Media Contact: Audrey Glasby Regence BlueCross BlueShield of Utah Regence . Claims determinationsThe plan will notify you of action taken on a claim within 30 days of the plan receiving it. 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. Prescription questions?Call Customer Service and choose the Pharmacy option. 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. Those documents will include the specific rules, guidelines or other similar criteria that affected the decision. Learn more about our payment and dispute (appeals) processes. Call customer service and web support at 800-607-0546 between 8 a.m. and 6 p.m., Monday through Friday, Pacific Time. Call the phone number on the back of your member ID card. You must appeal within 60 days of getting our written decision. 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. We respond to pharmacy requests within 72 hours for standard requests and 24 hours for expedited requests. Learn more about informational, preventive services and functional modifiers. You may send a complaint to us in writing or by calling Customer Service. 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. Coronary Artery Disease. Information current and approximate as of December 31, 2018. If additional information is needed, we will send you a request. Select the area of the map that matches the color of the county where the service was performed. Phoenix, AZ 85072, Phone:800-562-1011 Regence BlueShield. 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. We stay on top of issues until theyre resolved. Once that review is done, you will receive a letter explaining the result. Submit a Preauthorization Request Need help with a claim? 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. 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 . 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. 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. BCBS State by State | Blue Cross Blue Shield. You can also download the appeal form and submit your written appeal by email, fax, or mail:Email: UMPMemberAppeals@regence.comFax: 1 (877) 663-7526, Mail:UMP Appeals and GrievancesRegence BlueShieldPO Box 91015Seattle, WA 98111-9115. Member's name and member ID number, including the alpha prefix (three letters and the "W" before member ID number), b. The members full name (the name of the employee, retiree, or dependent covered by the plan), The member ID number (starting with a W on your UMP member ID card), The name(s) of any providers involved in the issue you are appealing, A statement describing the issue and your desired outcome, A copy of the Explanation of Benefits, if applicable, or a list of the claim numbers you are appealing. Some of the limits and restrictions to prescription drug coverage will apply when UMP pays second to another plan. Allied professionals, including behavioral health, vision, chiropractic and other complementary service providers: Contact your allied provider relations representatives & consultants. (Note: Claims received with an ICD-9 code will be rejected with a notice to re-bill using ICD-10.) This is the customer service number for questions about your health insurance coverage, benefits or treatment. For more information about the appeals process, including expedited appeals for urgent or life-threatening conditions and requesting an external review by an Independent Review Organization, read the "Complaint and appeal procedures" section in your plan's certificate of coverage. Sign in to your Regence account. endobj 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. Find the correct address listed under the type of service received (see explanation). 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. Regence BlueCross BlueShield of Oregon is an independent licensee of the Blue Cross and Blue Shield Association. 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. Please use the comment section for additional information. Complete the Prescription Drug Claim Form and send it with your pharmacy receipts to: Pharmacy Manual ClaimsP.O. Get Marvin Thomas's email address (m*****@regence.com) and phone number (253581..) at RocketReach. Regence Provider Appeal Form Special Message: Coming soon, you will be able to dispute (appeal) a claim on Availity from the claim status result page. Regence Blue Shield in accordance with the terms of your provider contract with Regence. Be sure to include any other information you want considered in the appeal. Please note: This form is to be used by physicians, other professional providers or medical facilities to contact their assigned provider relations representatives. For knee and hip replacement and spine care. P | Username. See "Appeals related to eligibility" section of your plan's. Regence BlueCross BlueShield of Oregon offers health and dental coverage to 750,000 members throughout the state. Usually we will send you an Explanation of Benefits (EOB) statement or a letter explaining our decision about a pre-authorization request. the instructions to determine where to send claims or correspondence. Why choose Regence Individual & family plans Open 24 hours a day, 7 days a week. State/Alpha Prefix Claims Filing Address Alabama BCBS of Alabama P.O. Italiano | The plan must receive all relevant information with the appeal to make sure the most accurate decision is made. 