We encourage you to submit claims electronically, via www.MagellanProvider.com or through a clearinghouse. 1001 E. Lookout Drive %
Claims Address. Explore more about our programs and services addressing behavioral health, including substance use disorder treatment, and integration with physical health. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 19 0 R 25 0 R 26 0 R] /MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>>
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<. Blue Cross Blue Shield members can search for doctors, hospitals and dentists: In the United States, Puerto Rico and U.S. Virgin Islands. Most PDF readers are a free download. Key Contact Information 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. (Note:For behavioral health professional providers, refer to the Network Management Office Locations listed above). Upon receipt of a claim, Magellan reviews the documentation and makes a payment determination. In Texas, Magellan uses the American Society of Addiction Medicine (ASAM) criteria as the basis for the utilization reviews of substance use disorder cases. all_rights_reserved. Box 660044 Fax: 1-713-663-1227 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 Phone: 1-972-766-7100 Note: Predetermination requests for members with Blue Cross and Blue Shield benefits in another state should be sent to the Plan indicated on the members ID card. San Antonio, TX 78257-8222 Attention: Claim Department . Why was my claim denied? 1999-2022 commercial_footer_copyright_magellan_link. P O Box 660044 Its similar to the CMS 1500 claim form, with additional fields to make the application HIPAA-compliant. In addition, some sites may require you to agree to their terms of use and privacy policy. 1-800-637-0171, press 3 or 1-713-663-1149 Availity provides administrative services to BCBSTX. Providers can refer members by contacting 1-877-214-5630. Does this timely filing limit apply to all claims for all members (e.g., COB, Medicare, etc.)?A. This claim is a resubmit; why was it denied for timely filing?A. <>
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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. 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). For status call: Attn: Predetermination Dept. What should I do? To view this file, you may need to install a PDF reader program. Fax: 972-766-2231 Fax 877-361-7646, Claims submission address: Eligibility and benefits We're here to help answer your questions. Box 211184 Eagan, MN 55121 Most PDF readers are a free download. Box 32593 Detroit, MI 48232-0593. 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. UB-04 claims Blue Cross Blue Shield of Michigan P.O. 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. Magellan has had sites accredited by URAC since 1992. Email to submit provider inquiries, Blue Cross and Blue Shield of Texas (BCBSTX). Dallas, TX 75266-0044, Behavioral health services - claims status inquiries, For services managed by BCBSTX: 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 The site may also contain non-Medicare related information. San Diego, CA 92171 . Make sure to send your claim form to the appropriate claims payer and specific address. Download information about our behavioral health solutions and public behavioral health overview. hb```@(]K@1%
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Most PDF readers are a free download. Mail Claims or Claims Correspondence to: Blue Cross Blue Shield of Arizona P.O. Email Us. Our innovative approach includes: These programs not only address the symptoms of addiction; they also address the causes. Q. I have never had a claim denied for timely filing reasons before; why is it being denied now?A. 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.. Email to submit provider inquiries, 1001 E. Lookout Drive If you still need to submit paper claims, use the Claims-Routing Tool to determine the correct mailing address for each member. Email: RxNetworksDept@magellanhealth.com. 2615 Calder St, Suite 700 As a Behavioral Health-Managed Care Organization (BH-MCO), Magellan manages members' benefits in coordination with you - our network providers. It is important to note that depression can occur during pregnancy as well as after the baby is born. Apply for individual or family medical, dental, and life insurance plans. Under Magellan's policies and procedures, the standardtimely filing limit is 60 days. Through the Homeless Outreach Positive Engagement intensive case management program, Magellan has helped 81% of members obtain housing and 61% reduce their number of hospital days.1. The EPSarrives fasterthan the PCS andis easier to archivefor future retrieval. Q. I have proof that I submitted the claim within the timely filing limits. To obtain information pertaining to your network status, contact our National Provider Line at (800) 397-1630 from 8 a.m.-8 . Resubmitted claims should include the Date of Original Submission and Claim number if applicable. BlueCard Box 7355 . Availity EFT & ERA Enrollment User Guide. 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 Childrens Health Insurance Program (CHIP), plans covering employees of the state of Texas, school districts, and the University of Texas and Texas A&M systems. Fax: 915-496-6614 NOTE: To gain access to the above Blue Cross and Blue Shield of Texas Medicaid Tools you must be registered with Availity. If necessary, government programs paper claims may be submitted. and the amount . Fax: 1-713-663-1227 This new site may be offered by a vendor or an independent third party. 10 things to check each time you submit a claim: Q. I believe I am being paid the incorrect rate. Magellan Healthcare Solutions for Complex Care Needs: Behavioral Health, Specialty Imaging, Automated Prior Authorization, Employee Assistance. Go directly to an emergency room. 1001 E. Lookout Drive. Email to submit provider inquiries and questions, Blue Cross and Blue Shield of Texas Refer to BCBSTX Medicaid website and Contact Us. Box 710400 . Claims Address: P.O. ET, Monday through Friday. If you have a question about . P.O. Richardson, TX 75082 Box 272640 Chico, Ca 95927-2640 Phone: (800) 541-6652 Fax: (818) 228-5014 Blue Cross and Blue Shield of Texas Richardson, TX 75082-4144 Customer Service. When your BCBS ID card arrives in the mail, take a moment to look for these five things: 1. With the backing of fully integrated health plans, and a wealth of experience collaboratively managing and coordinating care with physical health plan partners, we have the resources and expertise to achieve improved outcomes through: The linkages