Use the link below tofind your local BCBS company's website. First Character P is symbolizing that member plan/product type is BCBS PPO. The 835 eliminates the need for paper remittance reconciliation. Prefix ZGP identifies Blue Cross Blue Shield of Texas PPO Product. Member ID cards may include one of the logos below that identify the type of coverage the member has and/or indicate the providers reimbursement level. RIVERSIDE SAN BERNARDINO COUNTY INDIAN HEALTH INC. Rocky Mountain Health Plan- Grand Junction, Sacramento Primary Care Practices of Sacramento EHS, San Diego Hospice and The Institute for Palliative Medicine, San Diego Metropolitan Transit System (SCHIP Liability), Santa Clara Valley Tansportation Authority, SelectCare of Texas (HPN) Heritage Physicians Network, Sheet Metal Workers Local 104 Health Care Plan (San Ramon CA), Sinai Medical Group Chicago IL Family Health Network patients only, Solidarity Managed Care Organization (Ohio BWC), Sound Health (now known as First Choice Health Network), South Central Preferred PPO York PA (IHS Gateway Payer), Southern CA Childrens Network (SynerMed), Spectrum Administrators Inc. TPA Allentown PA (IHS Gateway Payer), St. Anthony Memorial Healthcare Centers MDWISE, St. Francis Health Care Chicago IL MG#112, St. Margaret Mercy Healthcare Centers MDWISE, Superior Administrators Inc (Santa Ana CA), Sutter East Bay Regional Hospital- Affinity, TEAMSTERS (UT/ ID / MT) Group Benefit Admin, The Care Network/The Savannah Business Group, The Health Plan (Massillon Ohio and St. Clairsville Ohio only), The Loomis Company TPA Wyomissing PA (IHS Gateway Payer), The MEGA Life & Health Insurance Company Insurance Center, The MEGA Life & Health Insurance Company Starbridge StarHRG, The Physicians Assurance Corp (TPAC) /Employee Benefit Management Corp (EBM, The Preferred Healthcare System (TPHS) PPO Altoona PA (IHS GatewayPayer), Thomas Staffing Services Inc/Venturi Staffing, Todays Options (American Progressive and Pyramid Life), TOUCHSTONE HEALTH/HEALTH NET SMART CHOICE, TransAmerica Occidental Life Insurance Company, Transchoice or TransSmile First Service Administrators Inc, TX Medicare Part A and Indian Health Services J4, UMR (formerly Harrington Benefit Services Westerville), UMR (formerly Harrington Benefit Services), UMR (formerly Lexington / CommonWealth Administrative Group), UMR (formerly UMR San Antonio Benefit Planners), UMR (formerly UMR Wausau Fiserv Benesight), UMR Westerville (formerly Harrington Benefit Services Columbus), UMR/Cincinnati (Repricing for HealthSpan Network Only), UNION PACIFIC RAILROAD EMPLOYES Health Systems, United Teacher Assoc Ins Co- Medicare Supplement, United Wisconsin Insurance Company-United Heartland, UnitedHealthcare (formerly Definity Health Plan), UnitedHealthcare (MAHP MD IPA Optimum Choice MAMSI), UnitedHealthcare / MAHP MD IPA Optimum Choice MLH (formerly MAMSI), UnitedHealthcare / UHIS UnitedHealth Integrated Services, UnitedHealthcare / UnitedHealthcare Plan of the River Valley, UnitedHealthcare / UnitedHealthcare StudentResources, UnitedHealthcare / UnitedHealthcare West (formerly PacifiCare), UnitedHealthCare Community Plan (KS / KanCare), UnitedHealthcare Community Plan / DC DE OH PA SC (formerly Unison), UnitedHealthcare Community Plan / AZ (formerly AZ Physicians IPA APIPA), UnitedHealthcare Community Plan / FLHI LA MD MS CAN OH RI TX WAWI), UnitedHealthcare Community Plan / IA (formerly AmeriChoice of Iowa), UnitedHealthcare Community Plan / MI (formerly Great Lakes Health Plan), UnitedHealthcare Community Plan / MS CHIP (formerly AmeriChoice MS-CHIP), UnitedHealthcare Community Plan / NY (formerly AmeriChoice NY Medicaid), UnitedHealthcare Community Plan / NY (formerly AmeriChoice Personal Care), UnitedHealthcare Community Plan / PA (formerly AmeriChoice PA Medicaid&CHIP, UnitedHealthcare Community Plan / PA (formerly AmeriChoice Personal Care ), UnitedHealthcare Community Plan / TN (formerly AmeriChoice TN: TennCare), UnitedHealthcare Community Plan / UnitedHealthcare Long Term Care, UnitedHealthcare Medicare Solutions / UnitedHealthcare Chronic