People with a hearing or speech disability can contact us using TTY: 711. MAXIMUS will review the file and ensure that our decision is accurate. First, you'll need to gather these documents: An itemized bill from your provider that describes the services and charges. You have the right to appeal, or request an independent review of, any action we take or decision we make about your coverage, benefits or services. Seattle, WA 98121, Support Phone Number: 1.888.427.0470 (toll free), Mon-Fri, 7:00 a.m. to 5:00 p.m. (PT), 1.800.AVAILITY (1.800.282.4548) (toll free), Run transactions to obtain member benefit, eligibility and claims information, Access eContracting to view and sign agreement documents, Our online newsletter (6 issues per year). 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. UMP may cover some supplies through the medical benefit and other supplies under the prescription drug benefit. Submit a Preauthorization Request Need help with a claim? Cancel Proceed User name or email REGENCE BS OF UTAH. Note: If the pick-up location is in Washington, refer to theWashington claims submission map to determine where to send your claim for processing. Premera Blue Cross Blue Shield of Alaska FEP PO Box 33932 Seattle, WA 98133-0932, Phone:800-562-1011 Kreyl Ayisyen | 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. In addition, you cannot obtain a brand-name drug for the copayment that applies to the generic drug. For more specific contact information, choose from the following: Individuals and familiesMedicareEmployersProducersProviders. In the left-hand column, locate the state where services were rendered. You can submit your appeal online, by email, by fax, by mail, or you can call using the number on the back of your member ID card. Please follow 2023 Regence BlueShield. You cannot ask for a tiering exception for a drug in our Specialty Tier. You can send your appeal online today through DocuSign. Locate a network pharmacy by using the Pharmacy Locator Tool. Ask your provider. <>>> The following information must appear on the provider's itemized bill for the plan to consider the claim for payment: a. To send an electronic claim, use the Availity clearinghouse with payer ID HMA01. A list of reciprocal partners as well as membership benefits can be found at lifeflight.org. For any appeals that are denied, we will forward the case file to MAXIMUS Federal Services for an automatic second review. To obtain information on the aggregate number of grievances, appeals and exceptions filed with the plan contact Customer Service. In every state and every community, BCBS companies are making a difference not just for our members, but For the Health of America. Many issues may be resolved with a phone call. If you do not submit your claims through Availity Essentials, follow this process to submit your claims to us electronically. Regence BlueCross BlueShield of Oregon offers health and dental coverage to 750,000 members throughout the state. . Learn more about informational, preventive services and functional modifiers. We know it is essential for you to receive payment promptly. When UMP pays second, you must still pay your deductible before UMP pays benefits. Why choose Regence Individual & family plans 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. Para humingi ng tulong sa Tagalog, pakitawagan ang numero ng telepono ng Serbisyo sa Kostumer (Customer Service) na nakasulat sa likod ng inyong kard bilang miyembro. BCBS State by State | Blue Cross Blue Shield. Information current and approximate as of December 31, 2018. Attn: Member Appeals 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 want a written response, you must request one. <>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Find the correct address listed under the type of service received (see explanation). 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. 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. Member's name and member ID number, including the alpha prefix (three letters and the "W" before member ID number), b. 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. A decision to deny, modify, reduce, or terminate payment, coverage, certification, or provision of health care services or benefits, including the admission to, or continued stay in, a health care facility. PO BOX 21267 SEATTLE, WA 98111 800-845-0377. 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. See "Appeals related to eligibility" section of your plan's. Note:TovieworprintaPDFdocument,youneed AdobeReader. If we must request additional information, the processing of your claim may be delayed. For prescription drug coverage, show both plan cards to the pharmacy and make sure they know which plan to bill first. Learn about electronic funds transfer, remittance advice and claim attachments. Any enrollee may appeal a decision made by the School Employees Benefits Board (SEBB) Program regarding SEBB eligibility, enrollment, premium payments, or premium surcharges (if applicable) to the SEBB Appeals Unit. x][o%~`C?3=k7A I87ggglM"_Unx9d,*Wdx cwU74/_C&$jTD/ew|/_t_~suJo~/X7/fTjz=u?