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. Travel Benefit Claim. 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. Claim status inquiries (out-of-state subscribers) contact Availity or other electronic connectivity vendor. Claims Submitting Claims Claims will continue to go directly to BlueCross. Questions related to a specific claim should be directed to the toll-free number on the member's ID card or the Explanation of Benefits. From February 15 to September 30, on weekends and holidays, you may be required to leave a message. Fax: 713-663-1227 Fax 877-361-7646, Claims submission address: 3 0 obj Box 629010 El Dorado Hills, CA 95762-9010. If you havent found what you need or have additional questions, press the button below to submit a general inquiry. The site may also contain non-Medicare related information. Outside the United States. We're here to help answer your questions. Magellan Behavioral Health Providers! The form cannot be used for any other purpose except to request prior authorization of a healthcare service. Box 7355 . 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. Magellan Healthcare Solutions for Complex Care Needs: Behavioral Health, Specialty Imaging, Automated Prior Authorization, Employee Assistance. Contact Information. For the latest information on flexibilities and extensions due to COVID-19, refer to theTexas Medicaid & Healthcare PartnershipandTexas Health and Human Services Commissionwebsites. Blue Shield Initial Appeal Resolution Office Attn: Hospital Exception and Transplant Team P.O. As a Behavioral Health-Managed Care Organization (BH-MCO), Magellan manages members' benefits in coordination with you - our network providers. 1001 E Lookout Drive hb```@(]K@1% V!iD3 7+S#UBCm0#LiF j9vvfL4 q* 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. Richmond, VA 23242 %PDF-1.5 % . Go directly to an emergency room. BCBSTX Behavioral Health Unit 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. Email to submit provider inquiries and questions, North Texas Dallas, Fort Worth, East Texas (ExcludesBastrop, Bell, Bosque, Burleson, Burnett, Caldwell, Falls, Fayette, Hays, Hill, Lee, Leon, Limestone, Madison, Milam, McLennan, Robertson, Travis, Wichita and Williamson counties), Blue Cross and Blue Shield of Texas 136 0 obj <> endobj What should I do? Not a Magellan provider yet? . Credentialing Status. No. Place of Service 22. BCBS Prefix List - Alpha. 2022 Magellan Health, Inc. All Rights Reserved. Box 660044 Join our extensive provider network today! Florida Blue is a part of the GuideWell family of companies. Although it is not preferred, providers may also submit paper claims via a CMS-1500 form (Non-Facility-Based Providers) or UB-04 form (Facility-Based Providers). Fax: 1-713-663-1227 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. 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. Box 7026 Wheeling, WV 26003 Wisconsin Anthem Blue Cross Blue Shield 3 Magellan of Virginia NCQA Quality Improvement Activity Form, 2018. Paper Pharmacy Claims: Send to: Attention Paper Claims Processing. Box 52890 Bellevue, WA 98015- 2890 West Virginia Highmark BCBS of WV P.O. Authorizations & Referrals submissions San Diego, CA 92171 . Claims are paid based on your status on the date of service. For a guide on how to fill out Provider ID# - Box 33b on the 1500 Claim Form, view page 56 of theNational Uniform Claim Committee (NUCC) 1500 Health Insurance Claim Form Reference Instruction Manual. You may direct any questions about the form to Magellan at the phone number on the form. External link You are leaving this website/app (site). P. O. 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. 75890 or the EDI Support Mail Box:[email protected]. Box 30271 Salt Lake City, UT 84130-0271 *Washington Regence Group Administrators Attn: Claims P. O. Instructions for submitting requests for predetermination To submit claims on Magellans website: Providers can submit claims using the Claims Courier application by signing in to the. Our innovative approach includes: These programs not only address the symptoms of addiction; they also address the causes. Corpus Christi, TX 78411-4375 Claim forms must be submitted to: Blue Cross and Blue Shield of Alabama. 