Complete, UnitedHealthcare Medicare Solutions / UnitedHealthcare Group Medicare Advan, UnitedHealthcare Medicare Solutions / UnitedHealthcare MedicareComplete, UnitedHealthcare Medicare Solutions / UnitedHealthcare MedicareDirect, UnitedHealthcare Medicare Solutions / UnitedHealthcare Nursing Home Plan, UnitedHealthcare West (formerly PacifiCare of Arizona), UnitedHealthcare West (formerly PacifiCare of CA Claims), UnitedHealthcare West (formerly PacifiCare of Colorado), UnitedHealthcare West (formerly PacifiCare PPO All States), UnitedHealthOne (American Medical Security), UnitedHeathcare Community Plan (formerly Unison Health Plan), Unitrin Direct Property & Casualty Company, Univera Healthcare SSA WNY PPO Traditional, University Family Care Healthcare Group, University Family Care Maricopa Health Plan, University of Illinois at Chicago Div of Specialized Care for Children, USAA (United Services Automobile Association), USFHP St. Vincent Catholic Medical Centers of New York, Utah Blue Cross (Regence Blue Cross of Oregon), Valley Health Care Management Services LLC, ValueOptions/MBHP (MA Behavioral Health Partnership), WASHINGTON State Dept of LABOR & INDUSTRY, Waterstone Benefit Administrators (Oklahoma Providers), Waterstone Benefit Administrators (Outside Oklahoma), webTPA/Community Health Electronic Claims/CHEC, West Texas Rural Counties Association Preferred Risk Pool WC, Western Southern Financial Group (Cincinnati OH), WINhealth Partners/Wyoming Health Solutions, Znat Insurance (Zenith National Insurance). There are two types of BCBS prefixes which are mentioned below: Plan Specific prefix are assigned by BCBS to each plan. Double click on the appropriate Insurance policy listed. Select Submit. BCBS Prefix: For a full list of contact information, please refer to the provider manual: Various logos may be displayed on member ID cards for Blue Cross Blue Shield (BCBS) Plans in the United States and International Licensees licensed through BCBSA. You can use the first three numbers on your member ID card to log into your account and access your benefits. Here are some options for submitting claims electronically: Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association. Or learn more online about coverage for: This number is used solely to receive calls and never to make calls to BCBS members. Some of our partners may process your data as a part of their legitimate business interest without asking for consent. For Example: ABC, A2B, 2AB, 2A2 etc. NaviNet submissions: Call the eBusiness Desk at 1-888-777-5075, Monday - Friday, 7 a.m. to 6 p.m. Professional providers using a clearinghouse: Call your vendor. The Blue Cross Blue Shield System is made up of 34 independent and locally operated companies. Availity offers flexibility to submit transactions through an existing EDI vendor or clearinghouse, or use your own EDI software. Right after completing my degree in 2011, I started my job career as an Accounts Receivable in a medical billing company. Many times, the Blue Shield payor ID used is 94036 or BS001. Access Your Benefits. rights reserved.Blue Cross and Blue Shield of South Carolina is an independent licensee of the Blue Cross Read more about the transition to the Availity provider portal. EFT deposits are assigned a trace number that is matched to the 835 Electronic Remittance Advice (ERA) for simple payment reconciliation. Use the following payer IDwhen submitting dental claims. 2023 Blue Cross Blue Shield Association. What should you do if your bluecross blueshield payer id number password is lost? It shows that these type of BCBS member IDs are different. Find My BCBS Company For UB-04 billing guidelines, go to the National Uniform Billing Committee or American Hospital Association websites. Note: If you use a billing company or clearinghouse for your EDI transmissions, . January 2022 . Note: Only registered Availity users can access Patient ID Finder. Your BCBS ID card may include a list of the co-pay amounts you can expect to pay for common services, like a doctors visit or trip to the emergency room. Americas 1st Choice Health Plans of North