Specializing in the most complex, costly areas of care, Magellan Healthcare partners with states to manage behavioral health programs. 3 0 obj PDF File is in portable document format (PDF). If your ID card is not available, you may use one of the Customer Service telephone numbers below. Note: For the requests below, utilize the indicated links: All other inquiries submit an email by selecting the office closest to your location and provide the Tax Identification Number, NPI, and if applicable, Medicare Numbers for your provider when contacting Network Management. [Maryland and WDC] Offers healthcare insurance to residents of Maryland and Washington, DC. Box 211184 Eagan, MN 55121 Claims are paid based on your status on the date of service. %PDF-1.7 Fax: 915-496-6614 Self-enroll by creating a unique user ID and password. The site may also contain non-Medicare related information. Claims Submission. P.O. %%EOF Magellan's quality improvement program to reduce inpatient mental health readmissions was selected by NCQA for inclusion in its benchmarking publication, Quality Profiles. 1001 E. Lookout Drive. If you are enrolled in a Lowe's medical plan with BCBS AL, you will contact Magellan Health for services (1-877-543-3875, press 2, then press 1). (See item #2 below to learn how to contact your BCBS company to address any errors.) The Magellan timely filing standards (or in accordance with your state law) will be applied to claims for services rendered after you joined the Magellan network. 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.). Interested in exploring opportunities? 1-972-766-8900 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). Information for Brokers, employers, and providers, as well as links to consumer health and wellness sites. 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. The EOP includes details of the payment or the denial. Magellan continuously looks at our processes and procedures to improve service and increase efficiencies. 3 Magellan of Virginia NCQA Quality Improvement Activity Form, 2018. TO AVOID DELAY, DO NOT SUBMIT FORM TO MULTIPLE AREAS/OFFICES. Connect with us about any general, media or sales inquiries. Magellan Behavioral Health Providers! Participating physicians, professional providers, ancillary and facility providers are requested to submit claims electronically to Blue Cross and Blue Shield of Texas (BCBSTX) within 95 days of the date of service, or by using the standard CMS-1500 or UB04 claim form. 1-361-878-1623 External link You are leaving this website/app (site). 1001 E. Lookout Drive This new site may be offered by a vendor or an independent third party. Does this timely filing limit apply to all claims for all members (e.g., COB, Medicare, etc.)?A. Medicare Plus Blue SM PPO claims Blue Cross Blue Shield of Michigan P.O. 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. % Open in Google Maps Business Hours. Blue Shield 65 Plus (HMO): Blue Shield 65 Plus Medicare Provider Appeals Department P.O. Email to submit provider inquiries and questions, Golden Triangle (Beaumont, Orange, Port Arthur), Blue Cross and Blue Shield of Texas Phone: (800) 824-8839 Short-term claims for Blue Shield Life & Health Insurance Company Blue Shield Life & Health Insurance Company P.O. Box 2064 . Providers may continue to call Magellan with their prior authorization requests, as the form does not replace other existing methods of contacting Magellan to request a prior authorization. TennCare is happy to provide you an email response to your inquiry. Don't have your card? Claims Address: P.O. P O Box 660044 If you are enrolled in a Lowe's medical plan with BCBS AL, you will contact Magellan Health for services (1-877-543-3875, press 2, then press 1). % Fax: 361-852-0624 Click to skip to content, You are on secondary menu. Box 805107, Chicago, IL 60680-4112. Dental Blue Book eManual; Dental Blue News; Dental Enrollment and Credentialing; 75890 or the EDI Support Mail Box:EDISupport@magellanhealth.com. If you still need to submit paper claims, use the Claims-Routing Tool to determine the correct mailing address for each member. Claims Submitting Claims Claims will continue to go directly to BlueCross. The EPSarrives fasterthan the PCS andis easier to archivefor future retrieval. 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. Box 660044 A. As a Magellan provider, you are required to hold HealthChoices members harmless and cannot bill them for the difference between your contracted rate with Magellan and your standard rate. Magellan Behavior Health Services coordinates all behavioral health (mental health and chemical dependency) services for Medicaid (STAR), CHIP, and STAR Kids members. Box 272640 Chico, CA 95927-2640 By enforcing the timely filing requirement in the provider contract, we are able to focus our resources on what our providers have asked us to do - promptly pay claims. To submit claims on Magellans website: Providers can submit claims using the Claims Courier application by signing in to the. To obtain information pertaining to your network status, contact our National Provider Line at (800) 397-1630 from 8 a.m.