These guidelines, in addition to the editor will assist you through the entire procedure. var jsonStr = jQuery.parseJSON(data); 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. Email the Sales Call Center (AdviseMe@bcbsal.org) anytime. 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. Instructions: 1. Blue Cross Blue Shield of Alabama CBAL1: W USA: Blue Cross Blue Shield of Alaska 47570: USA . I authorize release of any information relating to this claim. 2023, BlueCross and BlueShield of Alabama is an independent licensee of the BlueCross and BlueShield Association. Precertification also does not mean that we have been paid all monies necessary for coverage to be in force on the date that services or supplies are rendered. Resources - provider.bcbsal.org Node:bclrprvappp1002.corp.bcbsal.org:8080 . 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 should be sure to check with your provider to confirm whether precertification has been obtained. allows healthcare providers to submit claims electronically to Blue Crossand Blue Shield of Alabama. Claims Payment Policy & Other Information - bcbsal.org To determine your premium, call us . //show the chat available image You can take the Blue Health Assessment, check drug costs, change your address, request a member ID card and more. 2023, Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association. If you have questions, please contact your local Blue Cross and Blue Shield company. 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. When we receive an electronic claim, you will automatically be set up as an out-of-state provider in our systemand can register to use our provider website,ProviderAccess: Once you have registered for ProviderAccess, you can also use on our online claim entry application,eClaims, to submit claims to us: Resources for Out-of-State Dental Providers: CPT codes, descriptions and data copyright 2022 American Medical Association. Use this form to submit a health benefit claim for services that are covered under the Blue Cross and Blue Shield Service Benefit Plan. In certain situations, a claim may be reprocessed and denied retroactively, even after it has been paid. Business. You can also find our claim forms on our website at: Claims must be submitted and received by us within 24 months after the service takes place to be eligible for benefits. Patient. It is your responsibility to ensure that you or your provider obtains precertification. If you want to stay on Blue Cross' website, click "Cancel.". Blue Cross Community Health Plans, c/o Provider Services, P.O. } Blue Cross Blue Shield FEP Dental - Forms the page. Mail original claims to the appropriate address as noted below. The protection of your privacy will be governed by the privacy policy of that site. $42 /month. P.O. A retroactive denial is the reversal of a previously paid claim. You are about to leave Blue Cross and Blue Shield of Alabama's website and enter a website operated by HealthEquity. Are you a provider?Click to be directed to our Providers area. method: "GET", else You may access the Nondiscrimination and Accessibility notice, Navigate & Connect: Simplifying access to behavioral healthcare. In some cases, the plan requires that you or your treating provider precertify the medical necessity of your care. 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. ALL Kids. HealthEquity is our business associate and is an independent company that provides account-based plan services to Blue Cross. Overseas members must file claim forms for any covered medical or pharmacy servicesreceived outside of the United States. Child up to age 19. Start now! Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association. We make it easy to manage your healthcare finances, claims and health information. Call Customer Service at 1-855-504-BLUE (2583), 8 a.m. - 8 p.m. EST Monday - Friday, or Contact Us for further assistance. Resources - provider.bcbsal.org Brush up on important dental plan details Download your FREE dental guide to learn more about the range of plans available to you. You can use 3 available choices; typing, drawing, or uploading one. CPT codes, descriptions and data copyright 2022 American Medical Association. Guarantees that a business meets BBB accreditation standards in the US and Canada. HealthEquity has agreed to follow Blue Cross' privacy and security policies regarding the confidentiality and protection of your personal health information. 2023, Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association. Birmingham, Alabama 35244-2858, Grace periods and claims pending policies during the grace period. 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. BCBS State by State | Blue Cross Blue Shield Ensures that a website is free of malware attacks. Technology, Power of The first column represents the states of the US and the second column is the insurance name and the Third column represents the Phone number. In that case, you will be responsible for all charges billed to you by the out-of-network provider. The route you should take depends on your individual healthcare needs and financial situation. 