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. If your prescribing physician asks for a faster decision for you, or supports you in asking for one by stating (in writing or through a phone call to us) that he or she agrees that waiting 72 hours could seriously harm your life, health or ability to regain maximum function, we will give you a decision within 24 hours. | 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. 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. 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. 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 claim was denied or 30 months for claims subject to coordination of benefits. View the toolkit Claims submission 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. PO BOX 21267 SEATTLE, WA 98111 800-845-0377. <>>> The plan will decide on your expedited appeal within 72 hours of the request. 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. Those documents will include the specific rules, guidelines or other similar criteria that affected the decision. Uniform Medical Plan (UMP) is a self-insured Preferred Provider Organization (PPO) medical plan offered through the Washington State Health Care Authority. Consult theFEP local plan directory to find addresses and telephone numbers Stay up to date on what's happening from Salt Lake to St. George. 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. Regence BlueShield - FEPPO Box 31207Salt Lake City, UT 84131, (Attended sleep study at outpatient part of a hospital, home hospice, organ/tissue transplants, clinical trials. 6:00 AM - 5:00 PM ASTFax: 877-239-3390 (Claims and Customer Service)Fax: 877-202-3149 (Member Appeals only)Fax: 866-948-8823 (FEP Care Learn about electronic funds transfer, remittance advice and claim attachments. All claims must be submitted to UMP within 12 months of the date of service or purchase to prevent denial of the claim. Search jobs. UMP medical plans are administered by Regence BlueShield. For more information about authorizing a representative to request an appeal for you, read the Confidentiality of your health information section of your plans certificate of coverage. Regence BlueCross BlueShield of Oregon is an independent licensee of the Blue Cross and Blue Shield Association. Regence BlueCross BlueShield of Oregon 3 0 obj The following information must appear on the provider's itemized bill for the plan to consider the claim for payment: a. REGENCE BS OF UTAH. Learn about Regence Lewiston, ID office. Make sure you contact the right company (see below). Open 24 hours a day, 7 days a week. Italiano | Marvin Thomas email address & phone number | Regence Bluecross Regence BlueShield of Idaho offers health and dental coverage to 142,000 members throughout the state. Regence BlueCross BlueShield of Oregon | OneHealthPort Find helpful phone, fax and email information for assistance. If services were rendered in New York or Pennsylvania, then use the state-specific file address PDF. Make sure you have your Member ID card handy when you call us. Blue Cross and Blue Shield of Montana will process the claim. Regence: The most trusted name in health insurance 3. If the decision was after the 60-day timeframe, please include the reason you delayed filing the appeal. See Occupational injury or illness (workers' compensation) claims in your certificate of coverage. With a plan powered by the most trusted name in health insurance, youll have coverage tailored to your health. Box 995 Birmingham, AL 35298 Arkansas Arkansas BCBS PO Box 2181 Little Rock AR 72203 -2181 Arizona BCBS of Arizona . When we make a decision about what services we will cover or how well pay for them, we let you know. For questions about appeals, call the SEBB Appeals Unit at 1 (800) 351-6827. Box 999Appleton, WI 54912-0999Fax: 1 (855) 668-8550. Claims submission - Regence 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. MAXIMUS Federal Services is a contracted provider hired by the Center for Medicare and Medicaid Services (also known as CMS) and has no affiliation with us. If you want a written response, you must request one. Management - prior auth/pre-service requests), Email: Members: Log in/register at MyBlue Customer eService, Regence BlueShield - FEPPO Box 21709Seattle, WA 98111. 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. Ting Vit | You get a vaccine or flu shot from an out-of-network provider. Din kehji k'eyeedgo, t' shdi k anidaalwoi bi bsh bee hane ninaaltsoos bee atah nilinigii bined bik. Regence BlueShieldAttn: UMP ClaimsP.O. Is this your business? We will notify you once your application has been approved or if additional information is needed. 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 Blue Shield of Idaho - FEPPO Box 30270Salt Lake City, UT 84131-0207. 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. I . Claims and payment Claims submission Claims submission Claim attachments Learn more about when, and how, to submit claim attachments. Step 2: Next, locate the "Login" button at the top-right corner. Learn how to identify our members coverage, easily submit claims and receive payment for services and supplies. Chronic Obstructive Pulmonary Disease. View your credentialing status in Payer Spaces on Availity Essentials. For information on false claims, see False claims or statements in your certificate of coverage. 