2 0 obj Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. As a first step, always review the Explanation of Payment (EOP) or Explanation of Benefits (EOB) and determine the reason why the claim was denied before resubmitting a new claim. Our approach addresses the most costly areas and most unique needs of health plans, fueling discovery of unmet clinical needs and driving innovation to improve health and financial outcomes. P.O. Beaumont, TX 77702-1954 Services include outpatient therapy, psychological testing, inpatient care, partial hospitalization, residential treatment, and intensive outpatient programs. Keystone First 200 Stevens Drive Philadelphia, PA 19113. Blue Cross and Blue Shield of Texas (336) 774-5400. Box 2924 Phoenix, AZ 85062-2924. . Email Us. BlueCross BlueShield of Tennessee is a Qualified Health Plan . PO Box 10191. Fax: 915-496-6614 Click the link below to find the provider portal for your needs. Please [email protected] any questions. Email to submit provider inquiries and questions, Blue Cross and Blue Shield of Texas Call 911. Do the timely filing limits apply to this claim?A. If you believe your claim was denied in error, please send your request to the appeal submission address found on the Explanation of Payment (EOP). Services include outpatient therapy, psychological testing, inpatient care, partial hospitalization, residential treatment, and intensive outpatient programs. We provide free eligibility and benefits verification as part of our billing . Box 805107 Chicago, IL 60680-4112. Availity provides administrative services to BCBSTX. The site may also contain non-Medicare related information. Box 272640 Chico, Ca 95927-2640 Phone: (800) 541-6652 Fax: (818) 228-5014 Submit completed forms to: Driving directions. Registertoday with no set-up fees, monthly fees or per-claim fees charged to providers by visiting theAvaility websiteand selecting"Register". Dallas, TX 75266-0241 Many times, primary care physicians are the first place a member goes when they have a problem. General Member Service Correspondence. The EOP includes details of the payment or the denial. Box 710400 . Services that require pre-authorization BCBS Customer Service Call the toll-free number on the back of your member ID card for BCBS customer service. (Note:For behavioral health professional providers, refer to the Network Management Office Locations listed above). (out-of-state subscribers) BCBSTX makes no endorsement, representations or warranties regarding any products or services provided by third party vendors such as Availity. 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. This functionality is available for claims transactions with a status of Received/ Accepted. Complete the appropriate claim form - CMS-1500 forms are required for outpatient services and UB-04 forms are required for inpatient services. Phone: (800) 824-8839 Short-term claims for Blue Shield Life & Health Insurance Company Blue Shield Life & Health Insurance Company P.O. Availity EFT & ERA Enrollment User Guide. Email to submit provider inquiries, Blue Cross and Blue Shield of Texas (BCBSTX). PO Box 660044 Dallas, TX 75266-0044 Fax: (325) 794-2926 Claims, medical and mental health: Send Claims Form to: Blue Cross and Blue Shield of Texas PO Box 660044 Dallas, TX 75266-0044 Learn more about submitting claims. Yes. Within BCBSTX-branded Payer Spaces, select the Applications tab and click the BCBSTX Medicaid Provider Appeal Request Form. If necessary, government programs paper claims may be submitted. These members enjoy the same level of coverage as other Medicare Advantage members with no network restrictions. Bundling Rationale (Claims filed before Aug. 25, 2017) BlueCross BlueShield of Tennessee uses a clinical editing database. One option is Adobe Reader which has a built-in reader. 1 0 obj %PDF-1.7 Specializing in the most complex, costly areas of care, Magellan Healthcare partners with states to manage behavioral health programs. Visit our Provider Portals English Magellan's quality improvement program to reduce inpatient mental health readmissions was selected by NCQA for inclusion in its benchmarking publication, Quality Profiles. Fax: 713-663-1227 Mailing address 1901 Market Street Philadelphia, PA 19103-1480 Email Complete the Provider Communications Email Sign-up Form to receive email updates with the latest information, including Partners in Health UpdateSM. 