These guidelines, in addition to the editor will assist you through the entire procedure. As an Alfa representative, I agree to the payment terms and conditions of Blue Cross and Blue Shield of Alabama and will not collect any checking account, debit card or credit card information on behalf of the consumer for the purchase of health or dental insurance. Contact Us | Blue Cross and Blue Shield of Alabama - bcbsal.org Child up to age 19. //show the chat available image Technology, Power of As an Alabama Health Guidance representative, I agree to the payment terms and conditions of Blue Cross and Blue Shield of Alabama and will not collect any checking account, debit card or credit card information on behalf of the consumer for the purchase of health or dental insurance. With Blue Cross and Blue Shield of Alabama, all of our dental plans include regular dental exams, x-ray and routine cleaning - at no extra cost. Resources - provider.bcbsal.org */ All rights reserved. You are about to leave Blue Cross and Blue Shield of Alabama's website and enter a website operated by HealthEquity. We reference sites that we think might be useful or of interest to you, but we are not responsible for the content or privacy practices used by other site owners. ALL Kids. English, Download the overseas retail prescription drugclaim form: extra cost. { Shop On Exchange Shop Off Exchange HOW TO BUY AN AFFORDABLE CARE ACT (ACA) PLAN When we receive an electronic claim, you will automatically be set up as an out-of-state provider in our system and can register to use our provider website, ProviderAccess: Once . A primary plan is one whose benefits for a person's healthcare coverage must be determined first without taking the existence of any other plan into consideration. P.O. We use cookies to improve security, personalize the user experience, enhance our marketing activities (including cooperating with our marketing partners) and for other business use. HealthEquity is our business associate and is an independent company that provides account-based plan services to Blue Cross. Choose between our 3 dental plans today! A Qualified Health Plan is an insurance plan that has been certified by the Health Insurance Marketplace and provides essential health benefits, follows established limits on cost sharing and meets other requirements under the Affordable Care Act. Preservice and concurrent appeals should continue to be submitted to the member's Home Plan. 2023 New Directions Behavioral Health. **Dental Blue Plus is a Health Insurance Marketplace plan. An assessment will be scheduled and performed by a Blue Cross representative to determine if your situation and health needs meet claims benefit eligibility. Select the Sign button and create a digital signature. Medical necessity and prior authorization timeframes and enrollee responsibilities. Call 1-855-488-2515. CPT codes, descriptions and data copyright 2022 American Medical Association. Call Preferred Long-Term Care (LTC) Customer Service (1-888-331-4188) to complete the Claims Intake Form over the telephone. Questions? } Applicable FARS/DFARS apply. Patient. Available plans and pricing may vary depending on whether you purchase your plan on or off the Health Insurance Marketplace. Claim submission is supported for primary, secondary and tertiarypayment. With Blue Cross and Blue Shield of Alabama, all of our dental plans include regular dental exams, x-ray and routine cleaning - at no extra cost. Access a wealth of healthcare resources and tools with MyBlue. Double-check every area has been filled in correctly. You may access the Nondiscrimination and Accessibility notice, Navigate & Connect: Simplifying access to behavioral healthcare. Theft, Personal Birmingham, Alabama 35244-2858, Grace periods and claims pending policies during the grace period. If you want to stay on Blue Cross' website, click "Cancel.". Please note that precertification relates only to the medical necessity of care; it does not mean that your care will be covered under the plan. 2023, Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association. For claim status, eligibility, remittances and referrals, use one of the following methods: Access through your practice management software, Log in to our website, or Call the appropriate number listed below: In-State General Provider Inquiry Participating hospitals: 1-800-760-6852 Participating providers: 1-877-231-7239 1.833.663.8713 Other ways to connect By mail Credence Blue Cross and Blue Shield 450 Riverchase Parkway East Birmingham, Alabama 35244 Physicians and providers Credence Blue Cross and Blue Shield 450 Riverchase Parkway East Birmingham, Alabama 35244 Provider Appeals Blue Cross and Blue Shield of Alabama has an established appeals process for providers and physicians. Mail original claims to the appropriate address as noted below. Include the date to the document using the Date function. Box 3418, Scranton, PA 18505; Blue Cross Community MMAI (Medicare-Medicaid Plan), c/o Provider Services, P.O. If you believe you believe you have overpaid your premium due to our overbilling, please contact us by calling the Customer Service Department number on the back of your ID card. 3. It is your responsibility to ensure that you or your provider obtains precertification. CDT codes, descriptions and data copyright 2022 American Dental Association. Follow the