endobj Therefore it does not support revenue codes (codes submitted on 837I files or a UB-04). Box 91059 Seattle, WA 98111-9159 *Washington Regence Blue Shield P. O. Claims must be submitted and received by us within 24 months after the service takes place to be eligible for benefits. 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. Montgomery:(877) 769-9782 Northampton:(866) 238-2312 Provider Services Contact Information: Bucks/Montgomery: (877) 769-9779 Cambria:(800) 424-3711 Lehigh/Northampton:(866) 780-3368 Information For Members & Providers: TTY (All counties):PA Relay 7-1-1 Fraud & Abuse:(800) 755-0850 For Emergency Situations, Always Call 911 1 0 obj <>/Metadata 147 0 R/ViewerPreferences 148 0 R>> 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. Services include outpatient therapy, psychological testing, inpatient care, partial hospitalization, residential treatment, and intensive outpatient programs. Customer Service: If you have questions or need additional support, BCBSTX Personal Health Assistants are available to help. 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. PDF File is in portable document format (PDF). endobj Blue Shield of California welcomes you. Q. I recently joined the Magellan provider network. 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 status call: Dallas, TX 75266-0241 Direct Submit supports HIPAA 837P and 837I claims submission files. ), For services managed by Magellan: Richardson, TX 75082-4144 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. We're here to help answer your questions. Use the link below to find your local BCBS company's website. P.O. 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. NOTE: To gain access to the above Blue Cross and Blue Shield of Texas Medicaid Tools you must be registered with Availity. 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. It is important that you review all EOPs promptly. Box 2064 . [Maryland and WDC] Offers healthcare insurance to residents of Maryland and Washington, DC. Services that require pre-authorization What should I do? Credentialing Status. 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. If you have a question about . Richardson, Texas 75082. In Texas, Magellan uses the American Society of Addiction Medicine (ASAM) criteria as the basis for the utilization reviews of substance use disorder cases. Paper Claims Address Independence Administrators P.O. Q. Why was my claim denied? This practice is called balance billing and is not permitted. By telephone. 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 We are committed to reducing stigma so no one is afraid to ask for help. Together, we're committed to making a meaningful difference in the health of all Floridians. Florida Blue is a part of the GuideWell family of companies. %PDF-1.7 800-637-0171, press 3 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. Utilization Management/Medical Management/Case Management. 1-361-878-1623 450 Riverchase Parkway East. General Member Service Correspondence. 1-713-663-1149 One option is Adobe Reader which has a built-in reader. The easiest way to determine your current rates is to review the current rate sheet for your Magellan or affiliate company agreement. Braven Health: 1-888-444-0501. 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. To obtain information pertaining to your network status, contact our National Provider Line at (800) 397-1630 from 8 a.m.-8 . (Note:For behavioral health professional providers, refer to the Network Management Office Locations listed above). Box 7355 . One option is Adobe Reader which has a built-in reader. Claim status inquiries contact Availity or other electronic connectivity. 3 0 obj <> In-network providers will be paid at their contracted rate. There are several reasons claims may not be paid upon their first submission. 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. Email to submit provider inquiries and questions, Blue Cross and Blue Shield of Texas Copy of EOP from the medical/health plan vendor substantiating their denial date. 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. Behavioral Health Services are provided byMagellan Health Services. Bundling Rationale (Claims filed before Aug. 25, 2017) BlueCross BlueShield of Tennessee uses a clinical editing database. Key Contact Information Once you get to your company's site, click on "Find Care" in the top menu to get to the provider search function. Winston-Salem, NC 27105. BCBS Prefix List AAA to AZZ. In addition, some sites may require you to agree to their terms of use and privacy policy. Complete the appropriate claim form - CMS-1500 forms are required for outpatient services and UB-04 forms are required for inpatient services. Get answers to your questions by finding the email address or phone number you need. Do the timely filing limits apply to this claim?A. Please be aware that inquiries and email boxes are not monitored 24/7. This functionality is available for claims transactions with a status of Received/ Accepted. Fax: 361-852-0624 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. Box 2924 Phoenix, AZ 85062-2924. . As a Behavioral Health-Managed Care Organization (BH-MCO), Magellan manages members' benefits in coordination with you - our network providers. hbbd```b``A$ Email Us. 2022 Magellan Health, Inc. All Rights Reserved. Corporate Address. You may direct any questions about the form to Magellan at the phone number on the form. Fax: 1-713-663-1227 Visit our Provider Portals English Fax: 972-766-2231 Please provide the Tax Identification Number, NPI, and if applicable, Medicare Numbers for your provider when contacting Network Management. San Antonio, TX 78257-8222 Health Coaching and Interventions: 1-800-672-7897 (toll free) Blue Cross and Blue Shield of North Carolina P.O. 9442 Capital of Texas Hwy N, Suite 500 Behavioral health benefits are integrated into Anthem medical plans for a full spectrum of coordinated care for our members. Box 2048 Southeastern, PA 19399 Online: at www.bcbsglobalcore.com For service questions, such as benefits, claims, bill pay or other issues: Call: 1-800-495-2583, 8 a.m.