Carolina Inc. Americas 1st Choice Health Plans of South Carolina Inc. Anthem Blue Cross and Blue Shield (Virginia), Arizona & 21st Corp. DBA Berkley East Conv. So, to accomplish our goal, we have listed down the complete BCBS alpha prefix list so that you can easily identify correct BCBS plan. Submit by fax: 1-833-224-6929 Submit by mail to: Blue Cross and Blue Shield of Minnesota and Blue Plus ATTN: Consumer Service Center P.O. We look forward to working with you to provide quality services to our members. The content shared in this website is for education and training purpose only. Prospective customers can call to discuss options to purchase coverage. If you still have trouble logging in, click the Forgot Password? link and follow the steps to reset your password. Quality Care Thats Right for YouWhether you need a routine check-up or a specialty procedure, you want the best care you can find. Your local company can help you to: Change your coverage. BCBS Alpha Numeric Prefix from L2A to L9Z (Updated 2023), BCBS Provider Phone Number for Claims and Eligibility Verification, PR 27 Denial Code Description and Solution, How to Improve Your Coding Accuracy? Keeping your card in a secure location will also help protect you from medical identity theft. Get access to your online account. Were making changes that offer providers a new option for submitting Blue Cross, Medicare Plus BlueSM, Federal Employee Program, Blue Care Network, BCN AdvantageSM and Blue Cross Complete claims. Payer ID provider number reference Facility Use this guide as a reference tool when submitting facility claims. Reduce overhead and administrative costs by eliminating paper claim submissions. It means that BCBS members IDs prefix will must have alphabets and they may or may not have numbers. Learn more about our Total Care and Blue Distinction Specialty Care designation programs and find a designated doctor or hospital that meets your needs. BCBS recognizes doctors and hospitals for their expertise and exceptional quality in delivering care. For accurate and quick claims processing, it is necessary to get complete patient insurance information. You'll also find lists of claims that can't be processed electronically and a library with helpful documents. CCN Managed Care Inc. & PPO Oklahoma), First Service Administrators Inc Lakeland Florida, FOUNDATION BENEFIT ADMINISTRATORS/CONTRACTOR EMPLOYEE BENEFITS ADMIN. Anthem is a registered trademark of Anthem Insurance Companies, Inc. Availity, LLC is an independent company providing administrative support services on behalf of Anthem Blue Cross and Blue Shield. Verify Payer IDClick Encounters > Track Claim Status. For technical requirements and instructions, please call one of these numbers: 1996-2023 Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. We recently received a query from a provider that how I can identify that patient is BCBS health insurance member. LLC, an independent licensee of the Blue Cross and Blue Shield Association. Additionally, providers can also check status on previously submitted requests and/or . MedicalBillingRCM.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com. Providers in states other than Minnesota providing services to a patient with Blue Cross Blue Shield Minnesota coverage should submit their claims to their local Blue Cross Blue Shield plan and should not submit claims using payer ID CBMN1. BCBS Prefix will not only have numbers and the digits 0 and 1. %%EOF Ironworkers Health & Security Trust Fund, N.W. Your Blue Cross and Blue Shield Service Benefit Plan member ID card is your key to using your medical plan benefits. Now, with more than 15 years of experience as a medical biller and revenue cycle manager, I am on a mission to serve the medical billing industry with my vast knowledge and years of expertise. By Payer Id, every provider and insurance company or payer systems connect electronically with each other. Not registered? Don't have your card? Corrected claims, secondary claims or BlueCard claims cannot be submitted through NaviNet at this time. We and our partners use cookies to Store and/or access information on a device. If youre a medical biller or a provider and going to submit BCBS plan member claim to the insurance, make sure to submit member ID including prefix. 