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External link You are leaving this website/app (site). 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? From 2015 to 2017, our programs contributed to a 26% increase in members who were asked by their behavioral health providers to authorize communication with their PCP providers.3, Working with HealthConnections, the team helped get me to a place of not having fear, not having pain, exercising and doing yoga. Q. stream In addition, some sites may require you to agree to their terms of use and privacy policy. 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. Participating physicians, professional providers, ancillary and facility providers may not seek payment from the member for claims submitted after the 95-day filing deadline. 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. Place of Service 22. and the amount . 4444 Corona, Suite 148 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. Make sure to send your claim form to the appropriate claims payer and specific address. When your BCBS ID card arrives in the mail, take a moment to look for these five things: 1. endstream endobj startxref Once you get to your company's site, click on "Find Care" in the top menu to get to the provider search function. 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 1-800-749-0966 Beaumont, TX 77702-1954 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. Most PDF readers are a free download. 2 0 obj The site may also contain non-Medicare related information. Authorization In an effort to make the authorization process easier for our EAP providers, New Directions EAP offers an authorization prompt on its telephone system (800-624-5544, prompt 3). Box 272640 Chico, CA 95927-2640 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. If your ID card is not available, you may use one of the Customer Service telephone numbers below. 1001 E. Lookout Drive. Select Blue Cross Blue Shield Global or GeoBlue if you have international coverage and need to find care outside the United States. PDF Magellan Complete Care Provider Quick Guide Payers with unique claim filing rules - SimplePractice Support Blue Cross Blue Shield of Illinois is the location of the claims processing center and customer service center. Magellan has separate post office boxes for the accounts for which we provide claims payment services. To connect with someone on the right team, please choose an option below. 2. Tricare Phone Number and Claim Address. The State Health Benefits Program (SHBP) and the School Employees' Health Benefits Program (SEHBP) Program: 1-800-991-5579. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. Are you a member looking to access behavioral health or EAP services sponsored through your employer? EFT is a direct deposit claim payment from BCBSTX to your designated bank account. endobj Fax: 361-852-0624 1800 West Loop South, Suite 600 PDF File is in portable document format (PDF). Visit our job search tool to find and apply to a position. 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. %PDF-1.5 % 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. Open in Google Maps Business Hours. If you still need to submit paper claims, use the Claims-Routing Tool to determine the correct mailing address for each member. 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. 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 Copyright 2022Health Care Service Corporation. 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. All claims for covered services provided to HealthChoices Members must be submitted to and received by Magellan as follows: Within sixty (60) days from date of service for most levels of care except as provided below; Within sixty (60) days from date of discharge for 24/hr level of care; Within sixty (60) days of the last day of the month or the discharge date, whichever is earlier when billing monthly for longer treatment episodes of care at a 24/hr level facility; Within sixty (60) days of the claim settlement for third party claims. View the 2021 GuideWell Social Impact Report. Make sure to send your claim form to the appropriate claims payer and specific address. Fax: 361-852-0624 Direct Submit supports HIPAA 837P and 837I claims submission files. MagellansMedical Providers Behavioral Health Toolkitgives medical practitioners the information and screening tools needed to assist in making behavioral health referrals. Sign up to receive information and updates from Magellan Healthcare on behavioral health webinars and education! In addition, some sites may require you to agree to their terms of use and privacy policy. What is the appeals process? 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. . Richmond, VA 23242 For service questions, such as benefits, claims, bill pay or other issues: Call: 1-800-495-2583, 8 a.m.