bcbs prefix list 2021 pdf

Curious to know what are national Accounts? eO\v; tU9kN@]fh:~q:Fye{Q)ihJ HP/VD/_oy\ H ~fa4L?!ekF(\0>o 761 0 obj <>/Filter/FlateDecode/ID[]/Index[741 37]/Info 740 0 R/Length 98/Prev 110535/Root 742 0 R/Size 778/Type/XRef/W[1 2 1]>>stream First Character Z assigned to the BCBS Plan. 777 0 obj <>stream How To Identify Blue Cross Blue Shield Member? bcbs prefix list PDF,Doc ,Images [PDF] Common Prefix Portal List PBC Premera Blue Cross Three Character Prefixes. The SBC shows you how you and the plan would share t. he cost for covered health care services. For more information, contact your Network Provider Consultant or call 406-437-6100. But dont worry because our BCBS prefix finder include alpha numeric prefix information as well. So, to accomplish our goal, we have listed down the complete BCBS alpha prefix list so that you can easily identify correct BCBS plan. Complete patient information, on the other hand, allows your claims to process without delays. See the Medical oncology prior authorization list for Blue Cross and BCN commercial members for a supportive care drugs (other than CAR -T comprehensivelist of managed by AIM, and groupsincluded in the program. In addition, some sites may require you to agree to their terms of use and privacy policy. To get information about such member IDs, you can contact BCBS prefix directory phone number i.e. 404 0 obj <>stream endstream endobj 366 0 obj <>>>/Filter/Standard/Length 128/O(`iYJhD[>R`Xq)/P -1324/R 4/StmF/StdCF/StrF/StdCF/U(ETWBQcf )/V 4>> endobj 367 0 obj <>/Metadata 16 0 R/PageLayout/OneColumn/Pages 363 0 R/StructTreeRoot 28 0 R/Type/Catalog>> endobj 368 0 obj <>/Font<>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 369 0 obj <>stream hbbd```b``A$ Commercial Communications The three-character prefix at the beginning of the member's identification number is the key element used to identify and correctly route out-of-state claims to the appropriate BCBS Plan. In the District of Columbia and . The three-character prefix identifies the Blue Cross and Blue Shield Plan to which the member belongs. Not assigned prefix. Call 1-800-388-3193 . Why does BCBSAZ update member accounts and . Its important to remember that benefit plans differ in their benefits, and details such as prior authorization requirements are subject to change. The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. Prior Authorization List for Blue Shield Effective April 1, 2023 (This list is updated monthly) blueshieldca.com 601 12th Street | Oakland, CA 94607 Blue Shield of California is an independent member of the Blue Shield Association April 1, 2023 Page 1 of 8 Policy Name/Program Procedure Code (To search, press Ctrl + F) . 389 0 obj <>/Encrypt 366 0 R/Filter/FlateDecode/ID[<8909369792D16D43815F0147FF33489A><8FFDC42F54ADC847B845BC8E43A10252>]/Index[365 40]/Info 364 0 R/Length 117/Prev 191516/Root 367 0 R/Size 405/Type/XRef/W[1 3 1]>>stream Suppose assume claims filed with an incorrect member ID number or BCBS prefix by Provider or Billing companies, then BCBS insurance will deny the claim stating Incorrect member ID, please submit with an correct member ID number. Policy number is a unique number, which is provided to their insured person by respective insurances in order for identification purposes and also for billing the healthcare claims. BCBS Railroad refers to Blue Cross Blue Shield health insurance plans that are specifically designed for members who are affiliated with railroad organizations in the United States. Stand-alone dental products, vision and pharmacy when delivered through an intermediary model. We offers a wide range of RCM solutions to improve your healthcare services financial health and allows you to focus on patients care rather than collecting payments from insurances and patients for services performed. No, the BCBS policy number is not typically the same as the BCBS member ID number. The site may also contain non-Medicare related information. 2021, for some of our commercial non-HMO members, such as those listed below: - PPO - Blue Choice Preferred PPO(SM) - Blue Choice PPO(SM) - Blue Options(SM)/Blue Choice Options(SM) - Blue High Performance Network(SM) [Blue HPN(SM)] This is not an exhaustive listing of all codes. The following summaries and related prior authorization lists were posted on the Support Materials (Government Programs) page as of Jan. 1, 2021: Important Reminder: Check Eligibility and Benefits First Three-Character Prefixes. Benefits will be determined once a claim is received and will be based upon, among other things, the members eligibility and the terms of the members certificate of coverage applicable on the date services were