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method: "GET", Thank you for your interest in our Short Term Plan. */ (SLC mailing address ) 61473: USA Blue Cross Blue Shield of North Carolina (Winston Salem mailing addr 61473 . 2023, Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association. 2. Access the most extensive library of templates available. 3. 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. If you want to stay on Blue Cross' website, click "Cancel.". Blue Cross and Blue Shield of Alabama has an established appeals process for providers and physicians. Applicable FARS/DFARS apply. Failure to timely pay premium payments is not a special open enrollment event for later coverage under the plan. Claim forms must be submitted to: In certain situations, a claim may be reprocessed and denied retroactively, even after it has been paid. I want to purchase services for my organization. { Get Started 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. It also tells you how much has been credited toward any required deductible and out-of-pocket maximums. Download the overseas medical claim form: 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 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. } if(window.location.host==='qaibcbsal.bcbsal.org') 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. When we receive an electronic claim, you will automatically be set up as an out-of-state provider in our system and can register to use our provider website, ProviderAccess: Once . Check out the changes and updates to our plan in 2023. 450 Riverchase Parkway East You will be going to a new website, operated on behalf of the Blue Cross and Blue Shield Service Benefit Plan by a third party. To continue to this 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 $('#chat-available').hide(); Enroll as a Blue Cross provider, update provider information, or begin the credentialing/recredentialing process. You can file your expenses for reimbursement as frequently as you want. Submit a separate claim for each patient. If you receive services from an out-of-network provider, these services may not be covered at all under the plan. Address: CHIP P.O. Access a wealth of healthcare resources and tools with MyBlue. Guarantees that a business meets BBB accreditation standards in the US and Canada. If you do not know this information, please contact us at 205-220-7725 or fax your request to 205-220-6354. Node:bclrprvappp1001.corp.bcbsal.org:8080, Pre-Service Review for Out-of-Area Members. Follow the simple instructions below: The days of distressing complex legal and tax forms have ended. Call the National Information Center at 1-800-411-BLUE (2583) weekdays from 8 a.m. to 8 p.m. Eastern time. Phone Numbers. Use this form to submit a claim to be reimbursed for services that are covered under Service Benefit Plan dental benefits. (For example, if your service was provided on March 5, 2022, you have until December 31, 2023 to submit your claim). (For example, if your service was provided on March 5, 2022, you have until December 31, 2023 to submit your claim). Download and complete the appropriate form below, then submit it by December 31 of the year following the year that you received service. We use cookies on this website to give you the best experience and measure website usage. Claim entry screens are divided into five categories: Patient, Claim Information, LineInformation, Other Insurance and Adjustments. Include proof that you paid a Medicare Part B premium. Questions? Blue Cross and Blue Shield of Alabama Preferred Long-Term Care Customer Service: 1-888-331-4188 or 1-205-733-7019, Blue Cross and Blue Shield of Alabama Preferred Long-Term Care Customer Accounts: 1-205-220-4503, LifePlans Claims Services:* 1-800-525-7279 extension 273, LifePlans Provider Pathway:* 1-800-886-7404 or. *Please do not contact LifePlans unless you have already contacted Blue Cross and Blue Shield of Alabama to start your claim. the page. Attach pharmacy receipts for covered prescriptions. For Indemnity policies - you will be paid your applicable Daily Benefit Amount. Questions? Blue Cross Community Health Plans, c/o Provider Services, P.O. Coordination of Benefits (COB) is a provision designed to help manage the cost of healthcare by avoiding duplication of benefits when a person is covered by two or more benefit plans. } If you want to stay on the Blue Cross website, click "Cancel.". You can view your personal EOBs through your MyBlue account. 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 . 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. 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. Start now! Blue Cross and Blue Shield of Alabama enrolls and credentials all individual providers as well as ancillary and facility providers. The protection of your privacy will be governed by the privacy policy of that site. For standard policies - all Qualified LTC expenses will be paid in full until you reach your Maximum Monthly Benefit (31 x your Daily Benefit Amount). Some areas of our site may provide links to other external sites that we don't own, control or influence. Review Blue Cross and Blue Advantage medical and pharmacy policiesor comment on draft policies. Blue Cross and Blue Shield of Alabama will send you a Claims Packet to be completed and returned to us. If you believe you believe you have overpaid your premium due to our overbilling, please contact us by calling the Customer Service Department number on the back of your ID card. If you are a contracted health plan partner, then you have a dedicated account manager you can call upon at any time for any reason. Theft, Personal $129 /month. Your local company can help you to: Change your coverage Estimate the cost of a medical procedure File or check on claim Replace your member ID card Review your balance View your plan details Looking for Insurance? $23 /month. Heres everything you need to know about it. Be sure the data you add to the Dental Claim Form - Blue Cross And Blue Shield Of Alabama - Bcbsal is up-to-date and accurate. 