|1w_k;vZ]!w??!~pw!cw DG6JOw{v?M.>~h9{/|0 _&CrOL%be_/WWc9U~;?#*bX Fz-w~7`e_ :5ZmLme'UFSgs\\@=~!r)Q;ZDf}Z1^W8qw`v0]wcEo5tLBn-4%x\I[s$8eBM:)$2dY9s>E;& The quality of care you received from a provider or facility. Deutsch | Blue cross blue shield address Medicaid Address and phone number - List 1 Medicaid claim submission address - List 2 Medicare . Please do not submit attachments (e.g., X-rays, periodontal chartings) with your pretreatment estimate or initial claims submission. To see if you qualify for Extra Help, call: 1-800-633-4227. Learn more about billing and how to submit claims to us for payment, including claims for BlueCross and BlueShield Federal Employee Program (BCBS FEP) members. To appeal by phone or if you have questions, contact UMP Customer Service at 1 (800) 628-3481 (TRS: 711) Monday through Friday 5 a.m. to 8 p.m. and Saturday 8 a.m. to 4:30 p.m. (Pacific). Note: If you submit your claim by mail, be sure to make copies of your documents for your records. TTY/TDD users can call 1-877-486-2048, 24 hours a day/7 days a week. Make sure Costco Mail Order Pharmacy or PPS has the information for both plans and knows which plan is primary. When a claim for workers compensation is accepted, all services related to that injury or illness are not covered, even if some services are denied by workers compensation. 1-800-962-2731. Oregon Regence BCBS of Oregon P. O. The Centers for Medicare & Medicaid Services values your feedback and will use it to continue to improve the quality of the Medicare program. Phoenix, AZ 85072, Phone:800-562-1011 I . Customer Service will help you with the process. 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 Regence BlueCross BlueShield of Oregon, headquartered in Portland, has been serving Oregonians since 1941 and now provides more than 974,000 people with comprehensive health insurance solutions. Please include the following information when requesting an appeal: The plan will send confirmation when it receives your appeal. Regence Blue Shield of Idaho - FEPPO Box 30270Salt Lake City, UT 84131-0207. Franais | For information on false claims, see False claims or statements in your certificate of coverage. We offer the option to subscribe to receive the following communications via email: Subscribe to receive an email when new editions of the provider newsletters are available. If MAXIMUS disagrees with our decision, we authorize or pay for the requested services within the timeframe outlined by MAXIMUS. Rev 3/2007 See Occupational injury or illness (workers' compensation) claims in your certificate of coverage. Coordination of Benefits, Medicare crossover and other party liability or subrogation. Mail or fax both the claim form and the provider's claim document (or bill) to: Regence BlueShield Attn: UMP Claims P.O. P | Regence users: make the switch to the Availity Web Portal You have been redirected from the Regence or Asuris Northwest Health Provider Center. 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. About Regence BlueCross BlueShield of Oregon. When you use a network provider or network pharmacy, you dont need to submit a claimthe provider or pharmacy will do it for you. Dissatisfaction with service provided by the health plan. Box 30805 Salt Lake City, UT 84130- 0805 *Pennsylvania BCNEPA P.O. Blue Cross Blue Shield Association (BCBS, BCBSA) is a federation, or supraorganization, of, in 2022, 34 independent and locally operated BCBSA companies that provide health insurance in the United States to more than 115 million people. Library Access our Administrative Manual and keep up to date with news. PO Box 1271 MS C7APortland, OR 97207-1271 This form is to be used only for services in Oregon and Clark County, WA. All from Regence, a company committed to service, community and this place we call home. Recommended Reviews. Quickly identify members and the type of coverage they have. 1 0 obj Instructions: 1. claim was denied or 30 months for claims subject to coordination of benefits. Learn more on the HCA website. Diabetes. No enrollment needed, submitters will receive this transaction automatically, Web portal only: Referral request, referral inquiry and pre-authorization request, Implementation Acknowledgement for Health Care Insurance. UMP medical plans are administered by Regence BlueShield. Send your claim or correspondence to the Blue Cross Blue Shield plan in the state where the ambulance picked up the patient.Example: An ambulance picks up the patient in Oregon and transports her to a care facility in Washington. Premera Blue Cross Blue Shield of Alaska - FEP PO Box 33932 Seattle, WA 98133-0932 Phone: 800-562-1011 6:00 AM - 5:00 PM AST Fax: 877-239-3390 (Claims and Customer Service) Fax: 877-202-3149 (Member Appeals only) Fax: 866-948-8823 (FEP Care Management - prior auth/pre-service requests) Email Members: Log in or register - MyBlue Customer eService When we make a decision about what services we will cover or how well pay for them, we let you know. Claims payment, processing, or reimbursement for health care services or supplies. Coverage decisionsA coverage decision is a decision we make about what well cover or the amount well pay for your medical services or prescription drugs. 