simple instructions below: The days of distressing complex legal and tax forms have ended. Or mail a paper copy, along with proof that you paid a Medicare Part B premium, to: Complete the form following the instructions on the back. All Rights Reserved. A retroactive denial is the reversal of a previously paid claim. Expenses will be applied against your Plan of Care and reimbursed accordingly. Contact Us | Blue Cross Blue Shield Print and mail the form to the Blue Cross and Blue Shield company in the state that the services were rendered by December 31 of the year following the year you received service. Attach pharmacy receipts for covered prescriptions. Make sure your documents include the five following pieces of information as required by the IRS: Provider name (which is Medicare in this case), You can fax the form, along with proof that you paid a Medicare Part B premium, to, You can upload the form through the EZ Receipts mobile app, available at the. All rights reserved. Liferay.on( If you use a provider outside of our network, you'll need to complete and file a claim form to be reimbursed. A secondary plan is one which takes into consideration the benefits of the primary plan before determining benefits available under its plan. Blue Cross Blue Shield window.open('https://cicqaaux.corp.bcbsal.org/I3Root/chatpopup.html?qname=cid_chat&fromUrl='+fromUrl, '', 'width=700, height=600'); Download and complete the appropriate form below, then submit it by December 31 of the year following the year that you received service. Already a Blue Cross member and have questions about your current plan? A healthy smile is an important part of your family's overall health. Download and complete the appropriate form below, then submit it by December 31 of the year following the year that you received service. Submit a separate claim for each patient. Node:bclrprvappp1002.corp.bcbsal.org:8080, Pre-Service Review for Out-of-Area Members, Anesthesia Sedation for Dental or Oral Surgery Procedures, Notification of Noncovered Dental Services, Predetermination of Benefits for Veneers and Anterior Crowns. If your drug is not covered and you think it should be, you may ask us to make an exception to the drug coverage rules by calling the Customer Service Department number on the back of your ID card. Node:bclrprvappp1001.corp.bcbsal.org:8080, Pre-Service Review for Out-of-Area Members, PRO-81 Professional Reimbursement Appeal Form, PRO-82 Utilization Management Appeal Form. With US Legal Forms the entire process of completing official documents is anxiety-free. Dental. For example, if an Alabama physician provides services to a member with Blue Cross and Blue Shield of Kansas coverage and a post-service appeal is needed, the physician should fill out the appropriate form from above and submit it to Blue Cross and Blue Shield of Alabama. You can take the Blue Health Assessment, check drug costs, change your address, request a member ID card and more. Blue Cross Blue Shield FEP Dental - Forms 2023, Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association. Your local company can help you to: Change your coverage Estimate the cost of a medical procedure File or check on claim Replace your member ID card Review your balance View your plan details Looking for Insurance? Blue Cross Community Health Plans, c/o Provider Services, P.O. function checkChatAvailability(userAction) { You can purchase ACA healthcare plans through a federal marketplace called the Health Insurance Marketplace or outside the Health Insurance Marketplace. LLC, Internet We will give you a response within 72 hours of receiving all information we need to make a decision for a standard review. If you have questions, please contact your local Blue Cross and Blue Shield company. The plan will only pay for care that is medically necessary and not investigational, as determined by us. In the left-hand column, locate the state where services were rendered. Claims Administrator Information contained in the external sites is not endorsed by BCBSAL. Patient & Claim. }).then(function(data) { Lastly mail the completed claim form to the address provided. For more information about the appeals process, see the following: Providers are required to file all post-service appeals to their local Blue Cross Plan regardless of the member's Home Plan. To determine your premium, call us at 1-855-488-2515 or click the "Get Started" link to compare your plans today. Highest customer reviews on one of the most highly-trusted product review platforms. Drug exceptions timeframes and enrollee responsibilities. } If you use our Care Coordinator services in developing your Plan of Care, and your claim is initiated with Home or Community Services, then your Lifetime Waiting Period will be reduced by half. Are you reporting a new case? . If you want to stay on Blue Cross' website, click "Cancel.". Tell us the type of service or supply for which you wish to file a claim (for example, hospital, physician, dentist or pharmacy), and we will send you the proper type of form. } url: "/ChatAvailabilityService/getAvailability?queueName=CID" (For example, if your service was provided on March 5, 2022, you have until December 31, 2023 to submit your claim). Using an electronic vendor approvedwith Blue Cross and Blue Shield of Alabama, submit an electronic claim using a valid Tax ID, Individual NPI