Similar behavioral health programs are implemented across product lines but may differ by product. . *interactive voice response (IVR) system to access, you must have document control number (claim number), Blue Cross and Blue Shield of Texas Medicaid. 1800 West Loop South, Suite 600 2615 Calder St, Suite 700 When the confirmation message displays, select, To enroll online for EFT, you must be a registered Availity, Texas Medicaid claims are normally finalized weekly on Mondays. Contact Magellan Health Services or call 1-800-788-4005 For prior authorization, benefits, eligibility, or claims status or questions contact Magellan at 1-800-327-7390 Effective 6/27/2022, a Behavioral Health Service Coordination can help members manage complex conditions related to mental health and substance use. What should I do? However, before sending an email to TennCare you may be able to find a quick answer online by clicking on one of these questions. Through this option, providers submit an 837 file to a third party middle-man who in turn submits the files to Magellan. The new Texas Clinicians Postpartum Depression Toolkit is intended to be a resource for Texas clinicians on screening, diagnosis and treatment of postpartum depression. Richardson, TX 75082 Skip to article content, Electronic Data Interface (EDI) via Direct Submit, Claims Courier-Magellans Web-based Claims submission tool, Paper Claims: CMS-1500 (Non-Facility-Based Providers) or UB-04 (Facility-Based Providers). Note: If you are a Blue Cross and Blue Shield of Alabama customer and need to reach us by phone, please use the telephone number(s) on the back of your ID card. Complete the appropriate claim form - CMS-1500 forms are required for outpatient services and UB-04 forms are required for inpatient services. 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. Predetermination form and Availity provides administrative services to BCBSTX. Select the best option and fill out a form and we will reach out to you as soon as possible! Magellan's quality improvement program to reduce inpatient mental health readmissions was selected by NCQA for inclusion in its benchmarking publication, Quality Profiles. Dental Blue Book eManual; Dental Blue News; Dental Enrollment and Credentialing; Magellan is committed to the fight against the opioid epidemic and other substance use disorders (SUDs) affecting far too many of our family members and friends. Does this timely filing limit apply to all claims for all members (e.g., COB, Medicare, etc.)?A. Refer to BCBSTX Medicaid website and Contact Us. Magellan Healthcare is contracted to perform behavioral health managed care functions supporting members and participants for the following Blue Cross and Blue Shield of Texas HMO networks; Blue Advantage HMO SM, Blue Cross Medicare Advantage HMO SM, Blue Cross Medicare Advantage Dual Care (HMO SNP) SM and MyBlue Health SM. Box 710400 . (page_last_updated 03/2022) Visit our Help Center . Blue Cross and Blue Shield of Texas Find My BCBS Company Box 2924 Phoenix, AZ 85062-2924. . x}[s6{&.JIOwZd o/v//lwzv}|y_&TBn}?l.}oQdMy{~HbSMP7 s~o[}tUG0/Nyo{,J:T$aI|H@O_jVLyjV@>G77 Aug@GQO_>d+l6T5>A.1z{;|})eE&)35~5om[|{w-re^P=Jw"4Y]GW>+>4 *lBC3zcmW~\U0e.t^j2PtTU/%xz.w`]7OBu'!EW>K(>QEJ@&lh5. . To view this file, you may need to install a PDF reader program. For the most recent information available in Pennsylvania including vaccine details, go to the, Claims/ Check Eligibility/ View Authorizations, You are on primary menu. Horizon BCBSNJ: 1-800-624-1110 or 1-800-626-2212. Eligibility and benefits For eligibility, prior authorization or claims inquiries, call 877-299-1008. Mail your payment to the address on your premium invoice or learn about other convenient ways to pay your bill. Outside the United States. Contact Magellan Healthcare. For urgent requests only: Email: RxNetworksDept@magellanhealth.com. Please select the appropriate version of the form below based on the members you serve. For Texas-specific ABA resources,sign into this website. Mailing Address, Customer Service and Claims Contact Information Line of Business Customer Service/ Telephone Number Address Blue Shield of CA (BSC)/ MHSA 1-877-263-9952 1-800-424-6064 1-800-424-5999, option 3 Claims Mailing Address Blue Shield of California Mental Health Service Administrator (MHSA) P O Box 710400 San Diego, CA 92171 The site may also contain non-Medicare related information. Other Adobe accessibility tools and information can be downloaded at https://access.adobe.com. *interactive voice response (IVR) system to access, you must have document control number (claim number), Eligibility