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. Our award-winning Customer Service team is made of compassionate people who care. Contact Us | Blue Cross Blue Shield BCBS Customer Service Call the toll-free number on the back of your member ID card for BCBS customer service. Media Contact: Audrey Glasby Regence BlueCross BlueShield of Utah Regence . Regence BlueCross BlueShield of Oregon Availity Web Portal Support Phone Number 1.800.AVAILITY (1.800.282.4548) (toll free) Support Hours Mon-Fri, 7:00 a.m. to 4:00 p.m. (PT) Site URL http://www.regence.com What's available in the portal On the Availity Web Portal, you can: 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. Lack of information. If you or your dependents are enrolled in UMP High Deductible and want to enroll in another health plan, you and your dependents can only enroll in other high-deductible health plans. You get a vaccine or flu shot from an out-of-network provider. Learn more about global periods, modifiers, virtual care, unlisted codes and NCCI bypass modifiers. PO BOX 25956 SALT LAKE CITY, UT 84125 800-662-0876. The Regence Operations Trainer I would have two years' experience in operational areas to include customer service, claims, membership and/or delivering training in a matrixed environment or . An appeal qualifies for the expedited process when the member or physician feels that the member's life or health would be jeopardized by not having an appeal decision within 72 hours. Sign in to your Regence account. Chronic Obstructive Pulmonary Disease. If you have any questions about your member appeal process, call our Customer Service department at the number on the back of your member ID card. Regence BlueCross BlueShield of Utah. The plan must receive all relevant information with the appeal to make sure the most accurate decision is made. Regence Provider Appeal Form Special Message: Coming soon, you will be able to dispute (appeal) a claim on Availity from the claim status result page. Rocketreach finds email, phone & social media for 450M+ professionals. If additional information is needed, we will send you a request. 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 3: Next, enter your Username/Password in the appropriate fields. Email: Send email through your WSRxS account at ump.regence.com/sebb/benefits/prescriptionsNote: This email is not secure. Out-of-network providers may submit a claim on your behalf. For the Health of America. You can also download the appeal form and submit your written appeal by email, fax, or mail:Email: UMPMemberAppeals@regence.comFax: 1 (877) 663-7526, Mail:UMP Appeals and GrievancesRegence BlueShieldPO Box 91015Seattle, WA 98111-9115. Stay up to date on what's happening from Portland to Prineville. Were empathetic, reliable and tenacious, too. THIS AMENDMENT, effective January 01, 2023, hereby amends the Medical Group Agreement ("Agreement" or as otherwise defined in the Agreement) and any and all amendments, addenda, attachments or exhibits thereto by and between Regence BlueCross BlueShield of Oregon (Regence or as otherwise defined in the Agreement and hereafter referred to as Box 999Appleton, WI 54912-0999Fax: 1 (855) 668-8550. Follow the prompts to submit your claim online. 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. View your credentialing status in Payer Spaces on Availity Essentials. Read the "Guidelines for prescription drugs UMP covers" section of your certificate of coverage for details. This 30-day period may be extended by 15 days when action cannot be taken on the claim due to: Manage your claimsSee the status of your claims, see how much you owe, find a specific claim, and more by logging in to your Regence account. Claims determinationsThe plan will notify you of action taken on a claim within 30 days of the plan receiving it. Download a form to use to appeal by email, mail or fax. Congestive Heart Failure. Address: 200 SW Market St Portland, OR, 97201-5715 United States See other locations Phone: Website: www.regence.com Employees (this site): Actual Employees (all sites): Actual Revenue: Modelled Year Started: Incorporated: ESG ranking: ESG industry average: What is D&B's ESG Ranking? Regence BlueShield of Idaho offers health and dental