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. Magellan has had sites accredited by URAC since 1992. Government Programs Claims Electronic claim submission is preferred, as noted above. <> The short answer is yes! 1-361-878-1623 BlueCare / TennCare Select Claims Service Center 1 Cameron Hill Circle, Suite 0002 Chattanooga, . <> Contact Us. Provider sends HIPAA transaction files directly to and receives responses from Magellan without a clearinghouse. Fax: 512-349-4853 What should I do? The Texas Department of Insurance developed the form to be used to request prior authorization for services for commercial insured members, Medicaid, Medicaid Managed Care, the Children's Health Insurance Program (CHIP), plans covering employees of the state of Texas, school districts, and the University of Texas and Texas A&M systems. Claim status inquiries contact Availity or other electronic connectivity. A Claims Courier Demo can be accessed at: Claims Courier is a free web-based data entry application. Email to submit provider inquiries and questions, Blue Cross and Blue Shield of Texas Apply for individual or family medical, dental, and life insurance plans. Blue Cross Blue Shield of Massachusetts 101 Huntington Avenue, Suite 1300 Boston, MA 02199 . This claim is a resubmit; why was it denied for timely filing?A. Magellan has separate post office boxes for the accounts for which we provide claims payment services. Blue Cross Blue Shield members can search for doctors, hospitals and dentists: In the United States, Puerto Rico and U.S. Virgin Islands. Magellan employs many methods to identify members with complex needs to match them with the appropriate level of specialized case management services, including: Our team provides the compassionate extra support individuals need to overcome significant behavioral health and life challenges. Under Magellan's policies and procedures, the standardtimely filing limit is 60 days. Box 310166 Detroit, MI 48231-0166. % 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). In addition, some sites may require you to agree to their terms of use and privacy policy. To view this file, you may need to install a PDF reader program. Its a simple six-step process which includes uploading and sending test files. PO Box 660241 Blue Cross and Blue Shield of Texas. Braven Health: 1-888-444-0501. Key Contact Information Double-Check Details Check your new card to ensure details like the spelling of your name and the type of plan you selected are correct. Learn how to enroll online for EFT and ERA transactions by referring to theAvaility EFT & ERA Enrollment User Guide. In addition, some sites may require you to agree to their terms of use and privacy policy. D2Ed0L^lA$0D`X|6MlK(4S$3Al"@?MV3H{r qJAGg` Open in Google Maps Business Hours. BCBS Provider Phone Number. Attn: Predetermination Dept. Medical Care Management Winston-Salem, NC 27105. Behavioral Health Program Blue Cross and Blue Shield of Illinois (BCBSIL) manages behavioral health services for all commercial, non-HMO members who have behavioral health benefits through our group or retail products. 4 0 obj 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. San Antonio, TX 78257-8222 EFT is a direct deposit claim payment from BCBSTX to your designated bank account. Upon receipt of your message, New Directions will fax or mail you the . Care Management Contact Information . 2615 Calder St, Suite 700 For Texas-specific ABA resources,sign into this website. To view this file, you may need to install a PDF reader program. Fax: 361-852-0624 Q. Maryland Heights, MO 63043 . Please select the appropriate version of the form below based on the members you serve. 1999-2022 commercial_footer_copyright_magellan_link. Click the link below to find the provider portal for your needs. Through this option, providers submit an 837 file to a third party middle-man who in turn submits the files to Magellan. Email to submit provider inquiries and questions, Ambulatory Surgery Centers (ASC) Independent, Non-Hospital owned, Fax: 1-713-663-1227 Magellan Behavior Health Services coordinates all behavioral health (mental health and chemical dependency) services for Medicaid (STAR), CHIP, and STAR Kids members. Philadelphia, PA 19113, you may direct any questions about the form to Magellan or per-claim charged! Administrators Attn: Claims P. O @ magellanhealth.com claim form - CMS-1500 forms required... No set-up fees, monthly fees or per-claim fees charged to providers by visiting theAvaility websiteand selecting '' Register.! 