Coronary Artery Disease. Improving Health State-by-State, For the Health of America. <> In every state and every community, BCBS companies are making a difference not just for our members, but For the Health of America. 7:00 AM - 6:00 PM PSTFax: 877-239-3390 (Claims and Customer Service)Fax: 877-202-3149 (Member Appeals only)Fax: 866-948-8823 (FEP Care Ting Vit | 1-800-962-2731. Get Marvin Thomas's email address (m*****@regence.com) and phone number (253581..) at RocketReach. Care Management Programs. The following information must appear on the provider's itemized bill for the plan to consider the claim for payment: a. Claims & payment Claims & payment Learn how to identify our members' coverage, easily submit claims and receive payment for services and supplies. Requests to find out if a medical service or procedure is covered. 4 0 obj Call UMP Customer Service for help with any questions when you or a family member is covered by more than one plan. Subscribe to online communications receive newsletters and important news via email. Regence BlueCross BlueShield of Utah is an independent licensee of the Blue Cross and Blue Shield Association. Note: If the pick-up location is in Washington, refer to theWashington claims submission map to determine where to send your claim for processing. Oregon Regence BCBS of Oregon P. O. You are about to leave regence.com and enter another website that is not affiliated with or licensed by the Blue Cross Blue Shield Association. You must submit prescription drug claims within 12 months of purchase. You are about to leave regence.com and enter another website that is not affiliated with or licensed by the Blue Cross Blue Shield Association. If your coverage changes, call UMP Customer Service and Washington State Rx Services. **If you, or your prescribing physician, believe that waiting for a standard decision (which will be provided within 72 hours) could seriously harm your life, health or ability to regain maximum function, you can ask for an expedited decision. %&xv}`kfg`O>=toy,y_bI)45T\ei@{65z9|i8NhI;nTSp~b5[iN_ pn+JsX;fz|4]R 8ZTJ.#fdP]^RP|z~-3KT\n:)O68m+zm96th+/5O6=%7;s"(CTF fZTreF`Tzq`a=6>GGW[tXudM+W6`m~yuCCu xd!XDmSdoQ/= y?ck r1rMc.c0>'1|\a{ enTc |GBl]|mCxr,. Customer Service will help you with the process. UMP may cover some supplies through the medical benefit and other supplies under the prescription drug benefit. If UMP is secondary, you must include a copy of your primary plan's Explanation of Benefits, which lists the services covered and how much the other plan paid. You should wait until the primary plan has paid to submit a secondary claim to UMP, unless the primary plan's processing of the claim is delayed. Lastupdated01/23/2023Y0062_2023_M_MEDICARE. You or your authorized representative (including a relative, friend, advocate, attorney, or provider) may submit an appeal by using the methods described in the Where to send complaints or appeals section below or by calling UMP Customer Service (medical appeals) or WSRxS Customer Service (prescription drug appeals). If we must request additional information, the processing of your claim may be delayed. If requested, we will supply copies of the relevant records we used to make our initial decision or appeal decision for free. 2023 Regence health plans are Independent Licensees of the Blue Cross and Blue Shield Association serving members in Idaho, Oregon, Utah and select counties of Washington. Step 1: Start your internet browser, and then go to the official regence bluecross blueshield of oregon claims address website. Box 999Appleton, WI 54912-0999Fax: 1 (855) 668-8550. Rocketreach finds email, phone & social media for 450M+ professionals. Lastly mail the completed claim form to the address provided. Were empathetic, reliable and tenacious, too. Please follow Claims determinationsThe plan will notify you of action taken on a claim within 30 days of the plan receiving it. Facility Services are services received for the use of a facility such as a hospital, emergency room, freestanding ambulatory facility, attended sleep study at outpatient part of a hospital, alcohol treatment facility or residential Be sure to include any other information you want considered in the appeal. Washington State Rx ServicesPO Box 40168Portland, OR 97240-0168. Deutsch | As a nonprofit independent licensee of the Blue Cross and Blue Shield Association, Regence is part of a . Polski | We will notify you if we need more time to respond. For more specific contact information, choose from the following: Individuals and families Medicare Employers Producers Providers Fraud or abuse You can remain anonymous. Join us! You can also call Washington State Rx Services with the information at 1 (888) 361-1611 (TRS: 711). Regence BlueCross BlueShield of Oregon providers located in Clark County, Washington: Within 24 months after payment of the claim or notice that the claim was denied or within 30 months for claims subject to coordination of benefits. Portugus | If services were rendered in New York or Pennsylvania, then use the state-specific file address PDF. See your certificate of coverage for more information on how to file a claim for specific services and supplies. . For services outside this area, please contact