and Organizational NPI. All rights reserved. Features expanded pediatric benefits for children up to the end of the month in which the member turns 19. Blue Cross and Blue Shield of Alabama enrolls and credentials all individual providers as well as ancillary and facility providers. Claim - provider.bcbsal.org For standard policies - all Qualified LTC expenses will be paid in full until you reach your Maximum Monthly Benefit (31 x your Daily Benefit Amount). If you fail to pay in full all periodic monthly payments due and payable before the end of the grace period for those coverage periods, your coverage under the plan will be retroactively canceled back to the last day of the first month of the grace period. *Subject to your Calendar Year Deductible. $.ajax({ Payer Name: Blue Cross Blue Shield of Alabama Payer ID: 510 Enrollment Required (ENR): Yes Type / Model: Commercial/Par State: AL Professional (CMS1500)/Institutional (UB04) [Hospitals] Real Time Eligibility (RTE): NO Real Time Claim Status (RTS): NO Electronic Remittance Advice (835) [ERA]: YES Secondary Electronic Claims (SEC): YES Thank you for your interest in our Short Term Plan. Please review your information to continue. Box 303017 Montgomery, AL 36130-3017. HealthEquity has agreed to follow Blue Cross' privacy and security policies regarding the confidentiality and protection of your personal health information. By clicking "Next", you are acknowledging that you would like to submit your application and continue onto the payment page otherwise, click "Cancel". If your ID card is not available, you may use one of the Customer Service telephone numbers below. Box 14053 Provider Phone Numbers PEEHIP P.O. Thank you for your interest in our Short Term Plan. If you purchased an individual plan through the health insurance marketplace and you are receiving advance payments of tax credits and/or cost sharing reductions in accordance with the Affordable Care Act, each of your monthly periodic payments is due on the first day of the month for that coverage period. By clicking "Next", you are acknowledging that you would like to submit your application and continue onto the payment page otherwise, click "Cancel". As an Alabama Health Guidance representative, I agree to the payment terms and conditions of Blue Cross and Blue Shield of Alabama and will not collect any checking account, debit card or credit card information on behalf of the consumer for the purchase of health or dental insurance. You are about to leave Blue Cross and Blue Shield of Alabama's website and enter a website operated by HealthEquity. Overseas members must file claim forms for any covered medical or pharmacy servicesreceived outside of the United States. Enjoy smart fillable fields and interactivity. In these cases, you are responsible for payment to the provider. *Please do not contact LifePlans unless you have already contacted Blue Cross and Blue Shield of Alabama to start your claim. An employee or dependent who loses coverage under Medicaid or a State Children's. var jsonStr = jQuery.parseJSON(data); Claim forms must be submitted to: method: "GET", Providers - ndbh.com View the latest providernews. Dental Blue } else { This login is for your Employer Account. Payer Name: Blue Cross Blue Shield of Alabama - thePracticeBridge Information contained in the external sites is not endorsed by BCBSAL. For Indemnity policies - you will be paid your applicable Daily Benefit Amount. Thank you for your interest in our Short Term Plan. 2023, Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association. In that case, you will be responsible for all charges billed to you by the out-of-network provider. Dental Claim Form - Blue Cross And Blue Shield Of Alabama - Bcbsal Your member ID card is your key to using your medical plan benefits. BCBS State by State | Blue Cross Blue Shield With Blue Cross and Blue Shield of Alabama, all of our dental plans include regular dental exams, x-ray and routine cleaning - at no extra cost. Each time Blue Cross processes a claim submitted by you or your healthcare provider, we send you an Explanation of Benefits (EOB). Member Services For general inquiries, you can reach us by calling the number below. 450 Riverchase Parkway East Three forms are also available to aid providers in preparing an appeal request. Our representatives can answer your questions and help you navigate these choices. Don't have a User ID? To continue to this website, click "Accept." $129 /month. 2023, Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross representative will assist you in developing a Plan of Care - a guide in determining the type and frequency of care services you need. allows healthcare providers to submit claims electronically to Blue Crossand Blue Shield of Alabama. Attorney, Terms of If you receive services from an out-of-network provider, these services may not be covered at all under the plan. Your Lifetime Waiting Period begins after you have been deemed Chronically Ill (or to have a significant Cognitive Impairment) and you have incurred one Qualified Long-Term Care expense. Upon completion of your Waiting Period, you will be eligible to begin receiving reimbursement of your benefits. Patient Consent Form for Provider Submitted Appeals View PDF. When you receive services from an in-network provider, your provider will generally file claims for you. You