Claims Correspondence to: Blue Cross Blue Shield of Arizona P.O. BlueCross BlueShield of Tennessee is a Qualified Health Plan . Through this option, providers submit an 837 file to a third party middle-man who in turn submits the files to Magellan. . Sign up to receive information and updates from Magellan Healthcare on behavioral health webinars and education! BCBSTX Behavioral Health Unit For prior authorization and referrals managed by Magellan: Magellan Behavioral Health Providers of Texas, Inc. 1-800-729-2422: Behavioral health services - claims status inquiries. BlueCard is our out-of-area program that allows members from other Blue Cross and Blue Shield Plans to receive health care benefits when travelling or residing in another Blue Plan's service area. In addition, some sites may require you to agree to their terms of use and privacy policy. hbbd```b``A$ Services include outpatient therapy, psychological testing, inpatient care, partial hospitalization, residential treatment, and intensive outpatient programs. Providers can refer members by contacting 1-877-214-5630. Arboretum Plaza II endobj Users will obtain immediate feedback regarding the results of the test to ensure compliance with HIPAA rules and codes. One option is Adobe Reader which has a built-in reader. Place of Service 23. Corporate Address. This claim is a resubmit; why was it denied for timely filing?A. Outside the United States. 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. You may direct any questions about the form to Magellan at the phone number on the form. Box 211184 Eagan, MN 55121 Click to skip to content, You are on secondary menu. Providers Are you a provider looking for information on Magellan plans, joining our network, or performing secure transactions related to your practice or Magellan members? 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. The ERA or ANSI 835 transaction is a HIPAA-compliant method of receiving claim payment and remittance details. TTY: 735-2989. P O Box 660044 PDF File is in portable document format (PDF). Magellan Behavior Health Services coordinates all behavioral health (mental health and chemical dependency) services for Medicaid (STAR), CHIP, and STAR Kids members. . Most PDF readers are a free download. <>/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>> Blue Cross and Blue Shield of . P.O. Member Services 1-800-521-6860 TTY: 1-800-684-5505 Representatives are available 24 hours a day, 7 days a week.. What should I do? Birmingham, Alabama 35244-2858. Claims Address. Box 7026 Wheeling, WV 26003 Wisconsin Anthem Blue Cross Blue Shield Molina Healthcare Phone Number claims address of Medicare and Medicaid. 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. Blue Cross and Blue Shield of Texas. Box 21974 Eagan, MN 55121 1-800-778-2119 Verify eligibility and benefits at 1-888-356-7899 www.pearprovider.com Independence Blue Cross Federal Employee Program (FEP) PPO "R" followed by 8 numeric characters 54704 837I - 12X26 Facility Providers Claims 1Only Claims Receipt Center We really moved forward together., -Magellan Behavioral Health of Pennsylvania (HealthConnections) member. Other Adobe accessibility tools and information can be downloaded at https://access.adobe.com. Richardson, TX 75082-4144 All Rights Reserved. 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 Visit our Provider Portals English Behavioral health benefits are integrated into Anthem medical plans for a full spectrum of coordinated care for our members. Email to submit provider inquiries and questions, Blue Cross and Blue Shield of Texas 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 Address Independence Administrators P.O. 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. This functionality is available for claims transactions with a status of Received/ Accepted. 1-915-496-6600, press 2 10 things to check each time you submit a claim: Q. I believe I am being paid the incorrect rate. Behavioral Health Services are provided byMagellan Health Services. (336) 774-5400. Join our extensive provider network today! The EOP includes details of the payment or the denial. Go directly to an emergency room. Don't have your card? To verify eligibility or obtain authorization, you may contact Magellan at 1-800-424-4399. . Find My BCBS Company Maryland Heights, MO 63043 . 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. Box 710400, San Diego CA 921710400 Phone Number: (877) 263-9952 Blue Shield of CA: Payer ID: BS001 Claims Address: P.O. Box 272640 Chico, Ca 95927-2640 Phone: (800) 541-6652 Fax: (818) 228-5014 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. For the most recent information available in Pennsylvania including vaccine details, go to the, Claims/ Check Eligibility/ View Authorizations, You are on primary menu. Contact Magellan Healthcare. Electronic claims filing system, Benefit disclosure information (form available online), Online: Use Availity Attachments application, Mail form to: These members enjoy the same level of coverage as other Medicare Advantage members with no network restrictions. 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 17806 IH 10 West, Bldg II, Suite 200 Mailing address: 5660 University Parkway. <> We are committed to reducing stigma so no one is afraid to ask for help. Claims must be submitted and received by us within 24 months after the service takes place to be eligible for benefits. The EPSarrives fasterthan the PCS andis easier to archivefor future retrieval. In addition, some sites may require you to agree to their terms of use and privacy policy. Need Help? 1999-2022 commercial_footer_copyright_magellan_link. NOTE: To gain access to the above Blue Cross and Blue Shield of Texas Medicaid Tools you must be registered with Availity. Effective 6/27/2022, a Behavioral Health Service Coordination can help members manage complex conditions related to mental health and substance use. 1-800-749-0966 If you are able to create an 837 file in a HIPAA compliant format, we. Click to skip to content. Claims Submitting Claims Claims will continue to go directly to BlueCross. 