and benefits contact your electronic connectivity vendor, Availity or other electronic connectivity vendor or call 1-800-451-0287*. A. A. This new site may be offered by a vendor or an independent third party. The following address should be used for claims related to outer counties: Outer County Claims - Lehigh, Lancaster, Northampton, and Berks County Claims Receipt Center P.O. If necessary, government programs paper claims may be submitted. % Email to submit provider inquiries and questions, Blue Cross and Blue Shield of Texas View help topics or login via our member website. Specializing in the most complex, costly areas of care, Magellan Healthcare partners with states to manage behavioral health programs. BCBSTX providers who receive paper checks and Provider Claim Summaries (PCSs) via the U.S. Mail may wish to consider the electronic alternatives listed below for greater efficiency, convenience and security of information. EDI Support: Contact Magellans EDI Hotline for support and/or assistance:1-800-450-7281ext. 1998-BlueCross BlueShield of Tennessee, Inc., an Independent Licensee of the Blue Cross Blue Shield Association. One option is Adobe Reader which has a built-in reader. Blue Cross and Blue Shield of Texas 1-800-451-0287* (Blue Choice PPO), 1-877-299-2377* (Blue Essentials and Blue Advantage HMO), 1-877-774-8592 (Blue Cross Medicare Advantage PPO & HMO), *interactive voice response (IVR) system - to access, you must have full member's information (for example, member's ID, patient's date of birth, etc.). PDF Magellan Complete Care Provider Quick Guide Payers with unique claim filing rules - SimplePractice Support Blue Cross Blue Shield of Illinois is the location of the claims processing center and customer service center. DO NOT COMPLETE THIS FORM IF YOU ARE A MAGELLAN COMPLETE CARE MEMBER OR PROVIDER. Fax: 915-496-6614 Customer Service. Box 660027 If after reviewing your rates you still believe there is an error, please contact the toll-free number on the member's ID card or the Members Explanation of Benefits, or call your Magellan network representative. Provider Services 1-800-521-6007 Representatives are available 24 hours a day, 7 days a week.. By email. If your ID card is not available, you may use one of the Customer Service telephone numbers below. Copyright 2022Health Care Service Corporation. In Pennsylvania, Magellan works with county partners in Bucks, Cambria, Lehigh, Montgomery and Northampton counties. Q. I have proof that I submitted the claim within the timely filing limits. It is important that you review all EOPs promptly. . We encourage you to submit claims electronically, via www.MagellanProvider.com or through a clearinghouse. Box 272640 Chico, CA 95927-2640 For prior authorization and referrals managed by Magellan: Magellan Behavioral Health Providers of Texas, Inc. 1-800-729-2422: Behavioral health services - claims status inquiries. Houston, TX 77027-3279 The site may also contain non-Medicare related information. Sign up to receive information and updates from Magellan Healthcare on behavioral health webinars and education! Place of Service 23. Email to submit provider inquiries, Blue Cross and Blue Shield of Texas (BCBSTX). TennCare Provider Services 1-800-852-2683. Authorization In an effort to make the authorization process easier for our EAP providers, New Directions EAP offers an authorization prompt on its telephone system (800-624-5544, prompt 3). Contact Information. Learn how to enroll online for EFT and ERA transactions by referring to theAvaility EFT & ERA Enrollment User Guide. Magellan did not receive your resubmitted claim within our timely filing limits (or within the timely filing limits of your state) after the initial date of denial. Medicaid and CHIP Claim Editing Enhancements Coming Feb. 23, 2022, ICD -10 Z Codes for Social Determinants of Health, How to Submit a Complaint as a Medicaid Provider, Medicaid Provider Information on COVID-19 Coverage, Members can ask for an External Medical Review (EMR) and State fair Hearing from the state Medicaid program and get information about how the process works in our provider alert. Paper Claims must be submitted to the below addresses (claims are not accepted at the Care Management Center in Newtown): MBH-Bucks, PO Box 1715, Maryland Heights, MO 63043 MBH-Cambria, PO Box 2157, Maryland Heights, MO 63043 MBH-Lehigh, PO Box 2127, Maryland Heights, MO 63043 MBH-Montgomery, PO Box 2277, Maryland Heights, MO 63043 BCBSTX Behavioral Health Unit Services billed beyond 95 days from the date of service are not eligible for reimbursement. Self-enroll by creating a unique user ID and password. Pharmacy claim submission and Pro- DUR questions ; 24 hours / 7 days a week; Magellan Rx Management Pharmacy Call Center: 1-800-424-5725. 