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. Lexington, KY 40512. We make completing any Dental Claim Form - Blue Cross And Blue Shield Of Alabama - Bcbsal easier. Ensures that a website is free of malware attacks. If you or your doctor believe there are exigent circumstances that require an expedited review, an expedited exception request can be submitted, and we will give a response within 24 hours. the range of plans available toyou. Choose a state to see how Blue Cross Blue Shield is working in your community. Node:bclrprvappp1001.corp.bcbsal.org:8080 Enjoy smart fillable fields and interactivity. ); HealthEquity is our business associate and is an independent company that provides account-based plan services to Blue Cross. 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. A retroactive denial is the reversal of a previously paid claim. Call Preferred Long-Term Care (LTC) Customer Service (1-888-331-4188) to complete the Claims Intake Form over the telephone. 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. 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. You are about to leave Blue Cross and Blue Shield of Alabama's website and enter a website operated by Prime Therapeutics, LLC. Box 3418, Scranton, PA 18505; Blue Cross Community MMAI (Medicare-Medicaid Plan), c/o Provider Services, P.O. 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. Are you reporting a new case? Applicable FARS/DFARS apply. Select Blue Cross Blue Shield Global or GeoBlue if you have international coverage and need to find care outside the United States. If you fail to pay in full all periodic monthly payments due and payable before the end of the grace period for those coverage periods, your coverage under the plan will be retroactively canceled back to the last day of the first month of the grace period. Patient. This link takes you to another website. Attorney, Terms of (You can fill the form in electronically or complete it by hand.). 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. 2023, Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association. Box 303017 Montgomery, AL 36130-3017. var jsonStr = jQuery.parseJSON(data); Member Services For general inquiries, you can reach us by calling the number below. A secondary plan is one which takes into consideration the benefits of the primary plan before determining benefits available under its plan. Complete the form following the instructions on the back. Get your online template and fill it in using progressive features. Emergency services are not covered out-of-network under our dental plans. USLegal fulfills industry-leading security and compliance standards. 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. ALL Kids. *Subject to your Calendar Year Deductible. Someone will get back to you within two business days. Blue Cross Blue Shield of Oregon -Regence FEP Claims TLW13 USA Blue Cross Blue Shield of Rhode Island: CB870 W: USA A primary plan is one whose benefits for a person's healthcare coverage must be determined first without taking the existence of any other plan into consideration. 2023, Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association. 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. The following documentation provides guidance regarding the process for appeals. window.open('https://cicchat.bcbsal.org/I3Root/chatpopup.html?qname=cid_chat&fromUrl='+fromUrl, '', 'width=700, height=600'); Be sure the data you add to the Dental Claim Form - Blue Cross And Blue Shield Of Alabama - Bcbsal is up-to-date and accurate. Download the Medicare Reimbursement Account (MRA) Pay Me Back claim form: Complete the form following the instructions on the front. dentists throughout Alabama. To determine your premium, call us at 1-855-488-2515 or click the "Get Started" link to compare your plans today. If your provider does not file your claim for you, you can call our Customer Service Department at the number on the back of your ID card and ask for a claim form. CPT codes, descriptions and data copyright 2022 American Medical Association. Use this form to submit a claim to be reimbursed for paying Medicare Part B premiums. Thank you for your interest in our Short Term Plan. Forms, Real Estate CDT codes, descriptions and data copyright 2022 American Dental Association. ProviderAccess Provider News View the latest provider news. services, For Small Find your plan. Include the date to the document using the. **Dental Blue Plus is a Health Insurance Marketplace plan. Node:bclrprvappp1002.corp.bcbsal.org:8080, Pre-Service Review for Out-of-Area Members, Anesthesia Sedation for Dental or Oral Surgery Procedures, Notification of Noncovered Dental Services, Predetermination of Benefits for Veneers and Anterior Crowns. Don't have a User ID? CDT codes, descriptions and data copyright 2022 American Dental Association. USLegal received the following as compared to 9 other form sites. When you receive services from an in-network provider, your provider will generally file claims for you. English, Download the overseas retail prescription drugclaim form: From October 1 through February 14, we are available 7 days a week. 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. Mail original claims to the appropriate address as noted below. Your doctor or other prescriber must give us a statement that explains the medical reasons for requesting an exception. Submit a separate claim for each patient. Learn more >, New Directions complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. 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
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