coverage to 142,000 members throughout the state. Oral coverage decision requests1 (855) 522-8896 To request or check the status of a redetermination (appeal): 1 (866) 749-0355 Fax numbersAppeals and grievances: 1 (888) 309-8784Prescription coverage decisions: 1 (888) 335-3016 Other specialized services (home hospice, organ/tissue transplants, and clinical trials). See what were doing in your community to keep people safe and healthy. We're ready. Click on your plan, then choose theGrievances & appealscategory on the forms and documents page. For more specific contact information, choose from the following: Individuals and families Medicare Employers Producers Providers Fraud or abuse You can remain anonymous. Subscribe to online communications receive newsletters and important news via email. You can submit a claim online through your Regence account, or you can fax or mail your claim to Regence. As a nonprofit independent licensee of the Blue Cross and Blue Shield Association, Regence is part of a . Learn about dental billing information to help ensure your dental claims are processed quickly and correctly. PO Box 52057 Regence BlueShield. All features have been transitioned to the Availity Provider Portal. 3. See our FAQs for more claim information and contacts. These forms explain what information should be included with your appeal and list the address and fax number of where to send your appeal. We respond to pharmacy requests within 72 hours for standard requests and 24 hours for expedited requests. We will accept verbal expedited appeals. A complaint or grievance is an oral statement or written document submitted by or on behalf of a member regarding: Note: If your issue is regarding a denial, reduction, or termination of payment or non-provision of medical services, it is an appeal. Regence Blue Shield in accordance with the terms of your provider contract with Regence. <> You may send a complaint to us in writing or by calling Customer Service. Regence BlueShield of Idaho. medical equipment supplier, ambulance services, applied behavior analysis services (ABA) or clinical social worker. Learn more about when, and how, to submit claim attachments. Complete and mail or fax a WSRxS Multiple Pharmacy Coverage Inquiry Form (Drug Coordination of Benefits) to Washington State Rx Services. Please note: This form is to be used by physicians, other professional providers or medical facilities to contact their assigned provider relations representatives. PO Box 91102Seattle, WA 98111-9202. An appeal is an oral or written request submitted by you or your authorized representative to Regence BlueShield or Washington State Rx Services to reconsider: You or someone you authorize to represent you may request an appeal. Step 2: Next, locate the "Login" button at the top-right corner. To request or check the status of a redetermination (appeal). 0. Your budget. Please use the comment section for additional information. Send to Regence Blue Shield in accordance with the terms of your provider contract with Regence. Open 24 hours a day, 7 days a week. Regence BlueShield serves select counties in the state of Washington and is an independent licensee of the Blue Cross and Blue Shield Association. Your life. Excluded pharmacies are pharmacies that have been excluded due to fraud, waste, or abuse. Your provider should supply clinically relevant information, such as medical records for services denied based on medical necessity or for other clinical reasons. Management - prior auth/pre-service requests), Email: Members: Log in/register at MyBlue Customer eService, Regence BlueShield - FEPPO Box 21709Seattle, WA 98111. Is this your business? Claims & payment Claims & payment Learn how to identify our members' coverage, easily submit claims and receive payment for services and supplies. You will also receive a decision on your appeal within 30 calendar days. Management - prior auth/pre-service requests), Members: Log in or register - MyBlue Customer eService, Retail Pharmacy Program PO Box 52057 Phoenix, AZ 85072, Retail Pharmacy Program PO Box 52080 Phoenix, AZ 85072, Phone:800-552-0733Fax: 801-333-6523 (Mark claims: Attn New Claims)Email: Log in or register - MyBlue Customer eService, Regence BlueShield - FEPPO Box 857Lewiston, ID 83501, Regence BlueShield - FEPPO Box 1388Lewiston, ID 83501Customer Service. Don't have your card? ), Tel:800-562-1011Fax: 877-239-3390 (Claims and Customer Service)Fax: 877-202-3149 (Member Appeals only)Fax: 866-948-8823 (FEP Care Management - prior auth/pre-service requests), Premera Blue Cross - FEPPO Box 33932Seattle, WA 98133, Retail Pharmacy Program Call UMP Customer Service for help with any questions when you or a family member is covered by more than one plan. for other plans. Those documents will include the specific rules, guidelines or other similar criteria that affected the decision. The second high-deductible health plan cannot include an HSA. View our clinical edits and model claims editing. You can also get information and assistance on how to submit a written appeal by calling the Customer Service number on the back of your member ID card. This is the customer service number for questions about your health insurance coverage, benefits or treatment. Search jobs. See Complaints about quality of care in your certificate of coverage to learn more. Regence BlueCross BlueShield of Utah PO Box 1106 Lewiston, Idaho 83501 Or Fax claim to: (888) 606-6582 FORM PD020-UT Page 2 of 3 (Eff. Availity and Regence Working with Regence online? Open 24 hours a day, 7 days a week. 