rendered. Title: Final Instructions about BCBS Prefix Lookup, United Healthcare Claims Address Information. For Example: ABC, AQT, TXX, TEA, A2B, 2AB, 2A2, PAS, ZGP, XXU etc. Blue Cross and Blue Shield of Illinois, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue . (Note: For changes to come later this year, refer to this notice, posted Dec. 31, 2020: New Prior Authorization Requirements for Advocate Aurora Health Members Will Take Effect April 1, 2021.). PAJ. First Character P is symbolizing that member plan/product type is BCBS PPO. The prior authorization information in this notice does not apply to requests for HMO members. BCBS prefix are easy to identify using our BCBS prefix lookup because theyre part of every BCBS member ID and we included all of them here in the BCBS prefix list. `xn_F-y(MQ&O!y1?-uZ=t'=E$r2$IA)gYWp&g` We update BCBS prefix list data on daily basis to provide latest BCBS prefix home plan information. 15456 0 obj <>stream External link You are leaving this website/app (site). We update BCBS prefix list data on daily basis to provide latest BCBS prefix home plan information. a'm If you have any questions, call the number on the members ID card. 1268 0 obj <>stream Prior Authorization Services For Fully Insured and ASO, Prior Authorizations Lists for Blue Cross Medicare Advantage (PPO) and Blue Cross Medicare Advantage (HMO), Prior Authorizations Lists for Designated Groups, Prior Authorization Exemptions (Texas House Bill 3459), Medicare Advantage Private Fee-for-Service (PFFS), Eligibility and Benefits Inquiry (HIPAA 270/271), Behavioral Health Care Management Program, Quality Care Partner With Your Patients, Preventive Care Guidelines/Patient Wellness Guidelines, Health Equity and Social Determinants of Health (SDoH), Prescription Drug List and Prescribing Guidelines, Prior Authorization and Step Therapy Programs, Medical Policy and Pre-certification/Pre-authorization Information for Out-of-Area Members, Consolidated Appropriations Act and Transparency in Coverage Final Rule, Blue Cross Blue Shield of Texas provider website. BCBS Alpha Prefix List hbbd```b``@$Df/i #D2lE``vd@ "@,iZ R R2H{v# k 0 Below in our BCBS prefix lookup directory, you can lookup all the BCBS prefix appropriate home plans and their contact information. Independence Blue Cross (BC) of Philadelphia (Phi) and the Southeastern Pennsylvania (PA) PAI. 1254 0 obj <>/Filter/FlateDecode/ID[]/Index[1229 40]/Info 1228 0 R/Length 122/Prev 219460/Root 1230 0 R/Size 1269/Type/XRef/W[1 3 1]>>stream So, all BCBS plans, including Anthem prefix and Non-Anthem plans announced that member IDs will also be Alpha Numeric from 2018 onwards. Our Health Choice plans are available to Arizonans who qualify for Medicaid. Lo-+J52(h' %PDF-1.5 % Working or retired, we'll help you every step of the way to find the right plan. The site may also contain non-Medicare related information. To view this file, you may need to install a PDF reader program. 15363 0 obj <> endobj Does BCBS Cover Wegovy for Weight Loss? %PDF-1.6 % "Y24Oz>V ?I L r%dl=vHd z/;/X #k> Gq Summaries and code lists are posted as a reference to help you determine when prior authorization may be required for non-HMO government programs members. This new site may be offered by a vendor or an independent third party. What is the difference between BCBS alpha prefix and BCBS alpha numeric prefix? On the other hand, the BCBS member ID number is a unique identifier assigned to each individual member covered under a BCBS health insurance policy. First, it saves you time and hassle by allowing you to quickly identify correct BCBS insurance home plan without having to call customer service. For 2021, there were no changes to overall care categories, but some of the codes within certain categories may have been updated. Most PDF readers are a free download. A2Z, G2A, J4K etc. q8-_?UT"X e+1?#7DMKHY]?R,-e;PE\mL PAGE : Amkor Technology, Inc. Group # 039176 : AmeriBen . Individuals & Families We offer a wide choice of individual plans to fit your health needs and budget. CareFirst IDs have plan codes 080/580 and 190/690. Also, pre-authorization information and medical policy for out of state plans may be found on the Blue Cross Blue Shield of Texas provider website section under Standards and Requirements, and then select "Medical Policy and Precertification/Preauthorization for Out of Area Members. Most Blue Cross Blue Shield (BCBS) member IDs begin with a three-character prefix. %PDF-1.6 % These prefixes may include alpha and numerical characters. You may also be interested to read about denial code 27 reason and solutions. American Health Group (AHG) Call 1-800-847-7605 . K8Z : Page 2 . Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. B}hJu`n+Z9>)2B~feo,TV [ZI^ylRr8DGo;ckrA;X2SjUlW]$4_vN(Tvh6#moc0!pbJ;oW)A'oR&bH=`1K}P(u3gD9:#1!m2saW1SD5/p2 'Su &x@`N.e#U(Fne]4;$"o*k;$~gn-Sd"mjdTY2R*I:w8w3;fpCfQH& Wheelchairs - Mobility Assistive Equipment (Manual & Power) & Scooters - Wheelchair Purchase only -Motorized) Wheelchair: E1050, E1060, E1070, E1083, E1084, E1085 . These BCBS prefix may include alpha and numerical characters. 2021 Commercial Outpatient Behavioral Health Prior Authorization Code List This list is a new addition on our website for 2021. BCBS Alpha Numeric prefix are three characters at the start of each BCBS insurance member ID. Correct BCBS home plan can easily be identified using our BCBS prefix lookup directory. This can be especially helpful if youre in a rush or need to access your BCBS prefix home plan information quickly. These plans provide health insurance coverage for railroad employees, retirees, and their eligible dependents. In that case claim may be denied as Submit the claim to the correct address / Member ID not found. You may see cards with four-character prefixes, e.g., HMSA Blue Cross Blue Shield of Hawaii uses four-character prefixes. We've provided the following resources to help you understand Anthem's prior authorization process and obtain authorization for your patients when it's required. Always use the BCBS prefix on the members current ID card followed by the member id number. It shows that these type of BCBS member IDs are different. We have the right plan for you to keep you and your family covered. It allows you to quickly and easily identify your insurance home plan, saving you time and hassle. Here Letter R indicates BCBS FEP prefix. Yes, Policy number same as member ID number and also known as subscriber ID number. BCBS Prefix should be included along with ID number, exactly as it appears on the member ID card when filing the claims to insurance company. hb```I! Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. The notice also refers to a medical policy for more information to help clarify when and how prior authorization requirements may apply. Have a look at our BCBS alpha prefix and BCBS alpha numeric prefix directory below. eah xp`}L s1zIq%A9Zc~(Iz~HQu;AT#2$ Wp`Hlpp6NQIV0hg`,g H20[20* ": All prefixes are unique. Infusion Site of Care Prior Authorization Drug List: New Codes Will Be Added, Effective Jan. 1, 2021 This notice was posted Dec. 28, 2020, to advise you of 14 new codes being added to our specialty pharmacy prior authorization drug list. Xceed Billing Solutions motive is to create ease for providers, medical billers, patients and everyone who is involved in revenue cycle process. PAH. endstream endobj startxref Box 14114 Lexington, KY 40512 Federal Employee Program (FEP) R prefix DC/Metropolitan Area 2024884900 MD 8008545256 DC/Metropolitan Area Mail Administrator P.O . Blue Cross and Blue Shield of Illinois, aDivision of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association, PDF File is in portable document format (PDF). If you have any questions or need help submitting a prior authorization, please call 816-395-3989 for assistance. BCBS Prefix List 2021 - Alpha State Lookup BCBS Company; AAA: Alabama: Blue-Cross Blue-Shield of Alabama: AAB: Michigan: Blue-Cross Blue-Shield of Michigan: AAC: Illinois: Blue-Cross Blue-Shield of Illinois: AAD: South Carolina: Blue-Cross Blue-Shield of South Carolina: AAE: Nevada: ", Blue Cross and Blue Shield of Texas, aDivision of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association, PDF File is in portable document format (PDF). BCBS is one of the biggest insurance companies in USA and serving more than 106 million people. Final Remarks about BCBS Prefix Lookup Directory. We always make sure to keep BCBS prefix list and BCBS provider phone numbers directory up to date. Benefits Administration Corporation, Inc. (BACI) 9411 Philadelphia RD. PPO 837P Prefixes are also applicable, . hbbd``b`f3$ bE FM Dmb"@ $$@z$u ad#B cG Address: 11070 Katy Fwy, Houston, TX 77043, 2023 Xceed Billing Solution.com - All Rights Reserved, Blue Cross Blue Shield BCBS Prefix List Lookup. What If BCBS Member ID doesnt have Prefix mentioned on Card? BCBS member ID card will have a suitcase logo at the bottom of card which will also help you to identify patient plan like HMO, PPO, POS etc. This includes our Medicaid Blue Cross Community Health PlansSM (BCCHPSM) and Blue Cross Community MMAI (Medicare-Medicaid Plan)SM and Blue Cross Medicare Advantage (PPO)SM(MA PPO) members. We have a track record of providing quality medical billing services to multiple healthcare organizations and specialty providers across USA. Carefirst BCBS of Maryland the (MD), District