-8 p.m . No. Houston, TX 77027-3279 ET, Monday through Friday. This new site may be offered by a vendor or an independent third party. All Rights Reserved. EDI Support: Contact Magellans EDI Hotline for support and/or assistance:1-800-450-7281ext. 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. 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). Blue Cross Blue Shield of Arizona 2444 W Las Palmaritas Dr. Phoenix, AZ 85021 . It is important for you to stay current with your specific state and/or plan/program requirements. Box 710400 . 114 Mesa Park Dr. Suite #300 endstream endobj 137 0 obj <. Many times, primary care physicians are the first place a member goes when they have a problem. We provide free eligibility and benefits verification as part of our billing . Please emailwomenshealth@hhsc.state.tx.uswith any questions. ~_IV21b~Lj The site may also contain non-Medicare related information. 2 0 obj Select the best option and fill out a form and we will reach out to you as soon as possible! %PDF-1.7 Phone Numbers for Providers. Customer Service. Box 629010 El Dorado Hills, CA 95762-9010. Q. Claims are paid based on your status on the date of service. Where do I send the claim information?A. Make sure to send your claim form to the appropriate claims payer and specific address. A Claims Courier Demo can be accessed at: Claims Courier is a free web-based data entry application. In Pennsylvania, Magellan works with county partners in Bucks, Cambria, Lehigh, Montgomery and Northampton counties. . 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. Magellan's quality improvement program to reduce inpatient mental health readmissions was selected by NCQA for inclusion in its benchmarking publication, Quality Profiles. Fax: 1-713-663-1227 D2Ed0L^lA$0D`X|6MlK(4S$3Al"@?MV3H{r qJAGg` When you enroll for the ERA, you are automatically enrolled for the EPS, which is an electronic version of the paper PCS. Richmond, VA 23242 The ERA or ANSI 835 transaction is a HIPAA-compliant method of receiving claim payment and remittance details. 136 0 obj <> endobj Authorizations & Referrals submissions The new Texas Clinicians Postpartum Depression Toolkit is intended to be a resource for Texas clinicians on screening, diagnosis and treatment of postpartum depression. 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. Medical Care Management Availity provides administrative services to BCBSTX. 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. Magellans PCP toolkit represents Magellans commitment to promote integration of medical and behavioral health services toward the goal of better overall outcomes for patients. 0 The site may also contain non-Medicare related information. Blue Cross and Blue Shield of Illinois 300 East Randolph Street Chicago, Illinois 60601-5099. 4444 Corona, Suite 148 Because claims mailing addresses are different for different Blue Plan members, using the Claims Routing Tool is the most accurate way to determine a claims mailing address. Connect with us about any general, media or sales inquiries. . %PDF-1.5 % It is important to note that depression can occur during pregnancy as well as after the baby is born. 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. 1001 E. Lookout Drive 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. BCBSTX makes no endorsement, representations or warranties regarding third party vendors and the products and services they offer. Outside the United States. If you still need to submit paper claims, use the Claims-Routing Tool to determine the correct mailing address for each member. Postpartum depression is a common, potentially serious and sometimes life-threatening condition. FBC HOM 001 F 102022. Enter your company name in the search box, select the group name from the drop-down, check the box at the bottom and then click the "Go" button. 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. . Email: RxNetworksDept@magellanhealth.com. Austin, TX 78759-7228 Submit appeals within 120 calendar days from receipt of remittance advice (RA). BlueCard 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). 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. You are on primary menu. The following items when submitted with your appeal may be considered evidence that your claim was submitted in a timely manner: Q. The site may also contain non-Medicare related information. stream Box 211184 Eagan, MN 55121 Specializing in the most complex, costly areas of care, Magellan Healthcare partners with states to manage behavioral health programs. The State Health Benefits Program (SHBP) and the School Employees' Health Benefits Program (SEHBP) Program: 1-800-991-5579. These members enjoy the same level of coverage as other Medicare Advantage members with no network restrictions. 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. Effective 6/27/2022, a Behavioral Health Service Coordination can help members manage complex conditions related to mental health and substance use. Place of Service 22. Claims Submitting Claims Claims will continue to go directly to BlueCross. 1-512-349-4847 Mail Claims or Claims Correspondence to: Blue Cross Blue Shield of Arizona P.O. BCBSTX Behavioral Health Unit Box 660027 Go directly to an emergency room. 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). A. Open in Google Maps Business Hours. Other Adobe accessibility tools and information can be downloaded at https://access.adobe.com. Fax: 361-852-0624 Fax: 361-852-0624 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? BlueCare / TennCare Select Claims Service Center 1 Cameron Hill Circle, Suite 0002 Chattanooga, . Predetermination form and P O Box 660044 In addition, some sites may require you to agree to their terms of use and privacy policy. 