800-676-2583. BCBS is one of the largest medical insurance company by total members of more than 45 million. Registered Marks of the Blue Cross and Blue Shield Association. The Blue Cross Blue Shield Association is an association of independent, locally operated Blue Cross and Blue Shield companies. Blue Cross Blue Shield of Arizona (BCBSAZ) requires providers to use electronic transactions in the standard HIPAA 5010 format. Manage Settings EDIT: If youre unsure, I think the U can look this up automatically so I would go with what . You'll need to get set up and follow some guidelines to send and receive information using EDI. Insurance Payer ID is unique series of letters and/or numbers that indicate the digital destination of an electronic claim. GROUP (or RxGroup): 788257. These prefixes may include alpha and numerical characters. First Character Z assigned to the BCBS Plan. Non-Discrimination Statement and Foreign Language AccessCopyright {{ new Date().getFullYear() }} All Serving Maryland, the District of Columbia and portions of Virginia, CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc. CareFirst BlueCross BlueShield Medicare Advantage is the shared business name of CareFirst Advantage, Inc. and CareFirst Advantage DSNP, Inc. CareFirst BlueCross BlueShield Community Health Plan Maryland is the business name of CareFirst Community Partners, Inc. CareFirst BlueCross BlueShield Community Health Plan District of Columbia is the business name of Trusted Health Plan (District of Columbia), Inc. After you've received three passed files foreach line of business tested, call the number on the test instruction letter to begin subsystem testing. This may help them route the claim to us. Registered Marks of Blue Cross and Blue Shield of Massachusetts, Inc., and Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc. Registered Marks, TM Trademarks. card with "MA PPO" in a suitcaseand a prefix not defined . We always make sure to keep BCBS prefix list and BCBS provider phone numbers directory up to date. Note- All information updated from reliable and authorized source of information and USA gov authorized web portals and other source of information likeCMS,AAPC, AHA, etc. . Insights, information and powerful stories on how Blue Cross Blue Shield companies are leading the way to better healthcare and health for America. Choose the patient with whom you would like to work with or you can enter the patient's name or chart ID in the . Payer Codes CareFirst's payer ID code for dental electronic claims is 00580. Your National Provider Identifier (NPI) must be used to identify your practice when submitting claims. If you have an HMO, your card may also list the physician or group youve selected for primary care. BCBS Alpha Prefix list is useful for both providers and BCBS enrolled members/patients. For any other EDI transaction companion documents, please visit our Provider Training Academy page. If you receive health insurance via your employer, your insurance card will most likely have a group plan number. Community Medical Group of the West Valley Inc. CompManagement Health Systems Inc. (Ohio BWC), CompManagement/Integrated Comp (Ohio BWC), Continental General Ins Co- Medicare Supplement, CONTRA COASTAL COUNTY SCHOOLS INSURANCE GROUP (CCCSIG), Contractors Laborers Teamsters & Engineers, Covenant Administrators Inc. (Atlanta GA), Coventry Health and Life Insurance Company administered by PersonalCare, Coventry Health and Life Insureance (Tennessee), Coventry Health Care Carelink West Virginia only, Coventry Health Care Carelink Medicaid West Virginia only, Cypress Insurance Company (Member of BHHC), DC Chartered Health Plan Inc. (Medicaid & Alliance), Denver Health Medical Plan Inc. Medicare Choice, Department of Labor (including Postal Employees), Department of Water and Power of the City of Los Angeles (LADWP). 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