Bcbs of illinois provider number. The site may also contain non-Medicare related information.
Bcbs of illinois provider number Altruista Health's GuidingCare ® Use this care management tool in Availity Essentials to monitor rendered services, activates, We contract with physicians, facilities and other health care professionals to form our provider networks to deliver quality, accessible and cost-effective health care services to our members. Medicare Supplement Coverage BCBSIL Provider Manual — October 2021 4 • IPA Name and Site Number - the unique number of the IPA that is assigned by the HMO and selected by the member. We contract with physicians, facilities and other health care Out-of-state provider notification: You should contact your local BCBS plan for 835 ERA enrollment. To confirm receipt and adjudication If you have any questions, call the number on the member's ID card. Provider Rights: Applicants Contact Name Address/Phone/Email/URL Blue Cross and Blue Shield of Texas 1001 E. For claims or any other inquiries, we’ll need your billing NPI. Blue Cross Additional Contact Information Pharmacy Program 800-423-1973 Membership Address Blue Cross and Blue Shield of Illinois P. 1, 2025, members of Blue Choice Preferred PPO SM and MyBlue Plus POS SM individual market benefit plans from Blue Cross and Blue Shield of Illinois purchased . The following Two teeth cleanings per 12 months (2 total per year) Note: BCCHP members can get an extra cleaning annually as part of member value-added benefits. Prior authorization is required for January 2019 New Professional Provider Network Relations Phone Number One of the fastest ways to work with us is online using electronic options listed on the Provider Tools page. Find a doctor or hospital in Illinois 2/22/22 What to Include When Emailing Our Provider Network Consultant Team 2/21/22 Any Provider Accepting Medicare Can See Flex Plan Members 2/18/22 Earn CME/CEU Credit at If you need more information or just want a little help understanding your benefits or the Medicare rules, call the number on the back of your member ID card. 4 – Additional Information 5 IL_BCCHP_DentalDir21 Filed 04082021 Dental Provider Directory Effective Date: 04/01/2022 Member Services: 1-877-860-2837 (TTY/TDD: 711) BlueCross Our goal is to serve your health For questions about Blue Cross and Blue Shield of Illinois Medicare coverage and benefits, call 1-877-213-1821 (TTY 711) 7 days a week or visit bcbsil. Learn how to verify patient eligibility and benefits online or by phone for BCBSIL members. To report suspected health care fraud involving a provider, use our Provider Fraud Hotline at 1-800-543-0867. Box 3686, Scranton, PA 18505 Additional Reminders Do NOT submit duplicate claims. Skip to main content please call the customer service number for your local Blue Cross and Blue Shield company. Two oral exams per 12 months (2 total per year) One set of preventive x-rays Find a doctor or hospital in Illinois quickly and easily using the Blue Cross Blue Shield of Illinois Provider Finder. This step will To check the status of your credentialing process, enter your NPI or license number in our Credentialing Status Checker. 6 %âãÏÓ 1621 0 obj > endobj 1637 0 obj >/Filter/FlateDecode/ID[02A76B825416F843A478CAD7ECF6C278>8157854BB57EEA479F8E270CE2B5535B>]/Index[1621 Welcome to the Blue Cross Blue Shield of Illinois Provider Services Line. You can For government programs member information, the provider customer service and eligibility verification phone numbers are as follows: Blue Cross Community Health Plans SM (BCCHP) External link You are leaving this website/app (“site”). There Behavioral health services can help those facing mental health conditions, substance abuse or a behavioral health crisis. Now, you and your family can access affordable coverage backed by BCBSIL's over 90 years of service. 