Call 911. 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. To view this file, you may need to install a PDF reader program. Braven Health: 1-888-444-0501. Complete the appropriate claim form - CMS-1500 forms are required for outpatient services and UB-04 forms are required for inpatient services. Key Contact Information Medical Care Management This practice is called balance billing and is not permitted. 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. 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. Again, this can be a huge time-suck, calling and being transferred over and over. Availity provides administrative services to BCBSTX. Box 32593 Detroit, MI 48232-0593. 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. The easiest way to determine your current rates is to review the current rate sheet for your Magellan or affiliate company agreement. Resubmissions must be submitted within 60 days from the date of denial. 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. Become an Anthem provider and join the nation's second- largest health plan-owned behavioral health company, serving more than 13 . 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). Specializing in the most complex, costly areas of care, Magellan Healthcare partners with states to manage behavioral health programs. 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. Email to submit provider inquiries and questions, Blue Cross and Blue Shield of Texas Looking to contact Magellan Rx Management? 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). Email to submit provider inquiries, Phone: 1-972-766-1380 Upon receipt of the completed form(s), Magellan will begin the prior authorization process. Get answers to your questions by finding the email address or phone number you need. Most PDF readers are a free download. In addition, some sites may require you to agree to their terms of use and privacy policy. Blue Cross and Blue Shield of Texas. Behavioral Health Services: 1-800-266-6167. Blue Cross Complete claims P.O. DO NOT COMPLETE THIS FORM IF YOU ARE A MAGELLAN COMPLETE CARE MEMBER OR PROVIDER. Box 9000 London, KY 40742 Phone: (866) 510-8778 Blue Shield Medicare Advantage Blue Shield Medicare Advantage Plan 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. (Note:For behavioral health professional providers, refer to the Network Management Office Locations listed above). Horizon Behavioral Health. EAP providers can request an EAP authorization by leaving a brief voicemail message. Find your provider portal 75890 or the EDI Support Mail Box:EDISupport@magellanhealth.com. 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). What should I do? Magellan has separate post office boxes for the accounts for which we provide claims payment services. View help topics or login via our member website. Utilization Management (Prior Authorizations), STAR Kids Referral and Authorization Process, Value-Added Services for STAR, CHIP and STAR Kids, Quality Improvements (QI) Toolkits and Tip Sheets, Home Delivery Pharmacy (Mail-Order Pharmacy), Medicaid (STAR) and CHIP Prior Authorization Forms, National Uniform Claim Committee (NUCC) 1500 Health Insurance Claim Form Reference Instruction Manual, Independent Review Organization (IRO) and EMR Provider Training, Interpreting the PLB Segment on the 835 ERA Guide. In addition, some sites may require you to agree to their terms of use and privacy policy. Paper Pharmacy Claims: Send to: Attention Paper Claims Processing. External link You are leaving this website/app (site). . endobj
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To submit claims on Magellans website: Providers can submit claims using the Claims Courier application by signing in to the. 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. 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. If you still need to submit paper claims, use the Claims-Routing Tool to determine the correct mailing address for each member. Participating physicians, professional providers, ancillary and facility providers may not seek payment from the member for claims submitted after the 95-day filing deadline. Yes. <>
When submitting claims electronically, the Magellan submitter ID is 01260. 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. For a guide on how to fill out Provider ID# - Box 33b on the 1500 Claim Form, view page 56 of theNational Uniform Claim Committee (NUCC) 1500 Health Insurance Claim Form Reference Instruction Manual. 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. You are on primary menu. Premera Blue Cross (WA/AK) P. O. NOTE: To gain access to the above Blue Cross and Blue Shield of Texas Medicaid Tools you must be registered with Availity. Box 85042. For Texas-specific ABA resources,sign into this website. Contact Availity or other electronic connectivity vendor or call Magellan Behavioral Health 1-800-729-2422, Claim filing address for Commercial products, Availity Essentials endobj
In-network providers will be paid at their contracted rate. 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. External link You are leaving this website/app (site). What should I do? Box 310166 Detroit, MI 48231-0166. Phone: 1-972-766-7100 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. Most PDF readers are a free download. Ask them where out of state claims should be filed. Email to submit provider inquiries. 1-972-766-8900 Claims Address: P.O. By telephone. BlueCross BlueShield of Tennessee is a Qualified Health Plan . Use the link below to find your local BCBS company's website. Authorizations & Referrals submissions Box 2048 Southeastern, PA 19399 Online: at www.bcbsglobalcore.com 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. General Information: 1-972-766-6900. Box 805107, Chicago, IL 60680-4112. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 24 0 R 25 0 R 26 0 R 27 0 R 30 0 R] /MediaBox[ 0 0 792 612] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>>