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. By continuing to use this website, you consent to these cookies. Dental Claim Form - Blue Cross And Blue Shield Of Alabama - Bcbsal Already a Blue Cross member and have questions about your current plan? Get Started All rights reserved. An EOB is an outline of what services you received from a provider and how your benefits were applied to cover those services. 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. #1 Internet-trusted security seal. If you receive out-of-network services for a medical emergency in the emergency room of a hospital, those services will be paid at the applicable in-network coinsurance amounts for benefits described in your benefit booklet, but subject to the out-of-network calendar year deductible.For emergency services for medical emergencies provided within the emergency room department of an out-of-network hospital, the allowed amount will be determined in accordance with the Affordable Care Act. An EOB is not a bill. Patient Consent Form for Provider Submitted Appeals View PDF. 2023 Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue ShieldAssociation. It's easy to protect your smile to the fullest with dental coverage that Claim Submission | Blue Cross and Blue Shield of Illinois - BCBSIL It also tells you how much has been credited toward any required deductible and out-of-pocket maximums. ); Generally, if precertification is required and not obtained, no benefits will be payable under the plan. If you pay a monthly payment later than the first day of the coverage period to which it applies, but before the end of the grace period for the coverage period, any claim you submit for benefits will be placed in a pending status (suspended) on the first day of the second month of the grace period and then processed by the plan only when all periodic monthly payments due during the grace period are received. You are about to leave Blue Cross and Blue Shield of Alabama's website and enter a website operated by Prime Therapeutics, LLC. Lexington, KY 40512. Get access to thousands of forms. Resources - provider.bcbsal.org Blue Cross and Blue Shield of Alabama Provider Directory > Claims Issues > or call 877-231-7239 or 205-220-6899 for eSolutions New Directions AL_ProviderRelations@ndbh.com or call 888-611-6285 < Back Blue Plus **. Forms, Real Estate 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. 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. 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. Adults age 19+. Some information on our site is secure; log in to ensure you're seeing all the news. Someone will get back to you within two business days. We will give you a response within 72 hours of receiving all information we need to make a decision for a standard review. Find your smile. A secondary plan is one which takes into consideration the benefits of the primary plan before determining benefits available under its plan. After determining your benefit eligibility, your Lifetime Waiting Period start date will be determined. Using an electronic vendor approved with Blue Cross and Blue Shield of Alabama, submit an electronic claim using a valid Tax ID, Individual NPI and Organizational NPI. Family. (You can fill the form in electronically or complete it by hand.). Medical necessity and prior authorization timeframes and enrollee responsibilities. In some cases, your provider will initiate the precertification process for you. Claim entry screens are divided into five categories: Patient, Claim Information, LineInformation, Other Insurance and Adjustments. } Patient Eligibility and Benefits; Pre-Service Review; Pre-Service Review for Out-of-Area Members . var fromUrl =window.location.host; Health . Upon completion of your Waiting Period, you will be eligible to begin receiving reimbursement of your benefits. A powerhouse editor is already at your fingertips supplying you with a range of useful instruments for filling out a Dental Claim Form - Blue Cross And Blue Shield Of Alabama - Bcbsal. A healthy smile is an important part of your family's overall health. TopTenReviews wrote "there is such an extensive range of documents covering so many topics that it is unlikely you would need to look anywhere else". The following documentation provides guidance regarding the process for appeals. BCBS Provider Phone Number list updated (2023) 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. 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? Home - provider.bcbsal.org Patient & Claim Payment & Refund Visit our COVID-19 Provider Update Center for the latest information about testing, treatment and telehealth coverage. Not a provider, but want to search our network?Search for Providers. What is the dental number for Blue Cross Blue Shield of Alabama? 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 services were rendered in New York or Pennsylvania, then use the state-specific file address PDF. Enjoy smart fillable fields and interactivity. Node:bclrprvappp1001.corp.bcbsal.org:8080 Handbook, Incorporation Authorization to Release Information Form View PDF. **Dental Blue Plus is a Health Insurance Marketplace plan. 