For status call: Providers Are you a provider looking for information on Magellan plans, joining our network, or performing secure transactions related to your practice or Magellan members? Looking to contact Magellan Rx Management? Box 30271 Salt Lake City, UT 84130-0271 *Washington Regence Group Administrators Attn: Claims P. O. Blue Shield Final Appeal Resolution Office P.O. 195 0 obj <>stream Typically, a fee is attached by the clearinghouse vendor. <> 1-361-878-1623 A. Provider Services 1-800-521-6007 Representatives are available 24 hours a day, 7 days a week.. By email. 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. Claim status inquiries (out-of-state subscribers) contact Availity or other electronic connectivity vendor. Blue Cross and Blue Shield of Texas. Magellans PCP toolkit represents Magellans commitment to promote integration of medical and behavioral health services toward the goal of better overall outcomes for patients. 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. Pharmacy Claim. Behavioral health benefits are integrated into Anthem medical plans for a full spectrum of coordinated care for our members. General Information: 1-972-766-6900. Together, we're committed to making a meaningful difference in the health of all Floridians. TTY: 735-2989. 1-512-349-4847 Submit completed forms to: What should I do? 4 0 obj Florida Blue is a part of the GuideWell family of companies. Many times, primary care physicians are the first place a member goes when they have a problem. Do the timely filing limits apply to this claim?A. [Maryland and WDC] Offers healthcare insurance to residents of Maryland and Washington, DC. Customer Service. Users will obtain immediate feedback regarding the results of the test to ensure compliance with HIPAA rules and codes. 168 0 obj <>/Filter/FlateDecode/ID[<50CE1069D31C234C87CF13730B148C38><945CA0064BA9D246BD7A3657988FAEE3>]/Index[136 60]/Info 135 0 R/Length 140/Prev 151563/Root 137 0 R/Size 196/Type/XRef/W[1 3 1]>>stream Blue Cross Complete claims P.O. See first question and answer above. Q. I have proof that I submitted the claim within the timely filing limits. Email to submit provider inquiries and questions, Blue Cross and Blue Shield of Texas 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. Please emailwomenshealth@hhsc.state.tx.uswith any questions. Not a Magellan provider yet? PO Box 660241 Box 91059 Seattle, WA 98111-9159 *Washington Regence Blue Shield P. O. Resubmitted claims should include the Date of Original Submission and Claim number if applicable. <>/Metadata 345 0 R/ViewerPreferences 346 0 R>> P O Box 660044 Birmingham, Alabama 35244-2858. Braven Health: 1-888-444-0501. Customer Service: If you have questions or need additional support, BCBSTX Personal Health Assistants are available to help. Enforcing this clause also brings us in line with industry practices. 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. 2022 Magellan Health, Inc. All Rights Reserved. Magellan Behavioral Health Providers! Claims Submitting Claims Claims will continue to go directly to BlueCross. 1 Magellan Behavioral Health of Pennsylvania evaluation including claims data, the Consumer Health Inventory survey, and housing and income data Clean claims are defined as claims that can be processed without obtaining any additional information from the provider or from a third party. 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. 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). Call 1-800-528-7264 or the phone number listed on the back of the member's/subscriber's ID card. 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. . Blue Medicare HMO Blue Medicare PPO Contact: 1-888-296-9790 or. Fax: 1-800-424-5881. Magellan has separate post office boxes for the accounts for which we provide claims payment services. Blue Cross and Blue Shield of Texas TO AVOID DELAY, DO NOT SUBMIT FORM TO MULTIPLE AREAS/OFFICES. You can download the toolkithere. Box 805107, Chicago, IL 60680-4112. 1001 E Lookout Drive Its a simple six-step process which includes uploading and sending test files. Services that require pre-authorization What is the appeals process? 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. Magellan Behavioral Health Providers of Texas, Inc. Request for claim review form and instructions, Wellness and clinical practice guidelines, Independent Diagnostic Testing Facility (IDTF), Intensive Outpatient facility programs (PHP/IOPs). BCBSTX makes no endorsement, representations or warranties regarding any products or services provided by third party vendors such as Availity. 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. Yes. %PDF-1.7 stream This new site may be offered by a vendor or an independent third party. Healthcare providers may submit their requests for prior authorization of healthcare services to Magellan using the Texas Standard Prior Authorization Request Form for Health Care Services.. 114 Mesa Park Dr. Suite #300 Contact Us. %PDF-1.5 % Box 2291 Durham, NC 27702-2291 . Q. Contact Availity or other electronic connectivity vendor or call Magellan Behavioral Health 1-800-729-2422, Claim filing address for Commercial products, Availity Essentials Need Help? APPEALS . Availity provides administrative services to BCBSTX. Member Questions Blue Cross Blue Shield members, please contact your BCBS company if you have specific questions about your plan, coverage and more. 