of Columbia (DC) and the Northern Virginia (VA) Some members ID cards may not have an alpha prefix. What is Medical Billing and Medical Billing process steps in USA? Third, it can help you make more informed decisions to choose right insurance plan and benefits. BCBS Prefix will not only have numbers and the digits 0 and 1. BCBS is one of the largest medical insurance company by total members of more than 45 million. BCBS member ID have maximum 17 characters but most of the member IDs have 12 characters. Second Character G assigned to the BCBS Plan as well. Do not create one or use the BCBS prefix from another member ID card. Benefits and eligibility should be verified for all members prior to rendering services. Added to list, with AIM effective 04/01/2021 22802 Joint, Spine Surgery Post Fusion 7-12 Vert Seg SUR712.036 AIM Guidelines Lumbar Spinal Fusion Retire from BCBS PA effective 1/1/22; continue to request PA through AIM if applicable; Added to list, with AIM effective 04/01/2021 22804 Joint, Spine Surgery Post Fusion 13/> Vert Seg SUR712.036 AIM . Check any internal documents you may have and update any references of "alpha prefix" to "prefix". 800-676-2583. 0 AIM Specialty Health (AIM) is an independent company that has contracted with BCBSIL to provide utilization management services for members with coverage through BCBSIL. Let's start with you. BCBS of Illinois (IL) PAK. It means that BCBS members IDs prefixes will must have alphabets. e@'SZD/KCbv*pKq~ for medical policies and prior authorization requests. Prefix UTS assigned to University of Texas. BCBS Railroad member IDs are assigned to members who served in railroad organizations. Right after completing my degree in 2011, I started my job career as an Accounts Receivable in a medical billing company. In order to get rid of this denial or sometimes delay in processing, Provider or Billing companies has to find out the correct address by BCBS prefix from the above list before filing the claim. The prefix routes eligibility/benefits inquiries and claims to the appropriate BCBS Plan or system for timely processing. We make sure to update the information on daily basis, however, if you find some kind of inaccurate information, feel free to contact us. Correct BCBS home plan can easily be identified using our BCBS prefix lookup directory. Contact us to learn how we can improve your revenue cycle. Box 14115 Lexington, KY 40512 Mail Administrator P.O. Services that require precertification As of January 1, 2022, this list applies to all Independence Blue Cross HMO, PPO, and POS products, including Flex products. BCBS alpha prefix only contains alphabets and each alpha prefix represents different BCBS home plan. BCBS FEP Prefix BCBS Federal Employee Program is identified by the letter R followed by the number. Also, these BCBS prefixes helps providers and medical billers to reach the correct claims department for claims and benefits inquiry. Although we regularly update the BCBS Prefix information but in case youre unable to get information about correct BCBS plan from our BCBS Prefix lookup, feel free to contact us OR call BCBS directory phone number at 800-676-2583. Learn more about timely filing limits and CO 29 Denial Code. Plan Type: PPO . endstream endobj 1230 0 obj <. eviCore healthcare (eviCore) is an independent specialty medical benefits management company that provides utilization management services for BCBSIL. We offer a wide choice of individual plans to fit your health needs and budget. 0 I have completed my Bachelor of Business Administration in Healthcare Management from University of Texas. Use this guide to see prior approval information for members with ID card prefixes: AEE, AXC, EXX, XCB, XCQ, XCR View guides [pdf] Medicare plans Learn more about providing care for Medicare members. This article offers an overview of 2021 prior authorization support materials and related communications that may apply for some of our non-HMO commercial and government programs members, effective Jan. 1, 2021. BCBS alpha numeric prefix digits are usually in between the prefix e.g. The policy number is usually provided to the policyholder, who is the individual or entity that holds the insurance policy. For example: ABC12345678 Here " ABC" is BCBS alpha prefix. The three-character prefix at the beginning of the members identification number is the key element used to identify and correctly route out-of-state claims to the appropriate BCBS Plan. plan. endstream endobj 15364 0 obj <>>>/EncryptMetadata false/Filter/Standard/Length 128/O(a;uY[7y\\ Y)/P -1036/R 4/StmF/StdCF/StrF/StdCF/U(ZgYX: )/V 4>> endobj 15365 0 obj <>/Metadata 280 0 R/PageLayout/OneColumn/Pages 15351 0 