between physical and behavioral health are real. The site may also contain non-Medicare related information. Find your provider portal Box 30271 Salt Lake City, UT 84130-0271 *Washington Regence Group Administrators Attn: Claims P. O. This new site may be offered by a vendor or an independent third party. External link You are leaving this website/app (site). See first question and answer above. Driving directions. Note: For the requests below, utilize the indicated links: All other inquiries submit an email by selecting the office closest to your location and provide the Tax Identification Number, NPI, and if applicable, Medicare Numbers for your provider when contacting Network Management. The form cannot be used for any other purpose except to request prior authorization of a healthcare service. Open in Google Maps Business Hours. Resubmissions must be submitted within 60 days from the date of denial. Please be aware that inquiries and email boxes are not monitored 24/7. Box 629010 El Dorado Hills, CA 95762-9010. For urgent requests only: 1-915-496-6600, press 2 Blue Cross Complete claims P.O. Availity provides administrative services to BCBSTX. Florida Blue is a part of the GuideWell family of companies. We are committed to reducing stigma so no one is afraid to ask for help. Email to submit provider inquiries. This practice is called balance billing and is not permitted. Instructions for submitting requests for predetermination Call 911. 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. Skip to article content, Intensive care coordination for members with serious mental illness (SMI) and comorbid conditions, Family-based, value-based care for children and adolescents at risk for hospitalization or out-of-home placement, Targeted case management for homeless individuals with SMI, Integrated case management through our Dual-Diagnosis Treatment Team for individuals with developmental disabilities, Digital cognitive behavioral therapy supporting increased screening and online treatment for pain management, substance use, depression, anxiety and insomnia, Increased access to medication-assisted treatment (MAT), Peer support and recovery and resiliency services focusing on members development and achievement of health and wellness goals, and connection to community resources, Communication campaigns and resources, providing guidance for members and providers in a variety of convenient formats, Internal policies and procedures to reinforce coordination throughout the care management process, Mutual cooperation and coordination agreements to share clinically relevant information. This functionality is available for claims transactions with a status of Received/ Accepted. 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. 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. 800-637-0171, press 3 BlueCross BlueShield of Tennessee payer ID number: 00390. %PDF-1.7
Questions related to a specific claim should be directed to the toll-free number on the member's ID card or the Explanation of Benefits. 2. 1-361-878-1623 Interested in exploring opportunities? Contact Availity or other electronic connectivity vendor or call Magellan Behavioral Health 1-800-729-2422, Claim filing address for Commercial products, Availity Essentials 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. endobj
This is the customer service number for questions about your health insurance coverage, benefits or treatment. Its a simple six-step process which includes uploading and sending test files. One option is Adobe Reader which has a built-in reader. If your state has multiple brands (WA, CA, OR, NY, NJ, to name just a few) then you'll want to ask for the exact address to file to. The site may also contain non-Medicare related information. Services that require pre-authorization BlueCross BlueShield of Tennessee is a Qualified Health Plan . 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. Fax: 361-852-0624 There, claims submission information is broken out by prefix/product name. Richardson, Texas 75082. Paper Claim Filing; Dental Providers. If you are able to create an 837 file in a HIPAA compliant format, we. To view this file, you may need to install a PDF reader program. You are leaving this website/app (site). BCBS Customer Service Call the toll-free number on the back of your member ID card for BCBS customer service. Or call your doctor or therapist for 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. In addition, some sites may require you to agree to their terms of use and privacy policy. Once you get to your company's site, click on "Find Care" in the top menu to get to the provider search function. Although it is not preferred, providers may also submit paper claims via a CMS-1500 form (Non-Facility-Based Providers) or UB-04 form (Facility-Based Providers). 1800 West Loop South, Suite 600 Member Services 1-800-521-6860 TTY: 1-800-684-5505 Representatives are available 24 hours a day, 7 days a week.. Claims submission address: Blue Cross and Blue Shield of Texas P O Box 660044 Dallas, TX 75266-0044. Keystone First 200 Stevens Drive Philadelphia, PA 19113. Enforcing this clause also brings us in line with industry practices. Horizon Behavioral Health. Other Adobe accessibility tools and information can be downloaded at https://access.adobe.com. Looking to contact Magellan Rx Management? You will be assigned an IT analyst to guide you through the process and address any questions. 1 Magellan Behavioral Health of Pennsylvania evaluation including claims data, the Consumer Health Inventory survey, and housing and income data Box 710400, San Diego CA 921710400 Phone Number: (877) 263-9952 Blue Shield of CA: Payer ID: BS001 Claims Address: P.O. Email to submit provider inquiries and questions, Blue Cross and Blue Shield of Texas BCBSTX Behavioral Health Unit PO Box 660241 Dallas, TX 75266-0241 Fax 877-361-7646 Claims submission address: Blue Cross and Blue Shield of Texas P O Box 660044 Dallas, TX 75266-0044 For prior authorization and referrals managed by Magellan: Magellan Behavioral Health Providers of Texas, Inc. 800-729-2422 Medicaid Phone Number. No. stream
Magellan Behavioral Health Providers! Beaumont, TX 77702-1954 TO AVOID DELAY, DO NOT SUBMIT FORM TO MULTIPLE AREAS/OFFICES. There is a simple testing process to determine if Direct Submit is right for you. 2 0 obj
Main telephone number 1-215-937-8000. 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). stream
Contact Information. Blue Cross and Blue Shield of Texas. Box 629011 El Dorado Hills, CA 95762-9011. 1 0 obj
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