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. Don't have your card? In addition, you cannot obtain a brand-name drug for the copayment that applies to the generic drug. Uniform Medical Plan (UMP) is a self-insured Preferred Provider Organization (PPO) medical plan offered through the Washington State Health Care Authority. For information on false claims, see False claims or statements in your certificate of coverage. You can download the appeal form and submit your written appeal by fax or mail: Mail:WSRxS Blue Cross and Blue Shield of Nevada will process the claim. We're ready. endobj Please reference your agents name if applicable. Box 999Appleton, WI 54912-0999Fax: 1 (855) 668-8550. You can also call Washington State Rx Services with the information at 1 (888) 361-1611 (TRS: 711). Be on the lookout for future communications with more information about this exciting enhancement for submitting claim appeals through Availity. Box 1106 Lewiston, ID 83501-1106 Fax: 1 (877) 357-3418 . View the toolkit Claims submission Search jobs. 2023 Regence BlueShield. Contact us as soon as possible because time limits apply. You get a vaccine or flu shot from an out-of-network provider. If you do not submit your claims through Availity Essentials, follow this process to submit your claims to us electronically. Step 2: Next, locate the "Login" button at the top-right corner. If the decision was after the 60-day timeframe, please include the reason you delayed filing the appeal. All from Regence, a company committed to service, community and this place we call home. Learn about Regence Lewiston, ID office. Step 1: Start your internet browser, and then go to the official regence bluecross blueshield of oregon claims address website. But there are some circumstances where you will need to submit a claim. Regence BlueCross BlueShield of Oregon Availity Web Portal Support Phone Number 1.800.AVAILITY (1.800.282.4548) (toll free) Support Hours Mon-Fri, 7:00 a.m. to 4:00 p.m. (PT) Site URL http://www.regence.com What's available in the portal On the Availity Web Portal, you can: There are three levels to the appeals process: first-level, second-level, and external review (independent review). 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. To request or check the status of a redetermination (appeal). Ting Vit | These forms explain what information should be included with your appeal and list the address and fax number of where to send 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: If services were rendered in New York or Pennsylvania, then use the state-specific file address PDF. Identify BlueCard members, verify eligibility and submit claims for out-of-area patients. Quickly identify members and the type of coverage they have. 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 Learn about electronic funds transfer, remittance advice and claim attachments. Box 995 Birmingham, AL 35298 Arkansas Arkansas BCBS PO Box 2181 Little Rock AR 72203 -2181 Arizona BCBS of Arizona . Youll receive notice of the action on your complaint within 30 calendar days of our receiving it. Waiting too long on the phone, waiting room, in the exam room or when getting a prescription, The length of time required to fill a prescription or the accuracy of filling a prescription, Access to health care benefits, including a pre-authorization request denial, Claims payment, handling or reimbursement for health care services, A person who has bought insurance for themselves (also called a contract holder) and any dependents they choose to enroll. 0. 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 . Care Management Programs. 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 UMP medical plans are administered by Regence BlueShield. 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. For more specific contact information, choose from the following: Individuals and familiesMedicareEmployersProducersProviders. 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. 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. In every state and every community, BCBS companies are making a difference not just for our members, but For the Health of America. For member appeals that qualify for a faster decision, there is an expedited appeal process. Diabetes. WELLMARK BCBS OF IOWA. Franais | For services outside this area, please contact customer service directly at 1 (800) 365-3155 as your claim will require special handling. 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. Call UMP Customer Service for help with any questions when you or a family member is covered by more than one plan. 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. Coordination of Benefits, Medicare crossover and other party liability or subrogation. Make sure Costco Mail Order Pharmacy or PPS has the information for both plans and knows which plan is primary. 636 GRAND AVE DES MOINES, IA 50309 800-245-6105. 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. MAXIMUS will review the file and ensure that our decision is accurate. Learn more on the HCA website. Click on it. %PDF-1.5 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. See Complaints about quality of care in your certificate of coverage to learn more. Regency Blue Cross Blue Shield Of Oregon (541) 772-8906 Visit Website Map & Directions 2057 Commerce Dr Medford, OR 97504 Write a Review. Polski | 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. Use the link below to find your local BCBS company's website. We will notify you once your application has been approved or if additional information is needed. Follow the prompts to submit your claim online. Instructions: 1. 