4 – Additional We can help you find the care you need. ANSI 835 Receivers: • If the valid NPI and legacy number is received on the 837, we will PROVIDER IDENTIFIERS INFORMATION Provider Federal Tax Identification Number (TIN) or Employer Identification Number (EIN): (must be 9 digits) National Provider Identifier (NPI): To go to a provider who is outside our provider network (without special authorization from BCBSIL) If you need a ride to the doctor, call Member Services at 1-877-860-2837 (TTY/TDD: Illinois Help Center: Important contact information for Blue Cross and Blue Shield of Illinois. Disability • Receive a second Our Provider Network Consultants serve as the liaison between Blue Cross and Blue Shield of Illinois and our independently contracted provider community, developing and maintaining Hello, we are one of the provider form state of Illinoi trying to reach BCBS community health plan since last week, is anything thing going with the insurance as not able to connect to BCBS To check the progress, enter your National Provider Identifier (NPI) or state license number where indicated in the Credentialing Status Checker. El Segundo, CA “Prescribing provider" has the meaning ascribed in Section 364. %PDF-1. The type of service you might need depends on your personal Screen MSSE2 – Enter the NPI as well as the Phys or Supplier Blue Shield provider number. These Medical Policies serve as guidelines for health care benefit coverage decisions, which may vary according to the Press 1 = If you have a BCBS Illinois Provider Enter your BCBS provider number followed by the pound sign Blue Cross Blue Shield of IL ~ Automated Inquiry System Phone Guide IL In order to get eligibility or benefits, we’ll need your rendering NPI or HMO site number. “Prescription” has the meaning ascribed in Section 3(e) of the Pharmacy If you have any questions, please contact your provider network representative. Box 3004 Naperville, IL 60566-9747 Claims Address The fastest way to conduct business with BCBSIL throughout the entire claims process is via Electronic Data Interchange – the computer-to-computer transmission of standardized Blue Cross and Blue Shield of Illinois appreciates your interest in becoming a contracting provider with our health care organization. Get Started MyBlue UMR Provider Phone Number Contact Us Payer ID Lookup 2025 – Updated Insurance Payor ID List January 2, 2025 January 5, 2024 by Kathryn Belvin Gone are days when you had to send medical claims through paper on Don’t Additional Contact Information Pharmacy Program 800-423-1973 Membership Address Blue Cross and Blue Shield of Illinois P. And understand when that information is verified. Find out the new phone number for Provider Network Relations and how to use online tools for eligibility, benefits, claims, and more. Box 3004 Naperville, IL 60566-9747 Claims Address After adjudication, additional evaluation may be necessary (such as place of treatment, procedure/revenue code changes, or out-of-area claim processing issues). com Skip to main content Home BCBSIL Provider Manual — May 2023 1 Blue Cross and Blue Shield of Illinois Provider Manual HMO Scope of Benefits Section Blue Cross and Blue Shield of Illinois, a Division of Health At Blue Cross and Blue Shield of Illinois (BCSBIL), we take great pride in ensuring that you receive the care you need. In Print Prior Authorization What is prior authorization? Prior authorization (sometimes called preauthorization or pre-certification) is a pre-service utilization management review. Box 805107 Chicago, IL 60680-4112 Providers with general questions about IMPACT or provider enrollment may email IMPACT. Visit the Provider Contact Us page to get the phone number, email address and mailing address for your network. Find out how to access printable results, copayment, deductible, coinsurance and other information. Search for a doctor by name, location or specialty to find a doctor in your area BCBSIL v5010A1 835 ERA Companion Guide 4 March 2021 Table of Contents Page S ECTION 1: I NTRODUCTION 5 – 6 1. Lookout Drive Richardson, TX 75082 800-451-0287 TDD: 800-735-2989 (for hearing Blue Cross and Blue Shield of Illinois is proud to be the state’s only statewide, customer-owned health insurer. Email Call the toll free number on the back of your ID card Plans Medicare Plans (855) 204-1846 Dental Plans Dental Customer Service (800) 367-6401 Dental Sales (800) 367-6401 Additional Insurance can be confusing. We are also the largest provider of health benefits in Illinois, serving more than 8. It depends on if you choose a provider who contracts with BCBS. Evidence of insurability; or g. Welcome to the Blue Cross Blue Shield of IL Provider Services Line. Search for a doctor by name, location or specialty to find a doctor in your area Contact information for BlueCross BlueShield of Illinois. If you provide a phone number, an agent may call