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Find forms that will aid you in the coverage decision, grievance or appeal process. Regence users: make the switch to the Availity Web Portal You have been redirected from the Regence or Asuris Northwest Health Provider Center. 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 Regence BlueCross BlueShield of Utah | Regence Your life. There are three levels to the appeals process: first-level, second-level, and external review (independent review). If you have questions about submitting a claim for services outside the U.S., call UMP Customer Service. Make sure you submit your complaint to the right company (see below). But there are some circumstances where you will need to submit a claim. . Prescription questions?Call Customer Service and choose the Pharmacy option. Box 1106 Lewiston, ID 83501-1106 Fax: 1 (877) 357-3418 . Please do not submit attachments (e.g., X-rays, periodontal chartings) with your pretreatment estimate or initial claims submission. Is this your business? If services were rendered in New York or Pennsylvania, then use the state-specific file address PDF. Get 5 free searches. Rev 3/2007 endobj complies with applicable Federal and Washington state civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, gender identity, or sexual orientation. You cannot ask for a tiering exception for a drug in our Specialty Tier. REGENCE BS OF UTAH. 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. Regence BlueCross BlueShield of Utah Regence Blue Shield of Idaho - FEPPO Box 30270Salt Lake City, UT 84131-0207. 2003 Western Ave # 600, Our award-winning Customer Service team is made of compassionate people who care. Phoenix, AZ 85072, Phone:800-562-1011 Step 3: Next, enter your Username/Password in the appropriate fields. Note: If the pick-up location is in Washington, refer to theWashington claims submission map to determine where to send your claim for processing. Recommended Reviews. Coding toolkit 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. Box 1106Lewiston, ID 83501-1106. 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. 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. You can download the appeal form and submit your written appeal by fax or mail: Mail:WSRxS Dental billing - Regence Please use the comment section for additional information. | Information current and approximate as of December 31, 2018. Claims & payment - Regence PDF Amendment to Regence Bluecross Blueshield of Oregon Medical Group Agreement First, you'll need to gather these documents: An itemized bill from your provider that describes the services and charges. Grievances must be filed within 60 days of the event or incident. Box 30805 Salt Lake City, UT 84130- 0805 *Pennsylvania BCNEPA P.O. Completion of the credentialing process takes 30-60 days. For Providers | Healthcare Management Administrators | Healthcare Locate a network pharmacy by using the Pharmacy Locator Tool. | 2 0 obj Usually we will send you an Explanation of Benefits (EOB) statement or a letter explaining our decision about a pre-authorization request. Don't have your card? Regence BlueShield of Idaho. Please contact the Medicare Appeals Team at 1 (866) 749-0355 or submit the appeal in writing and stating you need a fast, expedited, or hot" review, or a similar notation on the paperwork. About Regence BlueCross BlueShield of Oregon. Please do not submit attachments (e.g., X-rays, periodontal chartings) with your pretreatment estimate or initial claims submission. The quality of care you received from a provider or facility. **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. To send an electronic claim, use the Availity clearinghouse with payer ID HMA01. Regence Bluecross Blueshield of Oregon - Dun & Bradstreet Members: Log in/register at MyBlue Customer eService, Regence Blue Cross Blue Shield of Oregon - FEPPO Box 31105Salt Lake City, UT 84131, Regence Blue Cross Blue Shield of Oregon - FEPPO Box 1269Portland, OR 97207. The Centers for Medicare & Medicaid Services values your feedback and will use it to continue to improve the quality of the Medicare program. Stay up to date on what's happening from Portland to Prineville. Regence BlueCross BlueShield of Oregon For more specific contact information, choose from the following: Individuals and families Medicare Employers Producers Providers Fraud or abuse You can remain anonymous. %&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,. 3. Get help when you need it. Note: If you submit your claim by mail, be sure to make copies of your documents for your records. Blue Cross Blue Shield Association - Wikipedia If you wish to appoint someone to act on your behalf, you must complete an appointment of representative form and send it to us with your prescription coverage determination form. Many issues may be resolved with a phone call. PO BOX 21267 SEATTLE, WA 98111 800-845-0377. When the plan is the primary payer (pays first), UMP pays its normal benefit as described in the certificate of coverage. See what were doing in your community to keep people safe and healthy. Use the link below to find your local BCBS company's website. 