EFT is a direct deposit claim payment from BCBSTX to your designated bank account. Mailing address: 5660 University Parkway. Services billed beyond 95 days from the date of service are not eligible for reimbursement. 1-361-878-1623 You will be assigned an IT analyst to guide you through the process and address any questions. Copyright 2022Health Care Service Corporation. Become an Anthem provider and join the nation's second- largest health plan-owned behavioral health company, serving more than 13 . 800-637-0171, press 3 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). As a first step, always review the Explanation of Payment (EOP) or Explanation of Benefits (EOB) and determine the reason why the claim was denied before resubmitting a new claim. Please select the appropriate version of the form below based on the members you serve. 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. Make sure to send your claim form to the appropriate claims payer and specific address. Email to submit provider inquiries and questions, Blue Cross and Blue Shield of Texas Blue Cross Complete claims P.O. Phone: (800) 824-8839 Short-term claims for Blue Shield Life & Health Insurance Company Blue Shield Life & Health Insurance Company P.O. Box 32593 Detroit, MI 48232-0593. 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 Paper Pharmacy Claims: Send to: Attention Paper Claims Processing. Government Programs Claims Electronic claim submission is preferred, as noted above. Magellan was the first MBHO to have a program included in this publication. Place of Service 22. stream Fax: 713-663-1227 Go directly to an emergency room. PO Box 660044. DO NOT COMPLETE THIS FORM IF YOU ARE A MAGELLAN COMPLETE CARE MEMBER OR PROVIDER. P O Box 660044 A. Magellan has separate post office boxes for the accounts for which we provide claims payment services. . This practice is called balance billing and is not permitted. Don't have your card? Behavioral Health Services are provided byMagellan Health Services. 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. *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*. To view this file, you may need to install a PDF reader program. Please be aware that inquiries and email boxes are not monitored 24/7. This claim is a resubmit; why was it denied for timely filing?A. Mailing address (for paper claims): Blue Shield of California Mental Health Service Administrator (MHSA) P.O. 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. Not a Magellan provider yet? <> Box 211184 Eagan, MN 55121 2. Copyright 2022Health Care Service Corporation. Visit our Provider Portals English Box 710400, San Diego CA 921710400 Phone Number: (877) 263-9952 Blue Shield of CA: Payer ID: BS001 Claims Address: P.O. 3 0 obj Email to submit provider inquiries, Blue Cross and Blue Shield of Texas (BCBSTX). Registertoday with no set-up fees, monthly fees or per-claim fees charged to providers by visiting theAvaility websiteand selecting"Register". Explore more about our programs and services addressing behavioral health, including substance use disorder treatment, and integration with physical health. APPEALS . 1001 E. Lookout Drive 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. Behavioral Health Services: 1-800-266-6167. Magellan Healthcare Solutions for Complex Care Needs: Behavioral Health, Specialty Imaging, Automated Prior Authorization, Employee Assistance. Box 52890 Bellevue, WA 98015- 2890 West Virginia Highmark BCBS of WV P.O. Beaumont, TX 77702-1954 %%EOF ), For services managed by Magellan: The easiest way to determine your current rates is to review the current rate sheet for your Magellan or affiliate company agreement. Resubmissions on Claims Courier (MBH Website): changes/ corrections are allowed to Place of Service, Billed Amount, or Number of Units Only (all other corrections must be submitted via paper claim). Austin, TX 78759-7228 The ERA can be automatically posted to your patient accounting system. TO AVOID DELAY, DO NOT SUBMIT FORM TO MULTIPLE AREAS/OFFICES. 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. TTY: 735-2989. For service questions, such as benefits, claims, bill pay or other issues: Call: 1-800-495-2583, 8 a.m.-8 p.m . P.O. This new site may be offered by a vendor or an independent third party. endstream endobj startxref 1-915-496-6600, press 2 This functionality is available for claims transactions with a status of Received/ Accepted. 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. (page_last_updated 03/2022) Box 272640 Chico, Ca 95927-2640 Phone: (800) 541-6652 Fax: (818) 228-5014 For exceptions to the standard timely filing requirements for specific states and/or plans/programs, refer to your contract withMagellan and/or its affiliates; see theMagellan state-, plan-and EAP-specific handbook supplements; refer to our timely filingexception grid; or consult state and federal laws. AIM Specialty Health (AIM) is an operating subsidiary of Anthem and an independent third party vendor that is solely responsible for its products and services. 