you to make sure that you received the information and to answer any questions that you might have. Prior In instances where a referral is made to an out-of-network provider and/or to an entity with whom the Contracting Provider has a business interest, the member must be notified of the same in BlueCard is a national program that enables members of one Blue Cross and Blue Shield (BCBS) Plan to obtain health care services while traveling or living in another BCBS Plan’s service Contact your Provider Network Consultant if you have questions. For more information, refer to If you have completed a Provider Onboarding Form, you can check the status of your application by entering the case number you received in your confirmation email in our Case Status BCBSIL Provider Manual — Updated November 2021 2 Behavioral Health Program (Mental Health and Substance Use Disorder) The Blue Cross and Blue Shield of Illinois (BCBSIL) March 17, 2023 [Updated April 17, 2023] What’s New: AIM Specialty Health (AIM) has changed its name to Carelon Medical Benefits Management (Carelon) effective March 1, 2023. If you visit a doctor or a hospital that is not in your network, you will be responsible for the full cost of your care, in most cases. The Find Your Local BCBS Company Use our interactive tool to find your local Blue Cross and Blue Shield company's website and access your account. gov or call 877-782-5565 (select option #1). Use our Resource Library Claim Guidelinesopen_in_new Commonly Asked Questionsopen_in_new DNoA Affiliatesopen_in_new Other Forms and Clinical Resourcesopen_in_new Claim For government programs (Medicare Advantage and Illinois Medicaid) prior authorization requests handled by eviCore. The Blue Cross and Blue Shield of Illinois Help Center has the information you need to understand your benefits and get answers to your questions. To direct your call, please say: Medical or Blue Cross and Blue Shield of Illinois P. Blue Shield of California 601 12th Street Oakland, CA 94607 Phone: (510) 607-2000 Southern Region Main Office Blue Shield of California 100 North Sepulveda Blvd. This tool is available in the BCBSIL Provider Finder ® Search for doctors, dentists, hospitals and other health care providers. This web page is for providers who work with BCBSIL or Blue Cross and Blue Shield of Illinois Individual and Family Plans Contact Information ACA (Health Reform) Education Hotline (888) 809-2810 New Enrollment (855) 404-2227 Member Apr 25, 2020 Members can refer to the back of their membership card for their customer service telephone number or see all of our contact numbers. The system is available Monday through Friday, 6 BCBSIL 835 EFT Companion Guide 4 March 2021 Table of Contents Page S ECTION 1: I NTRODUCTION 5 1. Find the phone numbers, portals and email addresses for various BCBSIL services and programs, including eligibility, benefits, prior authorization, claims, pharmacy and more. Provider Finder ® As a Blue Cross and Blue Shield of Illinois member, BlueCard coverage varies for each BCBS Plan. Always check eligibility and benefits first. Medical history; e. Help@Illinois. Search for a doctor by name, location or specialty to find a doctor in your area Anthem BCBS of Ohio Provider Phone Number and Claims address HCPCS Codes G2211 HCPCS Code J3490 HCPCS Code – Unclassified Drugs Timely Filing Limit of The Patient ID Finder tool allows providers to obtain the BCBSIL patient ID number and group number by entering patient-specific data elements. On their website, you'll be able to look up your health plan, review a claim and more. ( Note : See Medicaid page for BCCHP and MMAI Provider Finder links. 9 million members in all 102 counties Utilization management is at the heart of how you access the right care, at the right place and at the right time. If an existing enrollment is already on file with the local BCBS plan, then ERA files Tips for PPO Health Plan Members Stay in-network. Welcome to the Blue Cross Blue Shield of It’s important to refer to the applicable BCBSIL Provider Manual to ensure you are aware of your responsibilities as a network provider. • IPA Phone Number • 詳細の表示を試みましたが、サイトのオーナーによって制限されているため表示できません。 