-8 p.m . %PDF-1.7 PDF File is in portable document format (PDF). 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. Most PDF readers are a free download. 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). Please select the appropriate version of the form below based on the members you serve. This new site may be offered by a vendor or an independent third party. 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. Email to submit provider inquiries, Blue Cross and Blue Shield of Texas (BCBSTX). Box 2048 Southeastern, PA 19399 Online: at www.bcbsglobalcore.com However, if a provider wishes to request a prior authorization by mail or fax using a form, it must be this form as prescribed by the Texas Department of Insurance. Box 2924 Phoenix, AZ 85062-2924. . You are leaving this website/app (site). Or call your doctor or therapist for help. These members enjoy the same level of coverage as other Medicare Advantage members with no network restrictions. Health Coaching and Interventions: 1-800-672-7897 (toll free) Blue Cross and Blue Shield of North Carolina P.O. One option is Adobe Reader which has a built-in reader. Pharmacy claim submission and Pro- DUR questions ; 24 hours / 7 days a week; Magellan Rx Management Pharmacy Call Center: 1-800-424-5725. Box 91059 Seattle, WA 98111-9159 *Washington Regence Blue Shield P. O. Select the best option and fill out a form and we will reach out to you as soon as possible! We're here to help answer your questions. Yes. 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. Do the timely filing limits apply to this claim?A. endobj Ask them where out of state claims should be filed. The process typically takes about 3 to 4 weeks to complete the process, so allow ample time to complete your independent testing. Place of Service 23. This new site may be offered by a vendor or an independent third party. Box 805107, Chicago, IL 60680-4112. 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 2022 Magellan Health, Inc. All Rights Reserved. Fax: 1-713-663-1227 BCBSTX Behavioral Health Unit . *interactive voice response (IVR) system to access, you must have document control number (claim number), Eligibility and benefits contact your electronic connectivity vendor, Availity or other electronic connectivity vendor or call 1-800-451-0287*. One option is Adobe Reader which has a built-in reader. P O Box 660044 Through this option, providers submit an 837 file to a third party middle-man who in turn submits the files to Magellan. Its a simple six-step process which includes uploading and sending test files. Resubmissions must be submitted within 60 days from the date of denial. 2022 Magellan Health, Inc. All Rights Reserved. FBC HOM 001 F 102022. Behavioral Health Services are provided byMagellan Health Services. . 195 0 obj <>stream 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. <>/Metadata 345 0 R/ViewerPreferences 346 0 R>> Again, this can be a huge time-suck, calling and being transferred over and over. The site may also contain non-Medicare related 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). You are responsible for verifying the member's coverage at the time of service. 3 0 obj 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. Eligibility and benefits contact Availity or other electronic connectivity vendor or call 1-800-442-4607*, Behavioral health services mental health and chemical dependency prior authorization and referrals (includes inpatient, residential treatment center (RTC) programs, partial hospitalization and outpatient behavioral health services) call 1-800-528-7264, Behavioral health services claims status inquiries contact Availity or other electronic connectivity vendor or call 1-800-442-4607*, Behavioral health services claim adjustments call 1-800-442-4607, Eligibility and benefits contact Availity or other electronic connectivity vendor or call 1-877-299-2377*, Claim status inquiries contact Availity or other electronic connectivity vendor, Medical Management Correspondence for the Health Insurance Marketplace for Blue Advantage HMO Members, Blue Cross Blue Shield of Texas From February 15 to September 30, on weekends and holidays, you may be required to leave a message. Horizon Behavioral Health. Most PDF readers are a free download. A Claims Courier Demo can be accessed at: Claims Courier is a free web-based data entry application. View help topics or login via our member website. 