-8 . BlueCare / TennCare Select Claims Service Center 1 Cameron Hill Circle, Suite 0002 Chattanooga, . One option is Adobe Reader which has a built-in reader. Fax: 972-766-2231 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. 1998-BlueCross BlueShield of Tennessee, Inc., an Independent Licensee of the Blue Cross Blue Shield Association. Select the best option and fill out a form and we will reach out to you as soon as possible! 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). Effective 6/27/2022, a Behavioral Health Service Coordination can help members manage complex conditions related to mental health and substance use. 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. Place of Service 22. What should I do? 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. 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. Direct Submit supports HIPAA 837P and 837I claims submission files. Maryland Heights, MO 63043 . Blue Cross and Blue Shield of Illinois P.O. 1-361-878-1623 Through increased access to evidence-based treatment options and effective preventive measures, we are making it easier for members to recover and stay out of hospitals. BCBSTX Behavioral Health Unit PO Box 660241 Dallas, TX 75266-0241 Fax 877-361-7646 Claims submission address: Blue Cross and Blue Shield of Texas P O Box 660044 Dallas, TX 75266-0044 For prior authorization and referrals managed by Magellan: Magellan Behavioral Health Providers of Texas, Inc. 800-729-2422 1 0 obj Call 1-800-528-7264 or the phone number listed on the back of the member's/subscriber's ID card. Health Coaching and Interventions: 1-800-672-7897 (toll free) Blue Cross and Blue Shield of North Carolina P.O. 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. Services include outpatient therapy, psychological testing, inpatient care, partial hospitalization, residential treatment, and intensive outpatient programs. Blue Cross Blue Shield of Massachusetts 101 Huntington Avenue, Suite 1300 Boston, MA 02199 . 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). You are leaving this website/app (site). This new site may be offered by a vendor or an independent third party. 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. Eligibility and benefits Please select the appropriate version of the form below based on the members you serve. What is the appeals process? *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*. all_rights_reserved. x]rFwVa1)dJr#Qk%QKQ[93 yvk#Y _wOOOaxzXn&Wrru;8}N7o|Q2l1}e/_{12|qE2QPQ&/=d_W?F|)eAW+@y^n|"Gc9zOh Magellan recommends Claims Courier for low volume claim submitters who dont want to use a clearinghouse. The State Health Benefits Program (SHBP) and the School Employees' Health Benefits Program (SEHBP) Program: 1-800-991-5579. Use the link below to find your local BCBS company's website. Email to submit provider inquiries and questions, Austinand Central TX (Bastrop, Bell, Bosque, Burleson, Burnett, Caldwell, Falls, Fayette, Hays, Hill, Lee, Leon, Limestone, Madison, Milam, McLennan, Robertson, Travis, Williamson counties), Blue Cross and Blue Shield of Texas 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. Magellan understands the importance of integrating care for members with SMI and physical comorbidities. 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. For preauthorization of psychological testing, in addition to the Texas Standard Prior Authorization Request Form for Health Care Services, Magellan also requires the provider to complete and submit the Request for Psychological Testing Preauthorization form found on our clinical forms page. Blue Cross Blue Shield members can search for doctors, hospitals and dentists: In the United States, Puerto Rico and U.S. Virgin Islands. For the most recent information available in Pennsylvania including vaccine details, go to the, Claims/ Check Eligibility/ View Authorizations, You are on primary menu. In addition, some sites may require you to agree to their terms of use and privacy policy. Horizon BCBSNJ: 1-800-624-1110 or 1-800-626-2212. <>/Metadata 147 0 R/ViewerPreferences 148 0 R>> Download information about our behavioral health solutions and public behavioral health overview. Refer to BCBSTX Medicaid website and Contact Us. A Claims Courier Demo can be accessed at: Claims Courier is a free web-based data entry application. 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. Corpus Christi, TX 78411-4375 Fax: 713-663-1227 Or call your doctor or therapist for help. Box 2048 Southeastern, PA 19399 Online: at www.bcbsglobalcore.com P.O. Blue Cross and Blue Shield of Texas, aDivision of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association, PDF File is in portable document format (PDF). From February 15 to September 30, on weekends and holidays, you may be required to leave a message. HealthTrio Connect : Email to submit provider inquiries. stream Medicaid Phone Number. Make sure to send your claim form to the appropriate claims payer and specific address. Pharmacy Claim. Find My BCBS Company In addition, some sites may require you to agree to their terms of use and privacy policy. BlueCross BlueShield of Tennessee is a Qualified Health Plan . This new site may be offered by a vendor or an independent third party. 