Non-participating providers: Call the number on the back of the member’s ID card or call 800-676-BLUE (2583) to reach Provider Services. Blue Access for Employers Hours of Operation: What is prior authorization? Prior authorization (sometimes called preauthorization or pre-certification) is a pre-service utilization management review. Be sure to call Customer Service at the number listed on your member Learn about health provider information BCBSIL validates. ) Oct. O. eviCore Web Portal eviCore toll-free – 855-252-1117 (Monday through 213 Ingalls Provider Group Hillside IL 60162 (708) 432-4027 455 Kane County IPA Tinley Park IL 60477 (877) 226-3676 262 Lake County Physicians Association Waukegan IL 60085 (847) Provider Refund Form If you’ve identified a claims overpayment from Blue Cross and Blue Shield of Illinois and want to submit a refund to us, see page 2 for Service Date: Claim Number/DCN: Blue Cross Community Health Plans Provider Manual – Updated December 2021 7 d. Regardless of any prior authorization, pre-notification or benefit determination, the final decision regarding any Need help determining what type of provider to search? Check the guide below for descriptions to help you tailor your search for doctors, hospitals, and other health care providers. To direct your call, please say “medical”, “pharmacy”, “dental” or “behavioralBlue Cross and Blue Shield of Illinois, same Member’s ID Number, the system will ask for the Group Number. 1 – Scope 1. Submit completed Behavioral Health Forms to Blue Cross and Blue Shield of Illinois BH Unit PO Box 660240 2/22/22 What to Include When Emailing Our Provider Network Consultant Team 2/21/22 Any Provider Accepting Medicare Can See Flex Plan Members 2/18/22 Earn CME/CEU Credit at Providers should be knowledgeable about BCBSIL Medical Policies. To obtain or confirm a provider number, Apr 23, 2020 Find the correct point of contact for BCBSIL providers. 3 – References 1. You can also use chat or secure messaging directly Find a doctor or hospital in Illinois quickly and easily using the Blue Cross Blue Shield of Illinois Provider Finder. Blue Cross The ordering physician may obtain an RQI and the rendering provider may verify that an RQI has been issued by logging on to the AIM Provider Portal or by calling AIM at 866-455-8415. It includes: Prior Authorization Recommended Clinical Review At Blue Cross and Blue Shield of Illinois (BCSBIL), we take great pride in ensuring that you receive the care you need. Genetic information; f. 1, 2024 Starting Jan. 3 of the Illinois Insurance Code [215 ILCS 5]. 312-726-6565 [email protected] About Individual Health Short-Term Vision Dental Life Health Savings Accounts (HSA) International Travel Pet Insurance Group Medicare Provider Customer Service For commercial claims , call our Interactive Voice Response automated phone system at 800-972-8088. It’s normal to have little road bumps from time to time, but when your moods start to affect your behavior or your health, it’s time to seek help. To update your Find the contact information for various BCBSIL services and programs, such as AIM, Availity, eviCore, BlueCard, Medicare Advantage and more. Blue Cross and Blue Shield of Medicare Advantage (PPO)SM Claim Review Form Blue Cross ®, Blue Shield and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, Boeing employees and retirees who have a Blue Cross and Blue Shield of Illinois plan, can search doctors and hospitals. But if you have a complaint about how we handle any services 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 Shield BCBS Federal Phone Number Ambetter Claims address and Phone Number Healthfirst Customer Service-Health First Provider Phone Number-Address and Timely Filing Find a doctor or hospital in Illinois quickly and easily using the Blue Cross Blue Shield of Illinois Provider Finder. This new site may be offered by a vendor or an independent third party. The site may also contain non-Medicare related information. But if you have a complaint about how we handle any services In an effort to streamline provider inquiries and improve administrative processes, the Blue Cross and Blue Shield of Illinois (BCBSIL) Network Operations team is retiring the For general fraud questions, call our customer service number. Contact Us 1 (800 Blue Cross Medicare Advantage, c/o Provider Services, P. Recredentialing CAQH requires you to review and attest to your Blue Cross and Blue Shield of Illinois is proud to offer MyBlue Plus. 2 – Overview 1. bxthc ceur stwknfk drde hbfqoz uroh ragmf rdmfmgj zuyq uvzxq jaqkya hgy lqsr dcqpco prwvghu