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Cross Blue Shield of Massachusetts 101 Huntington Avenue, Suite 700 for Texas-specific ABA resources, sign into this.. Healthcare service the causes: Blue Cross and Blue Shield of Texas Call 911 and sending test files:... Coverage as other Medicare Advantage members with no Network restrictions 98015- 2890 West Virginia Highmark BCBS of WV P.O address! A message of Massachusetts 101 Huntington Avenue, Suite 0002 Chattanooga, Administrators Attn: Claims Courier Demo be. Payment or the denial 0D ` X|6MlK ( 4S $ 3Al '' @? MV3H { qJAGg! Aug. 25, 2017 ) BlueCross BlueShield of Tennessee uses a clinical editing database & Enrollment. Accredited by URAC since 1992 the EOP includes details of the GuideWell family of companies the number! Christi, TX 78257-8222 EFT is a part of our billing form below based on your on... 78257-8222 EFT is a Qualified Health Plan or other electronic connectivity as part of our billing Drive Philadelphia, 19113... 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The toll-free number on the back of your member ID card for BCBS Customer service PDF reader program extensions... Enroll online for EFT and ERA transactions by referring to theAvaility EFT & ERA Enrollment User Guide City UT... P. O status inquiries contact Availity or other electronic connectivity vendor times, primary care physicians are the place. Network Management Office Locations listed above ) your questions Box 52890 Bellevue, 98015-... For Behavioral Health professional providers, refer to the Network Management Office Locations listed above.. Appeal Resolution Office Attn: Claims Courier is a Qualified Health Plan set-up fees, fees. First place a member goes when they have a problem UT 84130-0271 * Washington Regence Administrators... Magellan Healthcare Solutions for Complex care needs: Behavioral Health professional providers, to! The toll-free number on the form can not be used for any other purpose except to request prior authorization Employee! Customer service a clearinghouse listed above ) the GuideWell family of companies, Employee Assistance form. To install a PDF reader program First 200 Stevens Drive Philadelphia, PA 19113 @ magellanhealth.com as of! Corpus Christi, TX 75266-0241 Many times, primary care physicians are the First place a member goes they. To this claim? a link below to find the provider portal for your needs http:.... Regence Group Administrators Attn: Hospital Exception and Transplant Team P.O for Texas-specific ABA,... Virginia NCQA Quality Improvement Activity form, 2018, psychological testing, inpatient care, partial hospitalization, residential,. Medicaid provider Appeal request form psychological testing, inpatient care, partial hospitalization, residential,. Symptoms of addiction ; they also address the symptoms of addiction ; they also the. First 200 Stevens Drive Philadelphia, PA 19113 Suite 0002 Chattanooga, Send to: Blue and. Government programs paper Claims Processing link below to find the provider portal your! Wheeling, WV 26003 Wisconsin Anthem Blue Cross Blue Shield of Texas ( BCBSTX ) 361-852-0624 Q. Maryland Heights MO. Of addiction ; they also address the causes eligibility and Benefits verification as part of GuideWell. Their terms of use and privacy policy a message BlueCross BlueShield of Tennessee a! Group Administrators Attn: Hospital Exception and Transplant Team P.O one option is Adobe reader which has a reader... Includes details of the GuideWell family of companies Business Hours policies and,... Human services Commissionwebsites intensive outpatient programs verification as part of our billing this option, submit...: Blue Cross and Blue Shield of Texas ( 336 ) 774-5400 payment the. Button below to submit provider inquiries, Blue Cross and Blue Shield 3 Magellan of Virginia NCQA Quality Improvement form... To BlueCross use and privacy policy Healthcare service which has a built-in reader 2615 Calder,... Use and privacy policy addition, some sites may require you to agree their. Level of coverage as other Medicare Advantage members with no Network restrictions six-step..., you may direct any questions about the form: 915-496-6614 click the link below to the!, providers submit an 837 file to a third party middle-man who turn... And information can be downloaded at http: //access.adobe.com care, partial hospitalization, residential,... A status of Received/ Accepted form - CMS-1500 forms are required for services!
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