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. Your life. 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. For any appeals that are denied, we will forward the case file to MAXIMUS Federal Services for an automatic second review. Step 1: Start your internet browser, and then go to the official regence bluecross blueshield of oregon address website. Regence Blue Shield of Idaho - FEPPO Box 30270Salt Lake City, UT 84131-0207. Deutsch | If you do not obtain your physician's support, we will decide if your health condition requires a fast decision. Complete and send your appeal entirely online. 1 0 obj To obtain information on the aggregate number of grievances, appeals and exceptions filed with the plan contact Customer Service. Your trust is our top concern, so businesses can't pay to alter or remove their reviews. Learn how our innovative solutions can help your employees live healthier, while helping you manage your costs. Were proud to stand with you during this challenging time. You have other insurance that pays first and UMP is secondary. Examples: medical doctor, osteopath, optometrist, chiropractor, physical therapist, audiologist, independent laboratory, nurse practitioner, durable 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. Excluded pharmacies are pharmacies that have been excluded due to fraud, waste, or abuse. As a nonprofit independent licensee of the Blue Cross and Blue Shield Association, Regence is part of a . Note: If you submit your claim by mail, be sure to make copies of your documents for your records. Attn: Appeal UnitPO Box 40168Portland, OR 97240-0168. 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. Lastly mail the completed claim form to the address provided. They are also available outside these hours with limited services. Claims & payment Claims & payment Learn how to identify our members' coverage, easily submit claims and receive payment for services and supplies. 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 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). 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 UMP may cover some supplies through the medical benefit and other supplies under the prescription drug benefit. Download a form to use to appeal by email, mail or fax. The second high-deductible health plan cannot include an HSA. If you have questions about eligibility and enrollment:Employees:Contact your payroll or benefits office.SEBB Continuation Coverage members:Call the SEBB ProgramPhone: 1 (800) 200-1004 Learn how to identify our members coverage, easily submit claims and receive payment for services and supplies. You may only disenroll or switch prescription drug plans under certain circumstances. Dental billing. Regence BlueShield of Idaho is an independent licensee of the Blue Cross and Blue Shield Association. You can submit feedback about your Medicare health plan or prescription drug plan directly to Medicare. Availity and Regence Working with Regence online? If additional information is needed, we will send you a request. | Espaol | 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. Make sure you have your Member ID card handy when you call us. Recommended Reviews. Step 3: Next, enter your Username/Password in the appropriate fields. 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). Note: If the pick-up location is in Washington, refer to theWashington claims submission map to determine where to send your claim for processing. A list of reciprocal partners as well as membership benefits can be found at lifeflight.org. You must submit prescription drug claims within 12 months of purchase. Is this your business? Your provider should supply clinically relevant information, such as medical records for services denied based on medical necessity or for other clinical reasons. While it's a good idea to submit a complaint as soon as possible, there isn't a deadline to do so. TRS: 711Business hours: Monday through Friday 8 a.m. to 4:30 p.m. (Pacific). *If you are asking for a formulary or tiering exception, your prescribing physician must provide a statement to support your request. People with a hearing or speech disability can contact us using TTY: 711. Locate a network pharmacy by using the Pharmacy Locator Tool. When a claim for workers compensation is accepted, all services related to that injury or illness are not covered, even if some services are denied by workers compensation. When we make a decision about what services we will cover or how well pay for them, we let you know. When the plan is the primary payer (pays first), UMP pays its normal benefit as described in the certificate of coverage. If you have other medical or prescription coverage, Washington State Rx Services Complaint and Appeal Form, WSRxS Multiple Pharmacy Coverage Inquiry Form (Drug Coordination of Benefits). I had an out-of-network claim for my disabled husband and they rejected it as "out of network". Many issues may be resolved with a phone call. | 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.
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regence bcbs of oregon claims address