4 0 obj %&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,. 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. 1 0 obj Instructions are included on how to complete and submit the form. PDF Local Blue Cross and Blue Shield Mailing Addresses State/Alpha Prefix Regence Lewiston, ID Office | Glassdoor 636 GRAND AVE DES MOINES, IA 50309 800-245-6105. 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). Media Contact: Audrey Glasby Regence BlueCross BlueShield of Utah Regence . Medical records from your provider, if applicable. Pre-authorization View services and supplies that require pre-authorization. You can also get information and assistance on how to submit an appeal by calling the Customer Service number on the back of your member ID card. Prescription questions?Call Customer Service and choose the Pharmacy option. If you have questions, contact Premera at 1 (855) 784-4563 (TRS: 711) Monday through Friday 7 a.m. to 5 p.m. (Pacific). Don't have a Regence account yet? 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. Centers of Excellence and Washington State Prescription Services do not provide BlueCross BlueShield services and are separate companies solely responsible for their products/services. Phoenix, AZ 85072, Retail Pharmacy Program Please use the comment section for additional information. 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. 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. Products and networks Learn more about the products we offer and the provider networks that support them. TTY users should call, 1-800-325-0778; or your Medicaid Office. Note: If the pick-up location is in Washington, refer to theWashington claims submission map to determine where to send your claim for processing. Regence BlueShield in accordance with the terms of your Provider contract with Regence. Franais | Step 3: Next, enter your Username/Password in the appropriate fields. 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 can download the appeal form and submit your written appeal by fax or mail: Mail:WSRxS 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. You can send your appeal online today through DocuSign. PDF Member Reimbursement Form If UMP is secondary, you must include a copy of your primary plan's Explanation of Benefits, which lists the services covered and how much the other plan paid. Were proud to stand with you during this challenging time. Step 2: Next, locate the "Login" button at the top-right corner. Oregon's Sustainable Cost Growth program, and the ability the state's 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? Make sure Costco Mail Order Pharmacy or PPS has the information for both plans and knows which plan is primary. Diabetes. Dental billing. When UMP pays second, you must still pay your deductible before UMP pays benefits. You may send a complaint to us in writing or by calling Customer Service. 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 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 . Be sure to include any other information you want considered in the appeal. Facility Services are services received for the use of a facility such as a hospital, emergency room, freestanding ambulatory facility, attended sleep study at outpatient part of a hospital, alcohol treatment facility or residential Box 890179 Camp Hill, PA 17089 BCBS State by State | Blue Cross Blue Shield. Once that review is done, you will receive a letter explaining the result. If MAXIMUS disagrees with our decision, we authorize or pay for the requested services within the timeframe outlined by MAXIMUS. Coordination of Benefits, Medicare crossover and other party liability or subrogation. Your life. Overpayment Recovery Process - Regence Regence BlueShield of Idaho is an independent licensee of the Blue Cross and Blue Shield Association. Please include the following information when requesting an appeal: The plan will send confirmation when it receives your appeal. Phone:800-562-1011Fax: 877-239-3390 (Claims and Customer Service)Fax: 877-202-3149 (Member Appeals)Fax: 866-948-8823 (FEP Care Management - prior auth/pre-service requests), Email: All from Regence, a company committed to service, community and this place we call home. Provider home - Regence If you have any questions about specific aspects of this information or need clarifications, please email press@bcbsa.com . If additional information is needed, we will send you a request. endobj 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. They are also available outside these hours with limited services. Step 1: Start your internet browser, and then go to the official regence bluecross blueshield of oregon address website. Sign in Oregon Regence BCBS of Oregon P. O. Follow the prompts to submit your claim online. the instructions to determine where to send claims or correspondence. Get Marvin Thomas's email address (m*****@regence.com) and phone number (253581..) at RocketReach. You will also receive a decision on your appeal within 30 calendar days. As one of the state's largest health insurers, Regence BlueCross BlueShield of Oregon is committed to addressing current and emerging health needs for the nearly one million Oregonians we serve. All features have been transitioned to the Availity Provider Portal. 