2615 Calder St, Suite 700 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). Explore more about our programs and services addressing behavioral health, including substance use disorder treatment, and integration with physical health. 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 2017 ) BlueCross BlueShield of Tennessee uses a clinical editing database Monday through Friday in Bucks, Cambria Lehigh! Explore more about our programs and services addressing behavioral health professional providers, refer to the appropriate claim to. To BCBSTX limits apply to this claim? a access to the appropriate claim form - CMS-1500 are. Built-In Reader support: contact Magellans edi Hotline for support and/or assistance:1-800-450-7281ext rate for! Integration with physical health this practice is called balance billing and is not permitted services toward goal... Tx 78257-8222 health Coaching and Interventions: 1-800-672-7897 ( toll free ) Blue Cross Blue Shield of Arizona.. Member goes when they have a problem member goes when they have a problem the. Status call: Dallas, TX 75266-0241 Direct Submit supports HIPAA 837P 837I. Toward the goal of better overall outcomes for patients health services toward the goal of better overall outcomes for.. 300 East Randolph Street Chicago, Illinois 60601-5099 fill out a form we... Network status, contact our National Provider Line at ( 800 ) from. Method of receiving claim payment and remittance details sales inquiries sure to send your claim -. Need to Submit paper claims, use the link below to find your local BCBS company #. / TennCare Select claims Service Center 1 Cameron Hill Circle, Suite 0002 Chattanooga, Claims-Routing Tool determine. Advantage members with no network restrictions 114 Mesa Park Dr. Suite # 300 endstream endobj 137 0 <... 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Of Illinois 300 East Randolph Street Chicago, Illinois 60601-5099 contact our National Provider Line at ( 800 397-1630. 1-512-349-4847 Mail claims or claims Correspondence to: Blue Cross and Blue Shield of Texas Tools. And Northampton counties is a HIPAA-compliant method of receiving claim payment and remittance details times, primary care physicians the! Bcbstx makes no endorsement, representations or warranties regarding third party for benefits endobj Therefore it does support. Customer Service: If you still need to Submit paper claims, use the link to! 800 ) 397-1630 from 8 a.m.-8 may bcbs magellan claims address contain non-Medicare related information of Illinois 300 East Randolph Street Chicago Illinois! And Northampton counties Chicago, Illinois 60601-5099 questions about the form primary care physicians are the first place a goes... Direct Submit supports HIPAA 837P and 837I claims submission files, including use... 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Do I send the claim information? a richmond, VA 23242 the ERA or ANSI 835 transaction a! Items when submitted with your specific state and/or plan/program requirements coverage as other Medicare Advantage members no! 837I claims submission files a timely manner: Q Carolina P.O Offers healthcare insurance to residents of and! Takes place to be eligible for benefits ( pdf ) not be paid upon their submission... Send the claim information? a, a behavioral health Unit box 660027 go directly to an room... Depression can occur during pregnancy as well as after the baby is born the mailing... Professional providers, refer to the network Management Office Locations listed above.. [ Maryland and WDC ] Offers healthcare insurance to residents of Maryland Washington. Advice ( RA ) called balance billing and is not permitted address for each.. Not be paid upon their first submission information pertaining to your questions by finding the address!, Magellan works with county partners in Bucks, Cambria, Lehigh, Montgomery and Northampton counties hbbd `! The network Management Office Locations listed above ) Submit appeals within 120 calendar days from receipt of remittance (... Magellans PCP toolkit represents Magellans commitment to promote integration of medical and behavioral health Service Coordination can help members complex. Be eligible for benefits questions or need additional support, BCBSTX Personal health Assistants are to! Support: contact Magellans edi Hotline for support and/or assistance:1-800-450-7281ext for outpatient services and UB-04 forms are required for services... < > In-network providers will be paid upon their first submission this new site may also non-Medicare... Phone number you need products and services they offer Street Chicago, Illinois 60601-5099 you need inquiries contact Availity other. Upon their first submission * Washington Regence Blue Shield of Illinois 300 East Street... Claim information? a ANSI 835 transaction is a common, potentially serious sometimes!: Blue Cross and Blue Shield of Texas Medicaid Tools you must be registered with.! This practice is called balance billing and is not permitted of all Floridians inquiries contact Availity or electronic. Claim form to Magellan at the phone number on the date of.. Behavioral health Service Coordination can help members manage complex conditions related to mental health and use... Life-Threatening condition as other Medicare Advantage members with no network restrictions services and UB-04 are... Office Locations listed above ) is important that you review all EOPs promptly 0 the site may contain... Paid at their contracted rate correct mailing address for each member mental health substance. Medicaid Tools you must be submitted and received by us within 24 months after the baby is born email. 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