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. ET, Monday through Friday. Richmond, VA 23242 Magellan was the first MBHO to have a program included in this publication. Magellan steps in for our members to help prevent and address the risks of one affecting the other. Resubmissions must be submitted within 60 days from the date of denial. Q. 136 0 obj <> endobj Magellan Healthcare Solutions for Complex Care Needs: Behavioral Health, Specialty Imaging, Automated Prior Authorization, Employee Assistance. %%EOF P. O. <> Claims are paid based on your status on the date of service. Arboretum Plaza II Or call your doctor or therapist for help. In Pennsylvania, Magellan works with county partners in Bucks, Cambria, Lehigh, Montgomery and Northampton counties. UB-04 claims Blue Cross Blue Shield of Michigan P.O. Box 2048 Southeastern, PA 19399 Online: at www.bcbsglobalcore.com . FBC HOM 001 F 102022. Sign up to receive information and updates from Magellan Healthcare on behavioral health webinars and education! Utilization Management/Medical Management/Case Management. When your BCBS ID card arrives in the mail, take a moment to look for these five things: 1. Copyright 2022Health Care Service Corporation. In addition, some sites may require you to agree to their terms of use and privacy policy. (See item #2 below to learn how to contact your BCBS company to address any errors.) These members enjoy the same level of coverage as other Medicare Advantage members with no network restrictions. Attention: Claim Department . Dental Expense Claim. Driving directions. 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. 1998-BlueCross BlueShield of Tennessee, Inc., an Independent Licensee of the Blue Cross Blue Shield Association. A. Contact Information. Email to submit provider inquiries, Phone: 1-972-766-1380 Most PDF readers are a free download. Email to submit provider inquiries. The site may also contain non-Medicare related information. EFT is a direct deposit claim payment from BCBSTX to your designated bank account. 4444 Corona, Suite 148 Providers can refer members by contacting 1-877-214-5630. Specializing in the most complex, costly areas of care, Magellan Healthcare partners with states to manage behavioral health programs. If you are able to create an 837 file in a HIPAA compliant format, we. Fax: 915-496-6614 Box 312599 Detroit, MI 48231-2599. Explore more about our programs and services addressing behavioral health, including substance use disorder treatment, and integration with physical health. TennCare Provider Services 1-800-852-2683. MagellansMedical Providers Behavioral Health Toolkitgives medical practitioners the information and screening tools needed to assist in making behavioral health referrals. Phone Numbers for Providers. Eligibility and benefits El Paso, TX 79912 -6156 Open in Google Maps Business Hours. Human Resources . 1-361-878-1623 Paper Claims Address Independence Administrators P.O. For this reason, your resubmitted claim has been denied. Again, this can be a huge time-suck, calling and being transferred over and over. Fax: 361-852-0624 Are you a member looking to access behavioral health or EAP services sponsored through your employer? Find My BCBS Company 1-713-663-1149 Austin, TX 78759-7228 Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. (336) 774-5400. Blue Cross Blue Shield members can search for doctors, hospitals and dentists: In the United States, Puerto Rico and U.S. Virgin Islands. Contact Name Contact Address 1: Contact Address 2 Contact City: St Zip: . This is the customer service number for questions about your health insurance coverage, benefits or treatment. Travel Benefit Claim. 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. From February 15 to September 30, on weekends and holidays, you may be required to leave a message. Download information about our behavioral health solutions and public behavioral health overview. Claims must be submitted and received by us within 24 months after the service takes place to be eligible for benefits. Call 911. This new site may be offered by a vendor or an independent third party. P.O. 052 1366489049; 052; 1366489049 Franciscan PHO Northern IN Hammond; Claims Inquiry Patty Arredondo; Julie Lambertino; 7905 S Calumet Ave Munster; IN 46321 (219) 836-5800 66347 (219) 836-8025 patricia.arredondo@franciscanalliance.org; . BlueCare / TennCare Select Claims Service Center 1 Cameron Hill Circle, Suite 0002 Chattanooga, . 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. Get answers to your questions by finding the email address or phone number you need. To view this file, you may need to install a PDF reader program. Contact Availity or other electronic connectivity vendor or call 1-800-451-0287*, *interactive voice response (IVR) system to access, you must have full member's information (for example, member's ID, patients date of birth, etc. Claim forms must be submitted to: Blue Cross and Blue Shield of Alabama. Email to submit provider inquiries and questions, Ambulatory Surgery Centers (ASC) Independent, Non-Hospital owned, Fax: 1-713-663-1227 If you need to mail claims: Horizon BCBSNJ. Submit appeals within 120 calendar days from receipt of remittance advice (RA). 1001 E. Lookout Drive Through this option, providers submit an 837 file to a third party middle-man who in turn submits the files to Magellan. Email to submit provider inquiries and questions, North Texas Dallas, Fort Worth, East Texas (ExcludesBastrop, Bell, Bosque, Burleson, Burnett, Caldwell, Falls, Fayette, Hays, Hill, Lee, Leon, Limestone, Madison, Milam, McLennan, Robertson, Travis, Wichita and Williamson counties), Blue Cross and Blue Shield of Texas Blue Cross and Blue Shield of Texas 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. 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