Contact us as soon as possible because time limits apply. Send your claim or correspondence to the Blue Cross Blue Shield plan in the state where the ambulance picked up the patient.Example: An ambulance picks up the patient in Oregon and transports her to a care facility in Washington. Claims - SEBB - Regence Grievances must be filed within 60 days of the event or incident. Facility Services are services received for the use of a facility such as a hospital, emergency room, freestanding ambulatory facility, attended sleep study at outpatient part of a hospital, alcohol treatment facility or residential You are about to leave regence.com and enter another website that is not affiliated with or licensed by the Blue Cross Blue Shield Association. endobj You are about to leave regence.com and enter another website that is not affiliated with or licensed by the Blue Cross Blue Shield Association. Learn more on the HCA website. When you use a network provider or network pharmacy, you dont need to submit a claimthe provider or pharmacy will do it for you. Don't have your card? Allied professionals, including behavioral health, vision, chiropractic and other complementary service providers: Contact your allied provider relations representatives & consultants. Regence BlueCross BlueShield of Oregon offers health and dental coverage to 750,000 members throughout the state. Regence BlueShield of Idaho | Regence You must submit prescription drug claims within 12 months of purchase. You will also receive a decision on your appeal within 30 calendar days. We must notify you of our decision about your grievance within 30 calendar days after receiving your grievance. Make sure you contact the right company (see below). You have the right to file a grievance, or complaint, about us or one of our plan providers for matters other than payment or coverage disputes. Learn about Regence Lewiston, ID office. Regence BlueCross BlueShield of Oregon | Regence All features have been transitioned to the Availity Provider Portal. Management - prior auth/pre-service requests), Members: Log in or register - MyBlue Customer eService, Retail Pharmacy Program PO Box 52057 Phoenix, AZ 85072, Retail Pharmacy Program PO Box 52080 Phoenix, AZ 85072, Phone:800-552-0733Fax: 801-333-6523 (Mark claims: Attn New Claims)Email: Log in or register - MyBlue Customer eService, Regence BlueShield - FEPPO Box 857Lewiston, ID 83501, Regence BlueShield - FEPPO Box 1388Lewiston, ID 83501Customer Service. These forms explain what information should be included with your appeal and list the address and fax number of where to send your appeal. Step 4: After you have completed the login details correctly . MAXIMUS Federal Services is a contracted provider hired by the Center for Medicare and Medicaid Services (also known as CMS) and has no affiliation with us. Claims & payment Claims & payment Learn how to identify our members' coverage, easily submit claims and receive payment for services and supplies. You have the right to make a complaint if we ask you to leave our plan. You may only disenroll or switch prescription drug plans under certain circumstances. An appeal for services related to the Centers of Excellence Program must be submitted within 180 days after you receive notice of the denial to Premera.Submit appeals to: Mail:Premera Blue Cross We offer the option to subscribe to receive the following communications via email: Subscribe to receive an email when new editions of the provider newsletters are available. Regence users: make the switch to the Availity Web Portal You have been redirected from the Regence or Asuris Northwest Health Provider Center. Subscribe to online communications receive newsletters and important news via email. Note: If you submit your claim by mail, be sure to make copies of your documents for your records. You get a vaccine or flu shot from an out-of-network provider. If UMP is secondary, you must include a copy of your primary plan's Explanation of Benefits, which lists the services covered and how much the other plan paid. Coordination of Benefits, Medicare crossover and other party liability or subrogation. The plan will notify you within the 30-day period that an extension is necessary, with a description of the information needed and why it is needed. The member can appeal, or a representative the member chooses, including an attorney or, in some cases, a doctor. If you have any questions about specific aspects of this information or need clarifications, please email press@bcbsa.com . For information on false claims, see False claims or statements in your certificate of coverage. Availity and Regence Procedure and diagnosis (codes) or description of the injury or illness, d. Provider's name, address, phone number, and National Provider Identifier (NPI) or Tax ID number, e. For ambulance claims, also include the ZIP code where the member was picked up and where they were taken. Regence BlueCross BlueShield of Utah | Regence | First, you'll need to gather these documents: An itemized bill from your provider that describes the services and charges. Regence Blue Cross Blue Shield of Oregon - Yelp If you are a member of another air ambulance's membership program that is a reciprocal partner of Life Flight Network, please