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. Log into the Availity Provider Portal, select Payer Spaces from the top navigation menu and select BCBSTX. Claim Status; For Availity-related questions, please visit the Availity Essentials website or contact Availity Essentials Client Service at 1-800-282-4548, 8 a.m. to 8 p.m. Dental Blue Book eManual; Dental Blue News; Dental Enrollment and Credentialing; Will the timely filing standards be applied to claims I submitted prior to being a Magellan provider?A. For eligibility, prior authorization or claims inquiries, call 877-299-1008. If you believe your claim was denied in error, please send your request to the appeal submission address found on the Explanation of Payment (EOP). Predetermination form and Upon receipt of a claim, Magellan reviews the documentation and makes a payment determination. Email to submit provider inquiries and questions, Blue Cross and Blue Shield of Texas <>/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>> 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. Box 710400, San Diego CA 921710400 Phone Number: (877) 263-9952 Blue Shield of CA: Payer ID: BS001 Claims Address: P.O. EDI Support: Contact Magellans EDI Hotline for support and/or assistance:1-800-450-7281ext. Magellan is committed to the fight against the opioid epidemic and other substance use disorders (SUDs) affecting far too many of our family members and friends. Please be aware that inquiries and email boxes are not monitored 24/7. Pharmacy Claim. Blue Shield of California welcomes you. Q. I have a specific question about a claim. When the confirmation message displays, select, To enroll online for EFT, you must be a registered Availity, Texas Medicaid claims are normally finalized weekly on Mondays. Mail Claims or Claims Correspondence to: Blue Cross Blue Shield of Arizona P.O. Its similar to the CMS 1500 claim form, with additional fields to make the application HIPAA-compliant. This new site may be offered by a vendor or an independent third party. What should I do? Email to submit provider inquiries and questions, Blue Cross and Blue Shield of Texas Availity EFT & ERA Enrollment User Guide. 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. UB-04 claims Blue Cross Blue Shield of Michigan P.O. Claims are paid based on your status on the date of service. Member Questions Blue Cross Blue Shield members, please contact your BCBS company if you have specific questions about your plan, coverage and more. Fax: 713-663-1227 HealthTrio Connect : Attn: Predetermination Dept. To view this file, you may need to install a PDF reader program. 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. The easiest way to determine your current rates is to review the current rate sheet for your Magellan or affiliate company agreement. 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. Therefore it does not support revenue codes (codes submitted on 837I files or a UB-04). 1-361-878-1623 Blue Medicare HMO Blue Medicare PPO Contact: 1-888-296-9790 or. As a Magellan network provider, what is my timely filing limit?A. 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. Or call your doctor or therapist for help. Most people don't view their physical and mental health as separate, and neither do we. Corporate Address. Phoenix Corporate Office Street Address. For the latest information on flexibilities and extensions due to COVID-19, refer to theTexas Medicaid & Healthcare PartnershipandTexas Health and Human Services Commissionwebsites. endobj Richardson, TX 75082-4144 Winston-Salem, NC 27105. Postpartum depression is a common, potentially serious and sometimes life-threatening condition. Box 30271 Salt Lake City, UT 84130-0271 *Washington Regence Group Administrators Attn: Claims P. O. A. The EPSarrives fasterthan the PCS andis easier to archivefor future retrieval. 1-800-336-5696 Find plan-specific and program resourcesfor Texas STAR, STAR Kids and CHIP. Does this timely filing limit apply to all claims for all members (e.g., COB, Medicare, etc.)?A. HealthChoiceswill notmake payments if the full obligations of the primary insurer(s) are not met. Fax: 1-713-663-1227 BCBSTX makes no endorsement, representations or warranties regarding any products or services provided by third party vendors such as Availity. Richardson, TX 75082-4144 Magellan recommends Claims Courier for low volume claim submitters who dont want to use a clearinghouse. In Pennsylvania, Magellan works with county partners in Bucks, Cambria, Lehigh, Montgomery and Northampton counties. Together, we're committed to making a meaningful difference in the health of all Floridians. For urgent requests only: BCBSTX providers who receive paper checks and Provider Claim Summaries (PCSs) via the U.S. Mail may wish to consider the electronic alternatives listed below for greater efficiency, convenience and security of 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. Please note: as these requirements can be subject to change, thegrid may not contain a complete list of exceptions. x]rFwVa1)dJr#Qk%QKQ[93 yvk#Y _wOOOaxzXn&Wrru;8}N7o|Q2l1}e/_{12|qE2QPQ&/=d_W?F|)eAW+@y^n|"Gc9zOh 2 Magellan Pennsylvania provider data, July 2017-June 2018 The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies. For Texas-specific ABA resources,sign into this website. (See item #2 below to learn how to contact your BCBS company to address any errors.) Fax: 1-800-424-5881. All Rights Reserved. You can download the toolkithere. 