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 . FAQs & Resources Stay up to date on what's happening from Salt Lake to St. George. Complete and send your appeal entirely online. For member appeals that qualify for a faster decision, there is an expedited appeal process. Learn more about global periods, modifiers, virtual care, unlisted codes and NCCI bypass modifiers. Regency Blue Cross Blue Shield Of Oregon (541) 772-8906 Visit Website Map & Directions 2057 Commerce Dr Medford, OR 97504 Write a Review. Call customer service and web support at 800-607-0546 between 8 a.m. and 6 p.m., Monday through Friday, Pacific Time. Programs View our programs and requirements for radiology, inpatient admissions and patient care management. You can also call Washington State Rx Services with the information at 1 (888) 361-1611 (TRS: 711). If your primary plan uses a different mail-order pharmacy, you will have to use your primary plans mail order pharmacy and then submit a claim to Washington State Rx Services. Waiting too long on the phone, waiting room, in the exam room or when getting a prescription, The length of time required to fill a prescription or the accuracy of filling a prescription, Access to health care benefits, including a pre-authorization request denial, Claims payment, handling or reimbursement for health care services, A person who has bought insurance for themselves (also called a contract holder) and any dependents they choose to enroll. Your trust is our top concern, so businesses can't pay to alter or remove their reviews. Claims and payment Claims submission Claims submission Claim attachments Learn more about when, and how, to submit claim attachments. Appropriate staff members who were not involved in the earlier decision will review the appeal. Box 890179 Camp Hill, PA 17089 (Note: Claims received with an ICD-9 code will be rejected with a notice to re-bill using ICD-10.) PO Box 52080 Visit the Regence provider website, regence.com to learn more about: Contact Us View information about who to contact for questions and issues. Learn how to identify our members coverage, easily submit claims and receive payment for services and supplies. Follow the steps below to submit your claim online. 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). Once that review is done, you will receive a letter explaining the result. The plan will decide on your expedited appeal within 72 hours of the request. Identify BlueCard members, verify eligibility and submit claims for out-of-area patients. You receive services from an out-of-network provider. Circumstances beyond the plans control. An appeal for services related to the Centers of Excellence Program must be submitted within 180 days after you receive notice of the denial to Premera.Submit appeals to: Mail:Premera Blue Cross Completion of the credentialing process takes 30-60 days. Step 1: Start your internet browser, and then go to the official regence bluecross blueshield of oregon claims address website. Join us! They are also available outside these hours with limited services. For services outside this area, please contact customer service directly at 1 (800) 365-3155 as your claim will require special handling. Consult theFEP local plan directory to find addresses and telephone numbers for other plans.Note: If the equipment was sent from a DME provider in Washington, refer to thesubmission map to determine where to send your claim for processing. You have other insurance that pays first and UMP is secondary. Espaol | Regence BlueCross BlueShield of Utah With a plan powered by the most trusted name in health insurance, youll have coverage tailored to your health. Consult theFEP local plan directory to find addresses and telephone numbers for other plans.Note: If the laboratory work was sent to Washington for testing or analysis, refer to theWashington claims submission map to determine where to send your claim for processing. Coordination of Benefits or Other Party Liability . Learn about Regence Lewiston, ID office. The member can appeal, or a representative the member chooses, including an attorney or, in some cases, a doctor.