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: Listed below are claims payment policies and other information for Qualified Health Plans offered by Blue Cross and Blue Shield of Alabama. COB provisions determine which plan is primary and which is secondary. The following documentation provides guidance regarding the process for appeals. (SLC mailing address ) 61473: USA Blue Cross Blue Shield of North Carolina (Winston Salem mailing addr 61473 . Box 3418, Scranton, PA 18505; Blue Cross Community MMAI (Medicare-Medicaid Plan), c/o Provider Services, P.O. Provider Enrollment 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 } window.open('https://cicqaaux.corp.bcbsal.org/I3Root/chatpopup.html?qname=cid_chat&fromUrl='+fromUrl, '', 'width=700, height=600'); Blue Cross Blue Shield of Alabama. Three forms are also available to aid providers in preparing an appeal request. (For example, if your service was provided on March 5, 2022, you have until December 31, 2023 to submit your claim). }. You can purchase ACA healthcare plans through a federal marketplace called the Health Insurance Marketplace or outside the Health Insurance Marketplace. EDI enrollment is NOT required for submission of electronic claims. (For example, if your service was provided on March 5, 2022, you have until December 31, 2023 to submit your claim). Claims Administrator }); } By clicking "Next", you are acknowledging that you would like to submit your application otherwise, click "Cancel". Claim Statements Reimbursements Contract and Dependent Information Other Insurance Coverage Deductible & Out of Pocket Costs View Benefits and Coverage Resources Review and Pay my Bill ID Cards Forms and Materials Covered Immunizations Health Insurance Basics Policies and Guidelines Preventive Services Caregiver Resources If you use a provider outside of our network, you'll need to complete and file a claim form to be reimbursed. $129 /month. 2. Submit a separate claim for each patient. If you want to stay on the Blue Cross website, click "Cancel.". English, Download the overseas retail prescription drugclaim form: CDT codes, descriptions and data copyright 2022 American Dental Association. To determine your premium, call us at 1-855-488-2515 or click the "Get Started" link to compare your plans today. Box 3686, Scranton . 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. Enroll as a Blue Cross provider, update provider information, or begin the credentialing/recredentialing process. By clicking "Next", you are acknowledging that you would like to submit your application and continue onto the payment page otherwise, click "Cancel". 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. (You can fill the form in electronically or complete it by hand.). Call the National Information Center at 1-800-411-BLUE (2583) weekdays from 8 a.m. to 8 p.m. Eastern time. In these cases, you are responsible for payment to the provider. Applicable FARS/DFARS apply. Submit a separate claim for each member. USLegal has been awarded the TopTenREVIEWS Gold Award 9 years in a row as the most comprehensive and helpful online legal forms services on the market today. USLegal received the following as compared to 9 other form sites. Download your FREE dental guide to learn more about Provider Phone Numbers PEEHIP P.O. An assessment will be scheduled and performed by a Blue Cross representative to determine if your situation and health needs meet claims benefit eligibility. Experience a faster way to fill out and sign forms on the web. CDT codes, descriptions and data copyright 2022 American Dental Association. This link takes you to another website. function() { All rights reserved. I am a Broker or Blue Plan partner that wants to visit the Partner Portal. Out-of-network liability and balance billing. Some information on our siteis secure; log in to ensure youre seeingall the news. PDF State Mail to Mailing Address City, State Zip - Pnnl What is the fax number for BCBS Alabama appeals? & Estates, Corporate - For questions about claims payments, health, and dental benefits, or to order insurance cards, please call Blue Cross and Blue Shield of Alabama at 1-800-760-6851. Thank you for your interest in our Short Term Plan. ProviderAccess Professional Claims Submission Help - bcbsal.org . The plan will only pay for care that is medically necessary and not investigational, as determined by us. Include the date to the document using the Date function. Blue Cross and Blue Shield of Alabama. Dental Blue Benefit Summary Plan Benefit In-Network Benefits Dental Blue 2500A Dental Blue 2000A Dental Blue 1500A Dental Blue 1500B Dental Blue 1000A Dental Blue 1000B MAJOR SERVICES (CONTINUED) Major Services - Prosthetic Services to deductibleInlays, onlays, veneers or crowns Fixed or removable bridges Full or . 3. 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. Ifyou believe that this page should betaken down, please follow our DMCA take down process, Ensure the security ofyour data and transactions, Dental Claim Form - Blue Cross And Blue Shield Of Alabama - Bcbsal. To continue to the HealthEquity website, click "Accept." 