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 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. Submit a Preauthorization Request Need help with a claim? Attn: Appeal UnitPO Box 40168Portland, OR 97240-0168. claim was denied or 30 months for claims subject to coordination of benefits. If the decision was after the 60-day timeframe, please include the reason you delayed filing the appeal. 3 0 obj If your coverage changes, call UMP Customer Service and Washington State Rx Services. 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. While it's a good idea to submit a complaint as soon as possible, there isn't a deadline to do so. 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. Availity and Regence Those documents will include the specific rules, guidelines or other similar criteria that affected the decision. Stay up to date on what's happening from Bonners Ferry to Boise. PO Box 91102Seattle, WA 98111-9202. I . Tagalog | Premera Blue Cross Your budget. ), 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 endobj Coordination of Benefits, Medicare crossover and other party liability or subrogation. If you use mail-order pharmacy and your primary plan uses Costco Mail Order Pharmacy or Postal Prescription Services (PPS) as the network mail-order pharmacy, Costco Mail Order Pharmacy or PPS can process payments for both plans and charge only the remaining unpaid balance. Billing | Life Flight Network The ambulance claim will be processed by Blue Cross Blue Shield of Oregon. Subscribe to online communications receive newsletters and important news via email. Send your claim or correspondence to the Blue Cross Blue Shield plan in the state from which the durable medical equipment was sent.Example: You live in Seattle and order parts for a wheelchair from a company in Montana. Out-of-network providers may submit a claim on your behalf. Regence Blue Shield in accordance with the terms of your provider contract with Regence. Make sure Costco Mail Order Pharmacy or PPS has the information for both plans and knows which plan is primary. Regence bluecross blueshield of oregon claims address 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. 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;& Member's name and member ID number, including the alpha prefix (three letters and the "W" before member ID number), b. Phoenix, AZ 85072, Retail Pharmacy Program You must continue to use network pharmacies until you are disenrolled from our plan to receive prescription drug coverage under our formulary. Stay up to date on what's happening from Salt Lake to St. George. Click on it. PO Box 52080 You may only disenroll or switch prescription drug plans under certain circumstances. 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. Please include the following information when requesting an appeal: The plan will send confirmation when it receives your appeal. Claims must be submitted within 12 months of the date of service. 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. 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 . All from Regence, a company committed to service, community and this place we call home. <> 1 0 obj If MAXIMUS disagrees with our decision, we authorize or pay for the requested services within the timeframe outlined by MAXIMUS. Regence Blue Cross Blue Shield of Oregon - Yelp For member appeals that qualify for a faster decision, there is an expedited appeal process. 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. 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 Other specialized services (home hospice, organ/tissue transplants, and clinical trials). 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. Regence bluecross blueshield of oregon address 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. Open 24 hours a day, 7 days a week. 636 GRAND AVE DES MOINES, IA 50309 800-245-6105. FAQs & Resources You can submit a claim online through your Regence account, or you can fax or mail your claim to Regence. Ting Vit | You have the right to file a grievance, or complaint, about us or one of our plan providers for matters other than payment or coverage disputes. Your trust is our top concern, so businesses can't pay to alter or remove their reviews. <> 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. Once that review is done, you will receive a letter explaining the result. Library Access our Administrative Manual and keep up to date with news. Open 24 hours a day, 7 days a week. Complete and mail or fax a Multiple Coverage Inquiry Form to Regence: Regence BlueShieldAttn: UMP ClaimsPO Box 91015MS BU386Seattle, WA 98111-9115. Make sure you contact the right company (see below). You receive services from an out-of-network provider. Regence BlueShield in accordance with the terms of your Provider contract with Regence. You must submit prescription drug claims within 12 months of purchase. Learn more about our payment and dispute (appeals) processes. Blue Cross and Blue Shield of Nevada will process the claim. Instructions: 1. Follow the prompts to submit your claim online. 