75890 or the EDI Support Mail Box:EDISupport@magellanhealth.com. Upon receipt of your message, New Directions will fax or mail you the . Services that require pre-authorization Providers Are you a provider looking for information on Magellan plans, joining our network, or performing secure transactions related to your practice or Magellan members? If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly. Fax to: 1-888-579-7935 2022 Magellan Health, Inc. All Rights Reserved. Submit appeals within 120 calendar days from receipt of remittance advice (RA). Copyright 2022Health Care Service Corporation. 4 0 obj Fax: 361-852-0624 This date is based on the date of the other carriers decision. The easiest way to determine your current rates is to review the current rate sheet for your Magellan or affiliate company agreement. Box 710400, San Diego CA 921710400 Phone Number: (877) 263-9952 Blue Shield of CA: Payer ID: BS001 Claims Address: P.O. As a Behavioral Health-Managed Care Organization (BH-MCO), Magellan manages members' benefits in coordination with you - our network providers. 1-800-749-0966 <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 24 0 R 25 0 R 26 0 R 27 0 R 30 0 R] /MediaBox[ 0 0 792 612] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Credentialing Status. Birmingham, Alabama 35244-2858. 1-512-349-4847 Postpartum depression is a common, potentially serious and sometimes life-threatening condition. However, if a provider wishes to request a prior authorization by mail or fax using a form, it must be this form as prescribed by the Texas Department of Insurance. Blue Cross Blue Shield of Arizona 2444 W Las Palmaritas Dr. Phoenix, AZ 85021 . BCBS Customer Service Call the toll-free number on the back of your member ID card for BCBS customer service. You can download the toolkithere. For this reason, your resubmitted claim has been denied. Or call your doctor or therapist for help. Enter your company name in the search box, select the group name from the drop-down, check the box at the bottom and then click the "Go" button. From theResourcessection, selectState & Plan Information,then under State-Specific, click theTexaslinkto access to access the following forms: Texas State Bill 1742: Preauthorization requirements, Standard Prior Authorization Request Form for Health Care Services, Texas Health and Human Services Commission, Preauthorization requirementsfor Blue Cross and Blue Shield of Texas commercial plans, Provider bulletin regarding Texas HB 3041, American Society of Addiction Medicine (ASAM), BlueCross BlueShield of Texas Medicaid STAR,CHIP and STAR Kids, Texas-specificABA Treatment Plan/Concurrent Review. Make sure to send your claim form to the appropriate claims payer and specific address. Mailing address (for paper claims): Blue Shield of California Mental Health Service Administrator (MHSA) P.O. Still looking for additional help? All claims for covered services provided to HealthChoices Members must be submitted to and received by Magellan as follows: Within sixty (60) days from date of service for most levels of care except as provided below; Within sixty (60) days from date of discharge for 24/hr level of care; Within sixty (60) days of the last day of the month or the discharge date, whichever is earlier when billing monthly for longer treatment episodes of care at a 24/hr level facility; Within sixty (60) days of the claim settlement for third party claims. 450 Riverchase Parkway East. Paper Claims Address Independence Administrators P.O. Magellan was the first MBHO to have a program included in this publication. Email to submit provider inquiries. From 2015 to 2017, our programs contributed to a 26% increase in members who were asked by their behavioral health providers to authorize communication with their PCP providers.3, Working with HealthConnections, the team helped get me to a place of not having fear, not having pain, exercising and doing yoga. Claim status inquiries (out-of-state subscribers) contact Availity or other electronic connectivity vendor. Magellan Center for Recovery and Resiliency, Magellan Youth Leaders Inspiring Future Empowerment (MY LIFE), Digital emotional wellbeing for every day, Magellan Genetic Testing Information Request, Request More Information about Magellan Healthcares DecisionPoint, Nurse navigation and Wellness Recovery Teams focused on improved physical, and behavioral health, as well as the social determinants of health, You are on primary menu. Magellan steps in for our members to help prevent and address the risks of one affecting the other. FBC HOM 001 F 102022. If you are able to create an 837 file in a HIPAA compliant format, we. Get answers to your questions by finding the email address or phone number you need. All Rights Reserved. Paper Claim Filing; Dental Providers. 