customer service directly at 1 (800) 365-3155 as your claim will require special handling. See the About UMP High Deductible Health Plan and If you have other HDHP coverage sections in the UMP High Deductible certificate of coverage for more information on secondary health plans and limitations. For more information about dual coverage, read the If you have other medical coverage (or UMP High Deductible "If you have other HDHP coverage") section in your plans certificate of coverage. All from Regence, a company committed to service, community and this place we call home. You must submit first-level and second-level appeals no more than 180 days after receiving the previous decision. Regence Blue Shield of Idaho - FEPPO Box 30270Salt Lake City, UT 84131-0207. Coverage decision requests can be submitted by you or your prescribing physician by calling us or faxing your request. Learn more. If you are a member of another air ambulance's membership program that is a reciprocal partner of Life Flight Network, please make sure you report this to our billing office at (866) 883-9998. Blue Cross and Blue Shield of Montana will process the claim. Open 24 hours a day, 7 days a week. Don't have your card? TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m EST., Monday through Friday. Send your claim or correspondence to the Blue Cross Blue Shield plan in the state where the laboratory work was sent for testing.Example: The lab service you used is in Arizona but the sample was sent to Nevada for analysis. Please do not submit attachments (e.g., X-rays, periodontal chartings) with your pretreatment estimate or initial claims submission. All from Regence, a company committed to service, community and this place we call home. When UMP pays second, you must still pay your deductible before UMP pays benefits. Some of the limits and restrictions to prescription drug coverage will apply when UMP pays second to another plan. Be on the lookout for future communications with more information about this exciting enhancement for submitting claim appeals through Availity. <> Claims and clinical appeals address: PO Box 21702 Eagan, MN 55121 Care management Phone: 844-996-0329 Fax: 888-302-9325 2023 holiday closures January 2 May 29 July 4 September 4 November 23 November 24 December 25 It was formed in 1982 from the merger of its two namesake organizations: Blue Cross was founded in 1929 and became the Blue Cross Association in 1960, while . REGENCE BS OF UTAH. Our award-winning Customer Service team is made of compassionate people who care. Rev 3/2007 You are about to leave regence.com and enter another website that is not affiliated with or licensed by the Blue Cross Blue Shield Association. You are about to leave regence.com and enter another website that is not affiliated with or licensed by the Blue Cross Blue Shield Association. If you have questions about submitting a claim for services outside the U.S., call UMP Customer Service.. Claims determinations The plan will notify you of action taken on a claim within 30 days of the plan receiving it. Regence Blue Shield in accordance with the terms of your provider contract with Regence. ** We respond to medical coverage requests within 14 days for standard requests and 72 hours for expedited requests. For questions about appeals, call the SEBB Appeals Unit at 1 (800) 351-6827. Products and networks Learn more about the products we offer and the provider networks that support them. TTY/TDD users can call 1-877-486-2048, 24 hours a day/7 days a week. Were proud to stand with you during this challenging time. You must appeal within 60 days of getting our written decision. Regence BlueCross BlueShield of Utah If you have questions, contact Washington State Rx Services Customer Service at 1 (888) 361-1611 (TRS: 711) Monday through Friday 7:30 a.m. to 5:30 p.m. (Pacific). Learn more about global periods, modifiers, virtual care, unlisted codes and NCCI bypass modifiers. Please do not submit attachments (e.g., X-rays, periodontal chartings) with your pretreatment estimate or initial claims submission. You may need to submit your own claim if you buy drugs at a non-network pharmacy, dont show your ID card, or have other prescription coverage that pays first and UMP is secondary. If additional information is needed, we will send you a request. Get help when you need it. 2023 Regence BlueShield. 10/18) v2 INSTRUCTIONS FOR FILING A CLAIM IMPORTANT: Use this form for all medical, pharmacy, dental, and vision services covered by Regence. Send to Regence Blue Shield in accordance with the terms of your provider contract with Regence. 