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. BCBS State by State | Blue Cross Blue Shield 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. Though it is not required, you may want to include the UMP Appeals and Grievance form (for medical services) or the Washington State Rx Services Complaint and Appeal Form (for prescription drugs) with your appeal. The plan will notify you within the 30-day period that an extension is necessary, with a description of the information needed and why it is needed. Claims payment, processing, or reimbursement for health care services or supplies. Location. Don't have a Regence account yet? PDF Regence Provider Appeal Form Contact Us | FEP | Premera Blue Cross For any appeals that are denied, we will forward the case file to MAXIMUS Federal Services for an automatic second review. UMP medical plans are administered by Regence BlueShield. Franais | Box 995 Birmingham, AL 35298 Arkansas Arkansas BCBS PO Box 2181 Little Rock AR 72203 -2181 Arizona BCBS of Arizona . Oregon Regence BCBS of Oregon P. O. 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. State/Alpha Prefix Claims Filing Address Alabama BCBS of Alabama P.O. Din kehji k'eyeedgo, t' shdi k anidaalwoi bi bsh bee hane ninaaltsoos bee atah nilinigii bined bik. 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. Regence BlueShield of Idaho offers health and dental coverage to 142,000 members throughout the state. Premera Blue Cross Blue Shield of Alaska FEP PO Box 33932 Seattle, WA 98133-0932, Phone:800-562-1011 You will also receive a decision on your appeal within 30 calendar days. We must notify you of our decision about your grievance within 30 calendar days after receiving your grievance. Learn how to identify our members coverage, easily submit claims and receive payment for services and supplies. 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? Contact informationMedicare Advantage/Medicare Part D Appeals and GrievancesPO Box 1827, MS B32AGMedford, OR 97501, FAX_Medicare_Appeals_and_Grievances@regence.com, 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. Visit the Regence provider website, regence.com to learn more about: Contact Us View information about who to contact for questions and issues. PO BOX 25956 SALT LAKE CITY, UT 84125 800-662-0876. Select the area of the map that matches the color of the county where the service was performed. (Note: Claims received with an ICD-9 code will be rejected with a notice to re-bill using ICD-10.) 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. Deutsch | 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. 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 In every state and every community, BCBS companies are making a difference not just for our members, but For the Health of America. Your life. Regence BlueShield of Idaho is an independent licensee of the Blue Cross and Blue Shield Association. 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 . If you wish to appoint someone to act on your behalf, you must complete an appointment of representative form (PDF) and send it to us with your grievance form (PDF). Claims submission - Regence Regence BlueCross BlueShield of Utah. Get Marvin Thomas's email address (m*****@regence.com) and phone number (253581..) at RocketReach. 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 Sign in to your Regence account. Improving Health State-by-State, For the Health of America. Complete the Prescription Drug Claim Form and send it with your pharmacy receipts to: Pharmacy Manual ClaimsP.O. Programs View our programs and requirements for radiology, inpatient admissions and patient care management. 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. 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. We are now processing credentialing applications submitted on or before March 6, 2023. 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. 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. Send to Regence Blue Shield in accordance with the terms of your provider contract with Regence. PO Box 1271 MS C7APortland, OR 97207-1271 This form is to be used only for services in Oregon and Clark County, WA. REGENCE BS OF WASHINGTON. <>>> You must submit first-level and second-level appeals no more than 180 days after receiving the previous decision. 