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 Copy of an EOP with a date within the timely filing period, Certified or overnight mail receipts dated within the timely filing period, Copy of the claim with Magellan's date stamp within the timely filing period, Copy of 2nd level EDI 277 acceptance reports. Looking to contact Magellan Rx Management? BCBS Prefix List AAA to AZZ. Main telephone number 1-215-937-8000. For Emergency Situations, Always Call 911. Many times, primary care physicians are the first place a member goes when they have a problem. 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). NOTE: To gain access to the above Blue Cross and Blue Shield of Texas Medicaid Tools you must be registered with Availity. BCBS Prefix List. This new site may be offered by a vendor or an independent third party. Medicaid Phone Number. Claims Address. Claims must be submitted and received by us within 24 months after the service takes place to be eligible for benefits. San Antonio, TX 78257-8222 Phone Numbers for Providers. Blue Cross and Blue Shield of Texas Claims Submission. DO NOT COMPLETE THIS FORM IF YOU ARE A MAGELLAN COMPLETE CARE MEMBER OR PROVIDER. Box 7355 . 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. Phone: 1-972-766-7100 In addition, some sites may require you to agree to their terms of use and privacy policy. Visit our Help Center . The site may also contain non-Medicare related information. Please provide the Tax Identification Number, NPI, and if applicable, Medicare Numbers for your provider when contacting Network Management. D2Ed0L^lA$0D`X|6MlK(4S$3Al"@?MV3H{r qJAGg` Complete the appropriate claim form - CMS-1500 forms are required for outpatient services and UB-04 forms are required for inpatient services. ), For services managed by Magellan: Keystone First 200 Stevens Drive Philadelphia, PA 19113. Government Programs Claims Electronic claim submission is preferred, as noted above. Find your provider portal Box 272540, Chico CA 959272540 Phone Number: (800) 541-6652 Is Blue Shield MHSA the same as Magellan? 17806 IH 10 West, Bldg II, Suite 200 BlueCross BlueShield of Tennessee is a Qualified Health Plan . Eligibility and benefits Availity provides administrative services to BCBSTX. In Texas, Magellan uses the American Society of Addiction Medicine (ASAM) criteria as the basis for the utilization reviews of substance use disorder cases. Dallas, TX 75266-0241 1-915-496-6600, press 2 % It is important that you review all EOPs promptly. 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). Call 911. Claim forms must be submitted to: Blue Cross and Blue Shield of Alabama. Behavioral Health Services: 1-800-266-6167. Fax: 713-663-1227 Email: RxNetworksDept@magellanhealth.com. Horizon BCBSNJ: 1-800-624-1110 or 1-800-626-2212. *interactive voice response (IVR) system to access, you must have document control number (claim number), Blue Cross and Blue Shield of Texas Medicaid. In addition, some sites may require you to agree to their terms of use and privacy policy. You should also check with your billing service, clearinghouse or software vendor to confirm ERA-compatibility and availability of auto-posting software. Magellan Behavioral Health Providers! Contact Name Contact Address 1: Contact Address 2 Contact City: St Zip: . 2022 Magellan Health, Inc. All Rights Reserved. There are several reasons claims may not be paid upon their first submission. 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. P.O. Magellans PCP toolkit represents Magellans commitment to promote integration of medical and behavioral health services toward the goal of better overall outcomes for patients. Human Resources . To verify eligibility or obtain authorization, you may contact Magellan at 1-800-424-4399. . BlueCross BlueShield of Tennessee payer ID number: 00390. 1-713-663-1149 <>/Metadata 147 0 R/ViewerPreferences 148 0 R>> 136 0 obj <> endobj Box 660027 Mailing address: 5660 University Parkway. Contact us By mail. 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. 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 Magellans Primary Care Physician (PCP) Toolkit. Claims Address: P.O. TO AVOID DELAY, DO NOT SUBMIT FORM TO MULTIPLE AREAS/OFFICES. General Information: 1-972-766-6900. A. 800-676-BLUE (2583). 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 Merion Cricket Club Summer Membership, Articles B