will be going to a new website, operated on behalf of the Blue Cross and Blue Shield Service Benefit Plan by a third party. Please attach any additional information and/or medical records at the time of filing the appeal for consideration. CPT codes, descriptions and data copyright 2022 American Medical Association. If the out-of-network services are covered, in most cases, you will have to pay significantly more than what you would pay an in-network provider because of lower benefit levels and higher cost sharing. Address: CHIP P.O. Blue Cross and Blue Shield of Alabama has an established appeals process for providers and physicians. Blue Plus **. For general inquiries, please call Blue Cross Blue Shield FEP Dental Customer Service at 1-855-504-BLUE (2583), 8 a.m. - 8 p.m. EST Monday - Friday (TTY 711) You can also submit an online inquiry regarding claims; ID cards; website assistance; grievance or appeal; or fraud, waste, and abuse. If your provider does not file your claim for you, you can call our Customer Service Department at the number on the back of your ID card and ask for a claim form. It's easy to protect your smile to the fullest with dental coverage that Additional details about this and other exception review details can be found in the Claims and Appeals section of your benefit booklet. English Espaol. Blue Cross and Blue Shield of Alabama Preferred Long-Term Care Customer Service: 1-888-331-4188 or 1-205-733-7019, Blue Cross and Blue Shield of Alabama Preferred Long-Term Care Customer Accounts: 1-205-220-4503, LifePlans Claims Services:* 1-800-525-7279 extension 273, LifePlans Provider Pathway:* 1-800-886-7404 or. Submit a separate claim for each member. Blue Cross and Blue Shield of Alabama Check out the changes and updates to our plan in 2023. USLegal fulfills industry-leading security and compliance standards. ProviderAccess Professional Claims Submission Help - bcbsal.org Node:bclrprvappp1002.corp.bcbsal.org:8080 . Call Customer Service at 1-855-504-BLUE (2583), 8 a.m. - 8 p.m. EST Monday - Friday, or Contact Us for further assistance. Rev 3/2007 13. An EOB is an outline of what services you received from a provider and how your benefits were applied to cover those services. This link takes you to another website. In most cases, you can prevent a retroactive denial by paying your premiums on time and/or by promptly notifying the plan or, if applicable, the marketplace of changes in your eligibility status for the plan. Outside the United States. Submit a separate claim for each patient. I want to purchase services for my organization. else Dental Expense Claim Author: Blue Cross and Blue Shield of Alabama Subject: Dental Expense Claim Keywords: Dental Expense Claim,dental expense,dental,expense,claim Created Date: Please make sure you select the appropriate form to address your specific need. Member Services | Blue Cross Blue Shield I am a Broker or Blue Plan partner that wants to visit the Partner Portal. services, For Small COB provisions determine which plan is primary and which is secondary. Dental Blue Plans - bcbsal.org An EOB is not a bill. To continue to the HealthEquity website, click "Accept." Use this form to submit a claim to be reimbursed for paying Medicare Part B premiums. CLAIM.MD | Payer Information | AL BCBS Payer Information AL BCBS Payer ID: 00510 This insurance is also known as: Blue Cross Blue Shield of Alabama Other ID's: SB510, 12B54 Need to submit transactions to this insurance carrier? Claim Submission | Blue Cross and Blue Shield of Illinois - BCBSIL Contact Us | Credence Blue Cross and Blue Shield Health Insurance Get Started An EOB is a statement that describes what medical treatments and/or services we paid on your behalf, what our payment was and your financial responsibility under the terms of the plan. This function gets loaded when everything, including the portlets, is on You should be sure to check with your provider to confirm whether precertification has been obtained. Register With Form - AFP Annual Conference - Association For - An17 Afponline, Identity Get your online template and fill it in using progressive features. Out-of-network liability and balance billing. CPT codes, descriptions and data copyright 2022 American Medical Association. Include itemized bills for covered services or supplies. Claim forms must be submitted to: Blue Cross and Blue Shield of Alabama 450 Riverchase Parkway East Birmingham, Alabama 35244-2858 Grace periods and claims pending policies during the grace period **Dental Blue Plus is a Health Insurance Marketplace plan. Adults age 19+. (You can fill the form in electronically or complete it by hand.). All rights reserved. Applicable FARS/DFARS apply. PDF Dental Expense Claim - bcbsal.org (SLC mailing address ) 61473: USA Blue Cross Blue Shield of North Carolina (Winston Salem mailing addr 61473 . Print and mail the form to your local Blue Cross and Blue Shield company by December 31 of the year following the year you received service. As a CHA representative, I agree to the payment terms and conditions of Blue Cross and Blue Shield of Alabama and will not collect any checking account, debit card or credit card information on behalf of the consumer for the purchase of health or dental insurance. Thank you for your interest in our Short Term Plan. { Forms, Real Estate Download your FREE dental guide to learn more about