800-676-BLUE (2583). 2022 Magellan Health, Inc. All Rights Reserved. Providers can refer members by contacting 1-877-214-5630. Blue Cross Blue Shield members can search for doctors, hospitals and dentists: In the United States, Puerto Rico and U.S. Virgin Islands. Fax: 361-852-0624 For service questions, such as benefits, claims, bill pay or other issues: Call: 1-800-495-2583, 8 a.m.-8 p.m . PDF File is in portable document format (PDF). View help topics or login via our member website. Box 2291 Durham, NC 27702-2291 . Predetermination form and Email to submit provider inquiries. 800-637-0171, press 3 Clean claims are defined as claims that can be processed without obtaining any additional information from the provider or from a third party. Paper Claims Address Independence Administrators P.O. Contact Name Contact Address 1: Contact Address 2 Contact City: St Zip: . 4 0 obj <> 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. As a Magellan network provider, what is my timely filing limit?A. Enforcing this clause also brings us in line with industry practices. 1-800-637-0171, press 3 or 1-713-663-1149 We're here to help answer your questions. PO Box 10191. Premera Blue Cross (WA/AK) P. O. The ERA can be automatically posted to your patient accounting system. BCBS Customer Service Call the toll-free number on the back of your member ID card for BCBS customer service. 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. Fax: 713-663-1227 0 %PDF-1.7 Government Programs Claims Electronic claim submission is preferred, as noted above. BCBS Prefix List AAA to AZZ. For Emergency Situations, Always Call 911. . 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. Box 211184 Eagan, MN 55121 Find your provider portal Instructions for submitting requests for predetermination Austin, TX 78759-7228 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. HealthTrio Connect : Claim forms must be submitted to: Blue Cross and Blue Shield of Alabama. One option is Adobe Reader which has a built-in reader. PO Box 660241 Box 312599 Detroit, MI 48231-2599. Fax: 512-349-4853 (Note:For behavioral health professional providers, refer to the Network Management Office Locations listed above). 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. Interested in exploring opportunities? Postpartum depression is a common, potentially serious and sometimes life-threatening condition. Our innovative care coordination, case and utilization management programs, and vast network of behavioral health and specialty providers facilitate improved access to cost-effective and quality care while improving quality of life for the members we serve. Phoenix Corporate Office Street Address. The site may also contain non-Medicare related information. As a result of this determination, remittance advice, known as an Explanation of Payment (EOP) is sent to you. Box 52890 Bellevue, WA 98015- 2890 West Virginia Highmark BCBS of WV P.O. stream Fax: 1-713-663-1227 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. Q. I recently joined the Magellan provider network. 17806 IH 10 West, Bldg II, Suite 200 Preauthorization requirementsfor Blue Cross and Blue Shield of Texas commercial plans(PDF), Magellan'sannual preauthorization reportfor BCBSTX commercial plans (PDF), Provider bulletin regarding Texas HB 3041 (PDF). Upon receipt of the completed form(s), Magellan will begin the prior authorization process. 1998-BlueCross BlueShield of Tennessee, Inc., an Independent Licensee of the Blue Cross Blue Shield Association. TO AVOID DELAY, DO NOT SUBMIT FORM TO MULTIPLE AREAS/OFFICES. Florida Blue is a part of the GuideWell family of companies. Email to submit provider inquiries and questions, Blue Cross and Blue Shield of Texas Why was my claim denied? Other Adobe accessibility tools and information can be downloaded at https://access.adobe.com. There, claims submission information is broken out by prefix/product name. Email to submit provider inquiries and questions, Ambulatory Surgery Centers (ASC) Independent, Non-Hospital owned, Fax: 1-713-663-1227 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. 450 Riverchase Parkway East. Fax: 1-800-424-5881. Become an Anthem provider and join the nation's second- largest health plan-owned behavioral health company, serving more than 13 . Blue Cross Blue Shield of Massachusetts 101 Huntington Avenue, Suite 1300 Boston, MA 02199 . 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. Utilization Management/Medical Management/Case Management. For Texas-specific ABA resources,sign into this website. Eligibility and benefits 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). Find My BCBS Company Go directly to an emergency room. External link You are leaving this website/app (site). BlueCare Tennessee is an Independent Licensee of the Blue Cross Blue Shield Association. % TennCare Pharmacy Program 1-888-816-1680. ET, Monday through Friday. What should I do? This functionality is available for claims transactions with a status of Received/ Accepted. Looking to contact Magellan Rx Management? (page_last_updated 03/2022) Direct Submit supports HIPAA 837P and 837I claims submission files. Fax: 713-663-1227 Electronic claims filing system, Benefit disclosure information (form available online), Online: Use Availity Attachments application, Mail form to: 75890 or the EDI Support Mail Box:EDISupport@magellanhealth.com. Where do I send the claim information?A. Claims must be submitted and received by us within 24 months after the service takes place to be eligible for benefits. What should I do? 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 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. 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. In-network providers will be paid at their contracted rate. 1-361-878-1623 Click to skip to content, You are on secondary menu. Claims are paid based on your status on the date of service. 1 0 obj x]rFwVa1)dJr#Qk%QKQ[93 yvk#Y _wOOOaxzXn&Wrru;8}N7o|Q2l1}e/_{12|qE2QPQ&/=d_W?F|)eAW+@y^n|"Gc9zOh BCBS Provider Phone Number. 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. Medical Care Management 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. Mailing address (for paper claims): Magellan Health Services . <> Key Contact Information Care Management Contact Information . Winston-Salem, NC 27105. In accordance with applicable law, Magellan will pay clean claims within 45 days of the date of receipt. For the latest information on flexibilities and extensions due to COVID-19, refer to theTexas Medicaid & Healthcare PartnershipandTexas Health and Human Services Commissionwebsites. In Pennsylvania, Magellan works with county partners in Bucks, Cambria, Lehigh, Montgomery and Northampton counties. 1999-2022 commercial_footer_copyright_magellan_link. Magellan employs many methods to identify members with complex needs to match them with the appropriate level of specialized case management services, including: Our team provides the compassionate extra support individuals need to overcome significant behavioral health and life challenges. Claim status inquiries (out-of-state subscribers) contact Availity or other electronic connectivity vendor. . Users will obtain immediate feedback regarding the results of the test to ensure compliance with HIPAA rules and codes. Upon receipt of a claim, Magellan reviews the documentation and makes a payment determination. Read about our progress in the 2021 GuideWell Social Impact Report. 114 Mesa Park Dr. Suite #300 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. 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