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). CLAIM.MD | Payer Information | OR BCBS (Regence) Provider home - Regence | Note:TovieworprintaPDFdocument,youneed AdobeReader. You may need to submit a claim to UMP for payment if: UMP does not cover nor coordinate benefits with workers' compensation claims. Please reference your agents name if applicable. This is the customer service number for questions about your health insurance coverage, benefits or treatment. These forms explain what information should be included with your appeal and list the address and fax number of where to send your appeal. Regence BlueShield serves select counties in the state of Washington and is an independent licensee of the Blue Cross and Blue Shield Association. 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. PDF State Mail to Mailing Address City, State Zip Your budget. Box 999Appleton, WI 54912-0999Fax: 1 (855) 668-8550. Claims Submission Map | FEP | Premera Blue Cross Regence BlueCross BlueShield of Oregon | OneHealthPort The plan must receive all relevant information with the appeal to make sure the most accurate decision is made. You can send your appeal online today through DocuSign. 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. Diabetes. Learn about dental billing information to help ensure your dental claims are processed quickly and correctly. Products and networks Learn more about the products we offer and the provider networks that support them. Examples: medical doctor, osteopath, optometrist, chiropractor, physical therapist, audiologist, independent laboratory, nurse practitioner, durable 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 Availity and Regence Working with Regence online? Professional Services are performed by a doctor or other healthcare professional. Step 2: Next, locate the "Login" button at the top-right corner. 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). View your credentialing status in Payer Spaces on Availity Essentials. ** We respond to medical coverage requests within 14 days for standard requests and 72 hours for expedited requests. If you do not obtain your physician's support, we will decide if your health condition requires a fast decision. When UMP pays second to another plan that covers the member, UMP will pay only an amount needed to bring the total benefit up to the amount UMP would have paid if the member did not have another plan. Management - prior auth/pre-service requests), Email: Members: Log in/register at MyBlue Customer eService, Regence BlueShield - FEPPO Box 21709Seattle, WA 98111. PDF Member Reimbursement Form Regence BlueShield serves select counties in the state of Washington and is an Independent Licensee of the Blue Cross and Blue Shield Association. If you or your dependents have other insurance, you must let UMP Customer Service and Washington State Rx Services know so claims are paid correctly. Information current and approximate as of December 31, 2018. CLAIM.MD | Payer Information | OR BCBS (Regence) Payer Information OR BCBS (Regence) Payer ID: 00851 This insurance is also known as: Regence Blue Cross of Oregon Blue Cross Blue Shield of OR REGENCE BLUECROSS BLUESHIELD OF OREGON REGENCE BCBS OF OREGON FEP G00851 Other ID's: 12B41, SB850 Need to submit transactions to this insurance carrier? Requests to find out if a medical service or procedure is covered. You must submit the claim to Regence as a medical claim. For information on false claims, see False claims or statements in your certificate of coverage. WELLMARK BCBS OF IOWA. If you buy your prescription drugs at a network pharmacy, your claim will be submitted for you. <>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> You can submit a marketing complaint to us by calling the phone number on the back of your member ID card or by calling 1-800-MEDICARE (1-800-633-4227). 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. PDF Local Blue Cross and Blue Shield Mailing Addresses State/Alpha Prefix Regence BlueShieldAttn: UMP ClaimsP.O. 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. Download a form to use to appeal by email, mail or fax. Provider Representative Contact Form - Regence Washington State Rx ServicesPO Box 40168Portland, OR 97240-0168. Claims determinationsThe plan will notify you of action taken on a claim within 30 days of the plan receiving it. Rocketreach finds email, phone & social media for 450M+ professionals. See Occupational injury or illness (workers' compensation) claims in your certificate of coverage. 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. MAXIMUS will review the file and ensure that our decision is accurate. Provider Contacts | Provider | Premera Blue Cross complies with applicable Federal and Washington state civil rights laws, Determine the county where the service was performed* (see exceptions below). We stay on top of issues until theyre resolved. Media Contact: Audrey Glasby Regence BlueCross BlueShield of Utah Regence .

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