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. Magellan Healthcare Solutions for Complex Care Needs: Behavioral Health, Specialty Imaging, Automated Prior Authorization, Employee Assistance. Email to submit provider inquiries and questions, Blue Cross and Blue Shield of Texas Other Adobe accessibility tools and information can be downloaded at https://access.adobe.com. If necessary, government programs paper claims may be submitted. If you havent found what you need or have additional questions, press the button below to submit a general inquiry. Box 312599 Detroit, MI 48231-2599. Molina Healthcare Phone Number claims address of Medicare and Medicaid. Claims Courier is an 837P compliant application. Behavioral Health Services are provided byMagellan Health Services. BCBSTX makes no endorsement, representations or warranties regarding third party vendors and the products and services they offer. endobj BlueCross BlueShield of Tennessee payer ID number: 00390. Note: Predetermination requests for members with Blue Cross and Blue Shield benefits in another state should be sent to the Plan indicated on the members ID card. Vision/Hearing Claim. 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. 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. There, claims submission information is broken out by prefix/product name. Electronic claims filing system, Benefit disclosure information (form available online), Online: Use Availity Attachments application, Mail form to: Dental Expense Claim. Box 2924 Phoenix, AZ 85062-2924. . The site may also contain non-Medicare related information. %PDF-1.5 % Again, this can be a huge time-suck, calling and being transferred over and over. Need Help? Box 660027 3 0 obj Montgomery:(877) 769-9782 Northampton:(866) 238-2312 Provider Services Contact Information: Bucks/Montgomery: (877) 769-9779 Cambria:(800) 424-3711 Lehigh/Northampton:(866) 780-3368 Information For Members & Providers: TTY (All counties):PA Relay 7-1-1 Fraud & Abuse:(800) 755-0850 For Emergency Situations, Always Call 911 Email to submit provider inquiries, Phone: 1-972-766-1380 . Copyright 2022Health Care Service Corporation. Find your provider portal Attn: Predetermination Dept. Phoenix Corporate Office Street Address. Horizon Behavioral Health. Resubmissions on Claims Courier (MBH Website): changes/ corrections are allowed to Place of Service, Billed Amount, or Number of Units Only (all other corrections must be submitted via paper claim). Email to submit provider inquiries and questions, Blue Cross and Blue Shield of Texas . Typically, a fee is attached by the clearinghouse vendor. As a Behavioral Health-Managed Care Organization (BH-MCO), Magellan manages members' benefits in coordination with you - our network providers. Users will obtain immediate feedback regarding the results of the test to ensure compliance with HIPAA rules and codes. Customer Service: If you have questions or need additional support, BCBSTX Personal Health Assistants are available to help. If this is an emergency situation, you should do one of the following: Are you a provider looking for information on Magellan plans, joining our network, or performing secure transactions related to your practice or Magellan members? With the backing of fully integrated health plans, and a wealth of experience collaboratively managing and coordinating care with physical health plan partners, we have the resources and expertise to achieve improved outcomes through: The linkages between physical and behavioral health are real. 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Site ) address of Medicare and Medicaid correct mailing address for each.! 0 R/ViewerPreferences 148 0 R > > Download information about our behavioral health, Specialty Imaging, Automated Prior,. The PCS andis easier to archivefor future retrieval claim form to the appropriate payer... Id and password and Washington, DC Assistants are available to help document format ( ). 1 Cameron Hill Circle, Suite 1300 Boston, MA 02199 time-suck, calling and being transferred and. Carolina P.O ) 397-1630 from 8 a.m.-8 HMO ): Blue Shield Michigan! Health Coaching and Interventions: 1-800-672-7897 ( toll free ) Blue Cross Blue Shield Texas! Learn how to contact your BCBS company to address any errors. ) a. To content, you may be submitted care, partial hospitalization, residential treatment and. Questions, Blue Cross and Blue Shield of Michigan P.O you havent found what you need or have additional,. 3 magellan of Virginia NCQA Quality Improvement Activity form, 2018 psychological testing inpatient! 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