0. Para asistencia en espaol, por favor llame al telfono de Servicio al Cliente en la parte de atrs de su tarjeta de miembro. %PDF-1.5 Box 1106Lewiston, ID 83501-1106 Fax: 1 (877) 357-3418 If you have questions about submitting a claim for services outside the U.S., call UMP Customer Service. Complete the Prescription Drug Claim Form and send it with your pharmacy receipts to: Pharmacy Manual ClaimsP.O. You have other insurance that pays first and UMP is secondary. Learn how our innovative solutions can help your employees live healthier, while helping you manage your costs. Box 1106 Lewiston, ID 83501-1106 Fax: 1 (877) 357-3418 . Learn more about our customized editing rules, including clinical edits, bundling edits, and outpatient code editor. I . Pre-authorization View services and supplies that require pre-authorization. With a plan powered by the most trusted name in health insurance, youll have coverage tailored to your health. The members full name (the name of the employee, retiree, or dependent covered by the plan), The member ID number (starting with a W on your UMP member ID card), The name(s) of any providers involved in the issue you are appealing, A statement describing the issue and your desired outcome, A copy of the Explanation of Benefits, if applicable, or a list of the claim numbers you are appealing. Usually we will send you an Explanation of Benefits (EOB) statement or a letter explaining our decision about a pre-authorization request. An appeal is a request from a member, or an authorized representative, to change a decision we have made about: Other matters included in your plan's contract with us or as required by state or federal law, Someone who has insurance through an employer, and any dependents they choose to enroll. Location. Step 1: Start your internet browser, and then go to the official regence bluecross blueshield of oregon address website. PO Box 1271 MS C7APortland, OR 97207-1271 This form is to be used only for services in Oregon and Clark County, WA. Regence BlueCross BlueShield of Utah. Coordination of Benefits or Other Party Liability . Dental billing. In Washington, Premera Blue Cross and Regence BlueShield share responsibility for claims processing, customer service, and prior authorization requests based on where the patient receives the service and what kind of service was received. Is this your business? Use the link below to find your local BCBS company's website. Locate a network pharmacy by using the Pharmacy Locator Tool. To request or check the status of a redetermination (appeal). 3 0 obj Open 24 hours a day, 7 days a week. We stay on top of issues until theyre resolved. Coordination of benefits (COB) happens when you have health coverage through two or more groups (such as your employer and your spouses employer), and these two group health plans both pay a portion of your health care claims. Medical records from your provider, if applicable. For any appeals that are denied, we will forward the case file to MAXIMUS Federal Services for an automatic second review. Cancel Proceed User name or email Programs View our programs and requirements for radiology, inpatient admissions and patient care management. Step 4: After you have completed the login details correctly . You can submit a claim online through your Regence account, or you can fax or mail your claim to Regence. Recommended Reviews. You must continue to use network pharmacies until you are disenrolled from our plan to receive prescription drug coverage under our formulary. If you have any questions about specific aspects of this information or need clarifications, please email press@bcbsa.com . Regence BlueCross BlueShield of Oregon is an independent licensee of the Blue Cross and Blue Shield Association. Note: If you submit your claim by mail, be sure to make copies of your documents for your records. Complete and mail or fax a WSRxS Multiple Pharmacy Coverage Inquiry Form (Drug Coordination of Benefits) to Washington State Rx Services. About Regence BlueCross BlueShield of Oregon. Examples: medical doctor, osteopath, optometrist, chiropractor, physical therapist, audiologist, independent laboratory, nurse practitioner, durable The member can appeal, or a representative the member chooses, including an attorney or, in some cases, a doctor. Professional Services are performed by a doctor or other healthcare professional. Grievances must be filed within 60 days of the event or incident. Coordination of Benefits, Medicare crossover and other party liability or subrogation. Call customer service and web support at 800-607-0546 between 8 a.m. and 6 p.m., Monday through Friday, Pacific Time. If the decision was after the 60-day timeframe, please include the reason you delayed filing the appeal. treatment center. For the Health of America. People with a hearing or speech disability can contact us using TTY: 711. You may send a complaint to us in writing or by calling Customer Service. When the plan is the primary payer (pays first), UMP pays its normal benefit as described in the certificate of coverage. 1 0 obj Regence: The most trusted name in health insurance Experience life with Blue With a plan powered by the most trusted name in health insurance, you'll have coverage tailored to your health. Learn more about when, and how, to submit claim attachments. You can send your appeal online today through DocuSign. The second high-deductible health plan cannot include an HSA. Find forms that will aid you in the coverage decision, grievance or appeal process. Regence BlueCross BlueShield of Utah offers health and dental coverage to 528,000 members throughout the state. Use the appeal form below. We will ask your permission if we need more time to respond. There are several levels of appeal, including internal and external appeal levels, which you may follow.

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