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 Please send your claims for imaging procedures to the following address: BlueAdvantage Operations 1 Cameron Hill Suite 0002 Chattanooga TN 37402-0002 Please continue to use EDI claims submission. This practice is called balance billing and is not permitted. 75890 or the EDI Support Mail Box:EDISupport@magellanhealth.com. Appeals Provider Manual June 2021 15.5 15 Requesting an appeal For all Part C and Part D standard appeals, the Member or his or her authorized representative should mail the written appeal to: Keystone 65 HMO/Personal Choice 65 PPO Member Appeals Department Pharmacy claim submission and Pro- DUR questions ; 24 hours / 7 days a week; Magellan Rx Management Pharmacy Call Center: 1-800-424-5725. Box 629010 El Dorado Hills, CA 95762-9010. The site may also contain non-Medicare related information. The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies. 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. Paper Pharmacy Claims: Send to: Attention Paper Claims Processing. 2 Magellan Pennsylvania provider data, July 2017-June 2018 Medicare Plus Blue SM PPO claims Blue Cross Blue Shield of Michigan P.O. Horizon Behavioral Health. Box 660027 . ), For services managed by Magellan: Email to submit provider inquiries and questions, Blue Cross and Blue Shield of Texas Copyright 2022Health Care Service Corporation. Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association. PO Box 660241 Magellan has separate post office boxes for the accounts for which we provide claims payment services. Why was my claim denied? As a result of this determination, remittance advice, known as an Explanation of Payment (EOP) is sent to you. External link You are leaving this website/app (site). * (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. San Diego, CA 92171 . % Magellan's quality improvement program to reduce inpatient mental health readmissions was selected by NCQA for inclusion in its benchmarking publication, Quality Profiles. Box 629011 El Dorado Hills, CA 95762-9011. 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. Credentialing Status. 800-637-0171, press 3 Provider sends HIPAA transaction files directly to and receives responses from Magellan without a clearinghouse. Fax: 1-713-663-1227 External link You are leaving this website/app (site). 2 0 obj <>/Metadata 147 0 R/ViewerPreferences 148 0 R>> Blue Cross and Blue Shield of Texas TO AVOID DELAY, DO NOT SUBMIT FORM TO MULTIPLE AREAS/OFFICES. This new site may be offered by a vendor or an independent third party. Its a simple six-step process which includes uploading and sending test files. 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. In addition, some sites may require you to agree to their terms of use and privacy policy. 4444 Corona, Suite 148 endobj Phone: (800) 824-8839 Short-term claims for Blue Shield Life & Health Insurance Company Blue Shield Life & Health Insurance Company P.O. Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association. No. We provide free eligibility and benefits verification as part of our billing . Out-of-network providers will be paid the Medicare-allowed amount less any member cost-sharing. <>/Metadata 345 0 R/ViewerPreferences 346 0 R>> Please note: as these requirements can be subject to change, thegrid may not contain a complete list of exceptions. Email to submit provider inquiries. 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 havent found what you need or have additional questions, press the button below to submit a general inquiry. 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. 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. You are responsible for verifying the member's coverage at the time of service. 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. A Claims Courier Demo can be accessed at: Claims Courier is a free web-based data entry application. 4 0 obj If you still need to submit paper claims, use the Claims-Routing Tool to determine the correct mailing address for each member. The form cannot be used for any other purpose except to request prior authorization of a healthcare service. 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 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. To submit claims on Magellans website: Providers can submit claims using the Claims Courier application by signing in to the. Beaumont, TX 77702-1954 Richardson, Texas 75082. 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 Box 2291 Durham, NC 27702-2291 . Mailing address (for paper claims): Blue Shield of California Mental Health Service Administrator (MHSA) P.O. Specializing in the most complex, costly areas of care, Magellan Healthcare partners with states to manage behavioral health programs. Explore more about our programs and services addressing behavioral health, including substance use disorder treatment, and integration with physical health. endobj <> Contact Availity or other electronic connectivity vendor or call Magellan Behavioral Health 1-800-729-2422, Claim filing address for Commercial products, Availity Essentials 9442 Capital of Texas Hwy N, Suite 500 For urgent requests only: endobj Magellan steps in for our members to help prevent and address the risks of one affecting the other. 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.. 1800 West Loop South, Suite 600 Click the link below to find the provider portal for your needs. You will be assigned an IT analyst to guide you through the process and address any questions. 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.

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