make sure you report this to our billing office at (866) 883-9998. Chronic Obstructive Pulmonary Disease. As a nonprofit independent licensee of the Blue Cross and Blue Shield Association, Regence is part of a . Marvin Thomas email address & phone number | Regence Bluecross Box 995 Birmingham, AL 35298 Arkansas Arkansas BCBS PO Box 2181 Little Rock AR 72203 -2181 Arizona BCBS of Arizona . Blue cross blue shield address Medicaid Address and phone number - List 1 Medicaid claim submission address - List 2 Medicare . the instructions to determine where to send claims or correspondence. If you buy your prescription drugs at a network pharmacy, your claim will be submitted for you. See Complaints about quality of care in your certificate of coverage to learn more. | A complaint or grievance is an oral statement or written document submitted by or on behalf of a member regarding: Note: If your issue is regarding a denial, reduction, or termination of payment or non-provision of medical services, it is an appeal. P | A list of reciprocal partners as well as membership benefits can be found at lifeflight.org. Appeal form (PDF): Use this form to make your written appeal. Please reference your agents name if applicable. PDF State Mail to Mailing Address City, State Zip Library Access our Administrative Manual and keep up to date with news. Blue Cross Blue Shield Association - Wikipedia Locate a network pharmacy by using the Pharmacy Locator Tool. Regence BlueCross BlueShield of Oregon Availity Web Portal Support Phone Number 1.800.AVAILITY (1.800.282.4548) (toll free) Support Hours Mon-Fri, 7:00 a.m. to 4:00 p.m. (PT) Site URL http://www.regence.com What's available in the portal On the Availity Web Portal, you can: Contact informationMedicare Advantage/Medicare Part D Appeals and GrievancesPO Box 1827, MS B32AGMedford, OR 97501, FAX_Medicare_Appeals_and_Grievances@regence.com, Oral coverage decision requests1 (855) 522-8896, To request or check the status of a redetermination (appeal): 1 (866) 749-0355, Fax numbersAppeals and grievances: 1 (888) 309-8784Prescription coverage decisions: 1 (888) 335-3016. You or your authorized representative (including a relative, friend, advocate, attorney, or provider) may submit an appeal by using the methods described in the Where to send complaints or appeals section below or by calling UMP Customer Service (medical appeals) or WSRxS Customer Service (prescription drug appeals). Choose the right company to process your complaints and appeals: To appeal online, sign in to your Regence account, select Programs & Resources, and select Appeals. Select a State. Oregon Regence BCBS of Oregon P. O. Medical records from your provider, if applicable. 2 0 obj The following information must appear on the provider's itemized bill for the plan to consider the claim for payment: a. You can also call Washington State Rx Services with the information at 1 (888) 361-1611 (TRS: 711). The ambulance claim will be processed by Blue Cross Blue Shield of Oregon. Those documents will include the specific rules, guidelines or other similar criteria that affected the decision. 2023 Regence health plans are Independent Licensees of the Blue Cross and Blue Shield Association serving members in Idaho, Oregon, Utah and select counties of Washington. Step 2: Next, locate the "Login" button at the top-right corner. Oral coverage decision requests1 (855) 522-8896 To request or check the status of a redetermination (appeal): 1 (866) 749-0355 Fax numbersAppeals and grievances: 1 (888) 309-8784Prescription coverage decisions: 1 (888) 335-3016 You are about to leave regence.com and enter another website that is not affiliated with or licensed by the Blue Cross Blue Shield Association. Franais | Learn more. 3. We will notify you if we need more time to respond. Be on the lookout for future communications with more information about this exciting enhancement for submitting claim appeals through Availity. Consult theFEP local plan directory to find addresses and telephone numbers for other plans.Note: If the equipment was sent from a DME provider in Washington, refer to thesubmission map to determine where to send your claim for processing. You can submit feedback about your Medicare health plan or prescription drug plan directly to Medicare. Regence BlueCross BlueShield of Oregon is an independent licensee of the Blue Cross and Blue Shield Association. The plan must receive all relevant information with the appeal to make sure the most accurate decision is made. Phone:800-562-1011Fax: 877-239-3390 (Claims and Customer Service)Fax: 877-202-3149 (Member Appeals)Fax: 866-948-8823 (FEP Care Management - prior auth/pre-service requests), Email: Grievances and appeals - Regence Download a form to use to appeal by email, mail or fax. Quickly identify members and the type of coverage they have. Coordination of benefits (COB) happens when you have health coverage through two or more groups (such as your employer and your spouses employer), and these two group health plans both pay a portion of your health care claims. 10/18) v2 INSTRUCTIONS FOR FILING A CLAIM IMPORTANT: Use this form for all medical, pharmacy, dental, and vision services covered by Regence.
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