800-637-0171, press 3 1-800-637-0171, press 3 or 1-713-663-1149 For status call: Medicaid Phone Number. Therefore it does not support revenue codes (codes submitted on 837I files or a UB-04). 052 1366489049; 052; 1366489049 Franciscan PHO Northern IN Hammond; Claims Inquiry Patty Arredondo; Julie Lambertino; 7905 S Calumet Ave Munster; IN 46321 (219) 836-5800 66347 (219) 836-8025 patricia.arredondo@franciscanalliance.org; . Q. Blue Cross Blue Shield members can search for doctors, hospitals and dentists: In the United States, Puerto Rico and U.S. Virgin Islands. Email to submit provider inquiries and questions, Ambulatory Surgery Centers (ASC) Independent, Non-Hospital owned, Fax: 1-713-663-1227 Claim status inquiries contact Availity or other electronic connectivity. Attn: Predetermination Dept. x]rFwVa1)dJr#Qk%QKQ[93 yvk#Y _wOOOaxzXn&Wrru;8}N7o|Q2l1}e/_{12|qE2QPQ&/=d_W?F|)eAW+@y^n|"Gc9zOh Call 1-800-528-7264 or the phone number listed on the back of the member's/subscriber's ID card. TTY: 735-2989. endstream endobj startxref Magellan Healthcare Solutions for Complex Care Needs: Behavioral Health, Specialty Imaging, Automated Prior Authorization, Employee Assistance. 1001 E. Lookout Drive. P.O. BlueCross BlueShield of Tennessee is a Qualified Health Plan . Eligibility and benefits contact Availity or other electronic connectivity vendor or call 1-800-442-4607*, Behavioral health services mental health and chemical dependency prior authorization and referrals (includes inpatient, residential treatment center (RTC) programs, partial hospitalization and outpatient behavioral health services) call 1-800-528-7264, Behavioral health services claims status inquiries contact Availity or other electronic connectivity vendor or call 1-800-442-4607*, Behavioral health services claim adjustments call 1-800-442-4607, Eligibility and benefits contact Availity or other electronic connectivity vendor or call 1-877-299-2377*, Claim status inquiries contact Availity or other electronic connectivity vendor, Medical Management Correspondence for the Health Insurance Marketplace for Blue Advantage HMO Members, Blue Cross Blue Shield of Texas Phone: 1-713-354-7033 Together, we're committed to making a meaningful difference in the health of all Floridians. Behavioral health benefits are integrated into Anthem medical plans for a full spectrum of coordinated care for our members. Claims Submitting Claims Claims will continue to go directly to BlueCross. Box 2291 Durham, NC 27702-2291 . Government Programs Claims Electronic claim submission is preferred, as noted above. In accordance with applicable law, Magellan will pay clean claims within 45 days of the date of receipt. External link You are leaving this website/app (site). BlueCare / TennCare Select Claims Service Center 1 Cameron Hill Circle, Suite 0002 Chattanooga, . Use the link below to find your local BCBS company's website. 1-361-878-1623 As a result of this determination, remittance advice, known as an Explanation of Payment (EOP) is sent to you. Dental Expense Claim. %%EOF The State Health Benefits Program (SHBP) and the School Employees' Health Benefits Program (SEHBP) Program: 1-800-991-5579. 195 0 obj <>stream This practice is called balance billing and is not permitted. We're here to help answer your questions. For Emergency Situations, Always Call 911. Blue Cross and Blue Shield of . There is a simple testing process to determine if Direct Submit is right for you. Box 21974 Eagan, MN 55121 1-800-778-2119 Verify eligibility and benefits at 1-888-356-7899 www.pearprovider.com Independence Blue Cross Federal Employee Program (FEP) PPO "R" followed by 8 numeric characters 54704 837I - 12X26 Facility Providers Claims 1Only Claims Receipt Center To the appropriate claim form - CMS-1500 forms are required for inpatient services |y_ TBn. Your payment to the address on your premium invoice or learn about other convenient to... You are leaving this website/app ( site ), 7 days a ;. Which has a built-in reader health Service Administrator ( MHSA ) P.O https: //access.adobe.com implemented across lines! Into this website Adobe reader which has a built-in reader mail your payment to the on! 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