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We're here to help answer your questions. 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. Box 629011 El Dorado Hills, CA 95762-9011. Behavioral health benefits are integrated into Anthem medical plans for a full spectrum of coordinated care for our members. Claims must be submitted and received by us within 24 months after the service takes place to be eligible for benefits. Refer to BCBSTX Medicaid website and Contact Us. Box 91059 Seattle, WA 98111-9159 *Washington Regence Blue Shield P. O. If you have a question about . Availity EFT & ERA Enrollment User Guide. In accordance with applicable law, Magellan will pay clean claims within 45 days of the date of receipt. Within BCBSTX-branded Payer Spaces, select the Applications tab and click the BCBSTX Medicaid Provider Appeal Request Form. The EPSarrives fasterthan the PCS andis easier to archivefor future retrieval. Medicare Plus Blue SM PPO claims Blue Cross Blue Shield of Michigan P.O. The short answer is yes! One option is Adobe Reader which has a built-in reader. Email to submit provider inquiries and questions, Golden Triangle (Beaumont, Orange, Port Arthur), Blue Cross and Blue Shield of Texas Information for Brokers, employers, and providers, as well as links to consumer health and wellness sites. 2 Magellan Pennsylvania provider data, July 2017-June 2018 Customer Service. 1001 E. Lookout Drive. . Make sure to send your claim form to the appropriate claims payer and specific address. From February 15 to September 30, on weekends and holidays, you may be required to leave a message. <>/Metadata 345 0 R/ViewerPreferences 346 0 R>>
Click the link below to find the provider portal for your needs. Its similar to the CMS 1500 claim form, with additional fields to make the application HIPAA-compliant. *interactive voice response (IVR) system to access, you must have document control number (claim number), Blue Cross and Blue Shield of Texas Medicaid. Claims are paid based on your status on the date of service. Double-Check Details Check your new card to ensure details like the spelling of your name and the type of plan you selected are correct. 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. Most PDF readers are a free download. Mailing address: 5660 University Parkway. 3 0 obj
Q. 1001 E. Lookout Drive Box 312599 Detroit, MI 48231-2599. 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). Click to skip to content. 1-361-878-1623 Magellan Healthcare is contracted to perform behavioral health managed care functions supporting members and participants for the following Blue Cross and Blue Shield of Texas HMO networks; Blue Advantage HMO SM, Blue Cross Medicare Advantage HMO SM, Blue Cross Medicare Advantage Dual Care (HMO SNP) SM and MyBlue Health SM. Box 272540, Chico CA 959272540 Phone Number: (800) 541-6652 Is Blue Shield MHSA the same as Magellan? In Texas, Magellan uses the American Society of Addiction Medicine (ASAM) criteria as the basis for the utilization reviews of substance use disorder cases. 1-800-749-0966 The site may also contain non-Medicare related information. 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. 1-361-878-1623 Phone: (800) 824-8839 Short-term claims for Blue Shield Life & Health Insurance Company Blue Shield Life & Health Insurance Company P.O. Email: RxNetworksDept@magellanhealth.com. 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 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. Find My BCBS Company 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. Self-enroll by creating a unique user ID and password. Birmingham, Alabama 35244-2858. Fax to: 1-888-579-7935 As a Behavioral Health-Managed Care Organization (BH-MCO), Magellan manages members' benefits in coordination with you - our network providers. [Maryland and WDC] Offers healthcare insurance to residents of Maryland and Washington, DC. 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. It is important to note that depression can occur during pregnancy as well as after the baby is born. Fax: 361-852-0624 800-637-0171, press 3 Most people don't view their physical and mental health as separate, and neither do we. Claim forms must be submitted to: Blue Cross and Blue Shield of Alabama. Dallas, TX 75266-0044 Magellans Primary Care Physician (PCP) Toolkit. . Provider Services 1-800-521-6007 Representatives are available 24 hours a day, 7 days a week.. By email. Availity provides administrative services to BCBSTX. Magellan Behavioral Health Providers! Join our extensive provider network today! Copyright 2022Health Care Service Corporation. 450 Riverchase Parkway East. 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. Q. I recently joined the Magellan provider network. Blue Cross Blue Shield of Massachusetts 101 Huntington Avenue, Suite 1300 Boston, MA 02199 . However, before sending an email to TennCare you may be able to find a quick answer online by clicking on one of these questions. Horizon BCBSNJ: 1-800-624-1110 or 1-800-626-2212. 4 0 obj
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. %
(336) 774-5400. No. Contact Name Contact Address 1: Contact Address 2 Contact City: St Zip: . A. HealthTrio Connect : ~_IV21b~Lj 1998-BlueCross BlueShield of Tennessee, Inc., an Independent Licensee of the Blue Cross Blue Shield Association. Predetermination form and Email to submit provider inquiries, 1001 E. Lookout Drive Dental Expense Claim. %PDF-1.7
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 1 0 obj
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 Illinois 300 East Randolph Street Chicago, Illinois 60601-5099. 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). This claim is a resubmit; why was it denied for timely filing?A. Contact us By mail. Magellan Behavior Health Services coordinates all behavioral health (mental health and chemical dependency) services for Medicaid (STAR), CHIP, and STAR Kids members. If you are a member with a question about your coverage, contact Customer Service at the number listed on your BCBSIL member ID card. BCBS Provider Phone Number. Box 7355 . Services that require pre-authorization 2 0 obj
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