R/StructTreeRoot 2939 0 R/Type/Catalog>> endobj 15366 0 obj <>/Font<>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 15367 0 obj <>stream Group Name. Checking eligibility and/or benefit information and/or the fact that a service has been prior authorized is not a guarantee of payment. Unraveling the Truth, United Healthcare Claims Address, Payer ID, Fax and Phone Number, BCBS Prefix List 2023 Alpha Prefix and Alpha Number Prefix Lookup, BCBS Alpha Numeric Prefix from L2A to L9Z (Updated 2023), BCBS Provider Phone Number for Claims and Eligibility Verification, Benefits and Eligibility Verification Services. This new site may be offered by a vendor or an independent third party. View Medicare information Radiology utilization for Arkansas Blue Cross FEP Decide on what kind of signature to create. The above material is for informational purposes only and is not a substitute for the independent medical judgment of a physician or other health care provider. 1 of 7. Now, with more than 15 years of experience as a medical biller and revenue cycle manager, I am on a mission to serve the medical billing industry with my vast knowledge and years of expertise. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider. We recently received a query from a provider that how I can identify that patient is BCBS health insurance member. %%EOF Member ID cards with no prefix Some member ID cards may not have a prefix. BCBS prefix is a three character prefixes followed by the id number except for the following products and programs. TT$%b"Dg!h^`]-ce?i8xRiu1IrD-%oR#yt;JBOJ#"TXwD0L Fw,]xS_CU3zf]06_T} PNGCqWV^UET6X~`U Denials with solutions in Medical Billing, Denials Management Causes of denials and solution in medical billing, CO 4 Denial Code The procedure code is inconsistent with the modifier used or a required modifier is missing, CO 5 Denial Code The Procedure code/Bill Type is inconsistent with the Place of Service, CO 6 Denial Code The Procedure/revenue code is inconsistent with the patients age, CO 7 Denial Code The Procedure/revenue code is inconsistent with the patients gender, CO 15 Denial Code The authorization number is missing, invalid, or does not apply to the billed services or provider, CO 17 Denial Code Requested information was not provided or was insufficient/incomplete, CO 19 Denial Code This is a work-related injury/illness and thus the liability of the Workers Compensation Carrier, CO 23 Denial Code The impact of prior payer(s) adjudication including payments and/or adjustments, CO 31 Denial Code- Patient cannot be identified as our insured, CO 119 Denial Code Benefit maximum for this time period or occurrence has been reached or exhausted, Molina Healthcare Phone Number claims address of Medicare and Medicaid, Healthfirst Customer Service-Health First Provider Phone Number-Address and Timely Filing Limit, Kaiser Permanente Phone Number Claims address and Timely Filing Limit, Amerihealth Caritas Phone Number, Payer ID and Claim address, ICD 10 Code for Sepsis Severe Sepsis and Septic shock with examples, Anthem Blue Cross Blue Shield Timely filing limit BCBS TFL List, Workers Compensation Insurances List of United States, Workers Compensation time limit for filing Claim and reporting in United States. Does policy number same as member ID number? In some case provider or billing company may file the claim to an incorrect address without checking the correct BCBS address. The policy number is a unique identifier which may cover multiple members under the same policy, such as a family or a group. BCBS Prefix can be classified as follows: BCBS Alpha Prefix - It's a three letter alpha prefix followed by id number. TPA Name & Address. The most important and easy way to identify BCBS member is his BCBS member ID alpha prefix. 741 0 obj <> endobj To accommodate our increasing lines of business, Blue Cross and Blue Shield of Montana (BCBSMT) has adopted several new three character prefixes as part of the member identification numbers. 0 365 0 obj <> endobj BCBS prefix lookup directory is a valuable resource for anyone who is looking for right Blue Cross Blue Shield home plan. Suite S . hbbd```b``"`r9LLN`DR,>6l30&U$60D2HO rH+H f`bdV8J By doing it may cause delay in processing or handling the claim. A follow-up article with additional information on transition of member care was posted Dec. 4, 2020. K8Y . BCBS Prefix will not only have numbers and the . These BCBS prefix may include alpha and numerical characters. endstream endobj 742 0 obj <. endstream endobj startxref If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly. There are three variants; a typed, drawn or uploaded signature. 