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. If your coverage changes, call UMP Customer Service and Washington State Rx Services. Call UMP Customer Service for help with any questions when you or a family member is covered by more than one plan. 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 We are now processing credentialing applications submitted on or before March 6, 2023. 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). Billing | Life Flight Network The Centers for Medicare & Medicaid Services values your feedback and will use it to continue to improve the quality of the Medicare program. Complete and mail or fax a Multiple Coverage Inquiry Form to Regence: Regence BlueShieldAttn: UMP ClaimsPO Box 91015MS BU386Seattle, WA 98111-9115. Your life. 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. Read the "Guidelines for prescription drugs UMP covers" section of your certificate of coverage for details. Coverage decision requests can be submitted by you or your prescribing physician by calling us or faxing your request. Dissatisfaction with service provided by the health plan. Portugus | The plan must receive all relevant information with the appeal to make sure the most accurate decision is made. 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. 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 . Regence BlueCross BlueShield of Utah offers health and dental coverage to 528,000 members throughout the state. Cancel Proceed User name or email 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 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. Excluded pharmacies are pharmacies that have been excluded due to fraud, waste, or abuse. You can appeal a decision online; in writing using email, mail or fax; or verbally. Customer Service will help you with the process. You may need to submit a claim to UMP for payment if: UMP does not cover nor coordinate benefits with workers' compensation claims. Mail or fax both the claim form and the provider's claim document (or bill) to: Regence BlueShield Attn: UMP Claims P.O. Provider Contacts | Provider | Premera Blue Cross Appropriate staff members who were not involved in the earlier decision will review the appeal. Rocketreach finds email, phone & social media for 450M+ professionals. 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 Appeal form (PDF): Use this form to make your written appeal. Claims - PEBB - Regence Send to Regence Blue Shield in accordance with the terms of your provider contract with Regence. In keeping with our values as a tax paying nonprofit, 85% of every premium dollar goes to pay our members' medical claims and expenses. Recommended Reviews. Please follow Were empathetic, reliable and tenacious, too. 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. PO Box 1271 MS C7APortland, OR 97207-1271 This form is to be used only for services in Oregon and Clark County, WA. Coronary Artery Disease. 0. PO BOX 25956 SALT LAKE CITY, UT 84125 800-662-0876. 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. You may need to submit your own claim if you buy drugs at a non-network pharmacy, dont show your ID card, or have other prescription coverage that pays first and UMP is secondary. Claims & payment - Regence Regence Bluecross Blueshield of Oregon - Dun & Bradstreet You have the right to make a complaint if we ask you to leave our plan. 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;& Visit the Regence provider website, regence.com to learn more about: Contact Us View information about who to contact for questions and issues. In every state and every community, BCBS companies are making a difference not just for our members, but For the Health of America. UMP may cover some supplies through the medical benefit and other supplies under the prescription drug benefit. Don't have your card? Blue Cross Blue Shield Association - Wikipedia Completion of the credentialing process takes 30-60 days. First- and second-level appeals are part of an internal review process, while independent reviews are part of an external review process. Open 24 hours a day, 7 days a week. Please note: This form is to be used by physicians, other professional providers or medical facilities to contact their assigned provider relations representatives. <> For any appeals that are denied, we will forward the case file to MAXIMUS Federal Services for an automatic second review. Call customer service and web support at 800-607-0546 between 8 a.m. and 6 p.m., Monday through Friday, Pacific Time. See "Appeals related to eligibility" section of your plan's. Your provider should supply clinically relevant information, such as medical records for services denied based on medical necessity or for other clinical reasons. Usually we will send you an Explanation of Benefits (EOB) statement or a letter explaining our decision about a pre-authorization request.