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. If you need to mail claims: Horizon BCBSNJ. endobj HealthChoiceswill notmake payments if the full obligations of the primary insurer(s) are not met. We're here to help answer your questions. 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. Fax: 713-663-1227 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. In addition, some sites may require you to agree to their terms of use and privacy policy. (336) 774-5400. 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 Claim forms must be submitted to: Blue Cross and Blue Shield of Alabama. Braven Health: 1-888-444-0501. To view this file, you may need to install a PDF reader program. 9442 Capital of Texas Hwy N, Suite 500 This date is based on the date of the other carriers decision. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. For Emergency Situations, Always Call 911. Find plan-specific and program resourcesfor Texas STAR, STAR Kids and CHIP. The State Health Benefits Program (SHBP) and the School Employees' Health Benefits Program (SEHBP) Program: 1-800-991-5579. If you have a question about . Fax: 1-713-663-1227 Still looking for additional help? For the latest information on flexibilities and extensions due to COVID-19, refer to theTexas Medicaid & Healthcare PartnershipandTexas Health and Human Services Commissionwebsites. 195 0 obj <>stream Availity EFT & ERA Enrollment User Guide. 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). 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 310166 Detroit, MI 48231-0166. Attn: Predetermination Dept. Clean claims are defined as claims that can be processed without obtaining any additional information from the provider or from a third party. Need Help? Fax: 361-852-0624 Provider Services 1-800-521-6007 Representatives are available 24 hours a day, 7 days a week.. By email. It is important to note that depression can occur during pregnancy as well as after the baby is born. Claims for services provided to HealthChoices Members who have another primary insurance carrier must be submitted to the primary insurer first in order to obtain an EOB. 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. In-network providers will be paid at their contracted rate. 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. Direct Submit supports HIPAA 837P and 837I claims submission files. The 60-day inpatient readmission rate in Pennsylvania was nearly cut in half, from 21% to 11%, for members utilizing MAT at discharge versus those who were not.2. 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. Blue Cross Blue Shield members can search for doctors, hospitals and dentists: In the United States, Puerto Rico and U.S. Virgin Islands. Enforcing this clause also brings us in line with industry practices. The site may also contain non-Medicare related information. Medicaid Phone Number. Phone Numbers for Providers. To connect with someone on the right team, please choose an option below. P. O. Blue Shield of California welcomes you. Medicare Plus Blue SM PPO claims Blue Cross Blue Shield of Michigan P.O. In addition, some sites may require you to agree to their terms of use and privacy policy. Read about our progress in the 2021 GuideWell Social Impact Report. Fax: 972-766-2231 1001 E Lookout Drive Mailing address (for paper claims): Magellan Health Services . Looking to contact Magellan Rx Management? Claim status inquiries (out-of-state subscribers) contact Availity or other electronic connectivity vendor. Upon receipt of the completed form(s), Magellan will begin the prior authorization process. 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. The site may also contain non-Medicare related information. Contact Name Contact Address 1: Contact Address 2 Contact City: St Zip: . 1-361-878-1623 Effective 6/27/2022, a Behavioral Health Service Coordination can help members manage complex conditions related to mental health and substance use. Blue Cross and Blue Shield of Texas 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. 800-676-BLUE (2583). This new site may be offered by a vendor or an independent third party. Complete the appropriate claim form - CMS-1500 forms are required for outpatient services and UB-04 forms are required for inpatient services. P.O. To view this file, you may need to install a PDF reader program. External link You are leaving this website/app (site). 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. Boxes for the latest information on flexibilities and extensions due to COVID-19, refer to theTexas Medicaid & Healthcare Health. Important to note that depression can occur during pregnancy as well as the. Preferred, as noted above physical Health St Zip: appropriate version of the completed form ( s are! Install a PDF reader program: Contact address 2 Contact City: St Zip: in-network providers be... External link you are leaving this website/app ( site ) PDF reader program Contact Name Contact address Contact! Are available 24 hours a day, 7 days a week.. by email 837I submission!, WA 98015- 2890 West Virginia Highmark BCBS of WV P.O Imaging Automated... 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