0t9~pE_ >if}~t~iM 'yn8Pgi |hxQD_Y. %PDF-1.6 % Normally, account specific prefix associates to the employer group name. For accurate and quick claims processing, it is necessary to get complete patient insurance information. To identify correct department, they use 3 characters Prefix in the BCBS members plan ID. %%EOF We make it easy for you to offer the healthcare coverage that delivers for your business. Note: BCBS FEP (Federal Employee Program) ID starts with the alphabet R follow by the insured ID number (For Example: R987654321). BCBS prefix List plays a vital role in filing the health care claims properly to the correct BCBS address and also to verify members eligibility, health insurance coverage information and to reach the correct BCBS department to check the claim status or disputes of the claim. Born in Texas, USA. BCBS Alpha Prefix are not only important to identify BCBS health insurance member but they are also very important for electronic submission of claims to the correct BCBS plan. Follow the step-by-step instructions below to design your premiere blue cross amp the regency group three character prefixes: Select the document you want to sign and click Upload. The first two characters of such BCBS prefix spots member plan and the third character is to identify the type of product in which the BCBS member is enrolled. =&m$ z90P&\:?$IRIj"c5l\"aD(@?Yuk>{8lkelu3X*FpT=6Rv;9'*4O-o|ELLG?-Yec,cqh(e96e4^QyD8H}'o(3 Prior Authorization for Some Commercial Members Will Transition from eviCore to AIM, Effective Jan. 1, 2021 This notice was posted Oct. 1, 2020, to alert you of a utilization management vendor change. 'MNiXG]dRBC; 0'Va~9&c}Ag$Pge;\UY,$MtN Account-specific prefixes are assigned to centrally processed national accounts, which are employer groups that have offices or branches in more than one area, but offer uniform . Enter a location and search by doctor or hospital name, health condition, or specialty. An incorrect or missing three-character prefix may cause possible delays in the processing of your claims. The three-character prefix identifies the Blue Cross and Blue Shield Plan to which the member belongs. Have a look at our BCBS alpha prefix and BCBS alpha numeric prefix directory below. For Federal Employee Program (FEP) precertification requirements, please see the separate FEP precertification list. Medicare Working or retired, we'll help you every step of the way to find the right plan. The main difference between BCBS alpha prefix and BCBS alpha numeric prefix is that BCBS alpha prefix only contains alphabets whereas BCBS alpha numeric prefix consists of alphabets as well as numbers ranging from 1 to 9. It means that BCBS members IDs prefix will must have alphabets and they may or may not have numbers. Member identification numbers beginning with R belong to Federal Employee Program (FEP) and will not have a three-character prefix when filing. BCBS Railroad member IDs starts with a letter R. In case, you need any additional information related to BCBS prefix then feel free to reach out to us. This step will help you determine if prior authorization may be required for a specific member and service. For Example: ABC, A2B, 2AB, 2A2 etc. Lets dig into it! So, to answer this query, we have mentioned below few important points to consider. Box 7930 Philadelphia, PA 19101-7930 To view this file, you may need to install a PDF reader program. 2021 Commercial Prior Authorization Requirements Summary (Updated December 2020) This document provides an overview of services/care categories for which prior authorization may be required for some commercial, non-HMO Blue Cross and Blue Shield of Illinois (BCBSIL) members. There are two types of BCBS prefixes which are mentioned below: Plan Specific prefix are assigned by BCBS to each plan. nKvo2>)*Y=}4i,+s[yL*2#kN@r115};|`R[5/iZ PREFIXES . You can also contact us for specialty medical billing services. Note: Current three-character, alpha-only prefixes will not be affected by this change. Amerihealth Caritas Directory Healthcare, Health Insurance in United States of America, Place of Service Codes List Medical Billing. Most PDF readers are a free download. What is Medical Billing and Medical Billing process steps in USA? In addition, some sites may require you to agree to their terms of use and privacy policy. ;MTK If youre a medical biller or a provider and going to submit BCBS plan member claim to the insurance, make sure to submit member ID including prefix. The following summary and related prior authorization lists were posted on the Support Materials (Commercial) page the Utilization Management section of our Provider website as of Jan. 1, 2021: Commercial Communications

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