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 Phone Numbers. Additional details about this and other exception review details can be found in the Claims and Appeals section of your benefit booklet. English Espaol. What is the fax number for BCBS of Alabama claims? Contact Us | Credence Blue Cross and Blue Shield Health Insurance Providing us with your name and email address allows us to contactyou. The case number, contract number and/or accident date you've entered does not match our records. Choose between our 3 dental plans today! By clicking "Next", you are acknowledging that you would like to submit your application and continue onto the payment page otherwise, click "Cancel". Thank you for your interest in our Short Term Plan. $('#chat-available').show(); function checkChatAvailability(userAction) { Print and complete the form according to instructions on the front. CPT codes, descriptions and data copyright 2022 American Medical Association. $('#chat-available').hide(); if (jsonStr.Availability === 'YES') { 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. Follow the simple instructions below: The days of distressing complex legal and tax forms have ended. Resources - provider.bcbsal.org All rights reserved. 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. Name and Address of Carrier . For more information, view our privacy policy. Use this form to submit a claim to be reimbursed for services that are covered under Service Benefit Plan dental benefits. If your ID card is not available, you may use one of the Customer Service telephone numbers below. Your doctor or other prescriber must give us a statement that explains the medical reasons for requesting an exception. If we deny your request, you may request an internal appeal and an external review by an impartial third party reviewer, known as an Independent Review Organization (IRO). Include itemized bills for covered services or supplies. Attorney, Terms of Using this login enables you to manage the account for your organizations participating members. Box 3836, Scranton, PA 18505; Blue Cross Medicare Advantage, c/o Provider Services, P.O. Need to submit a claim? 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. }).then(function(data) { Contact Us - bcbsal.org Get your online template and fill it in using progressive features. All rights reserved. Spanish, Localized Drug exceptions timeframes and enrollee responsibilities. Highest customer reviews on one of the most highly-trusted product review platforms. To save time and incorrect billing process you can check the below table for the insurance numbers along with the respective states of the BCBS. Download the overseas medical claim form: Blue Cross and Blue Shield of Alabama will send you a Claims Packet to be completed and returned to us. Thank you for your interest in our Short Term Plan. LLC, Internet { Register With Form - AFP Annual Conference - Association For - An17 Afponline, Identity services, For Small Questions? * Sign up today and get a plan that's accepted by over 1,700 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. Dental Blue Plans - bcbsal.org Blue Cross Blue Shield FEP Dental - Contact Us *Please do not contact LifePlans unless you have already contacted Blue Cross and Blue Shield of Alabama to start your claim. Applicable FARS/DFARS apply. Blue Cross Blue Shield To ask for a formal decision about the coverage if you disagree, print and complete the appropriate form below and fax it to 1-800-693-6703 or mail to Prime Therapeutics LLC, Attention: Part D Appeals Department, 1305 Corporate Center Dr. How to File a Claim Call Preferred Long-Term Care (LTC) Customer Service (1-888-331-4188) to complete the Claims Intake Form over the telephone. Thank you for your interest in our Short Term Plan. Blue Cross and Blue Shield of Alabama enrolls and credentials all individual providers as well as ancillary and facility providers. *Subject to your Calendar Year Deductible. Failure to timely pay premium payments is not a special open enrollment event for later coverage under the plan. Claim - provider.bcbsal.org Claim submission is supported for primary, secondary and tertiarypayment. I want to purchase services for my organization. Some areas of our site may provide links to other external sites that we don't own, control or influence. The 34 independent BCBS companies insure more than 107 million members across all 50 states, the District of Columbia, and Puerto Rico 107 M members covered $ 382 M+ invested in community health initiatives 572 K+ Employee volunteer hours How to file a dental claim with Blue Cross Blue Shield Alabama? Register Now. CDT codes, descriptions and data copyright 2022 American Dental Association. Please review the terms of use and privacy policies of the new site you will be visiting. Call Preferred Long-Term Care (LTC) Customer Service (1-888-331-4188) to complete the Claims Intake Form over the telephone. Your member ID card is your key to using your medical plan benefits. Patient & Claim. Features expanded pediatric benefits for children up to the end of the month in which the member turns 19. Our representatives can answer your questions and help you navigate these choices. gives you access to exams, X-rays and routine cleaningsat no Attach pharmacy receipts for covered prescriptions. Claim forms must be submitted to: If you want to stay on Blue Cross' website, click "Cancel.". In the left-hand column, locate the state where services were rendered.
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