stream Claims Address: P.O. BCBSTX makes no endorsement, representations or warranties regarding third party vendors and the products and services they offer. Dental Expense Claim. *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*. Travel Benefit Claim. The EPSarrives fasterthan the PCS andis easier to archivefor future retrieval. As a Behavioral Health-Managed Care Organization (BH-MCO), Magellan manages members' benefits in coordination with you - our network providers. Availity provides administrative services to BCBSTX. Services that require pre-authorization Yes. For exceptions to the standard timely filing requirements for specific states and/or plans/programs, refer to your contract withMagellan and/or its affiliates; see theMagellan state-, plan-and EAP-specific handbook supplements; refer to our timely filingexception grid; or consult state and federal laws. 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. Magellan Healthcare is contracted to perform behavioral health managed care functions supporting members and participants for the following Blue Cross and Blue Shield of Texas HMO networks; Blue Advantage HMO SM, Blue Cross Medicare Advantage HMO SM, Blue Cross Medicare Advantage Dual Care (HMO SNP) SM and MyBlue Health SM. Please note: as these requirements can be subject to change, thegrid may not contain a complete list of exceptions. Resubmissions must be submitted within 60 days from the date of denial. In Pennsylvania, Magellan works with county partners in Bucks, Cambria, Lehigh, Montgomery and Northampton counties. endobj BCBSTX Behavioral Health Unit Box 7026 Wheeling, WV 26003 Wisconsin Anthem Blue Cross Blue Shield One option is Adobe Reader which has a built-in reader. In accordance with applicable law, Magellan will pay clean claims within 45 days of the date of receipt. Key Contact Information Email to submit provider inquiries. What is the appeals process? Braven Health: 1-888-444-0501. TennCare Pharmacy Program 1-888-816-1680. Birmingham, Alabama 35244-2858. Magellan's quality improvement program to reduce inpatient mental health readmissions was selected by NCQA for inclusion in its benchmarking publication, Quality Profiles. Place of Service 22. Our innovative care coordination, case and utilization management programs, and vast network of behavioral health and specialty providers facilitate improved access to cost-effective and quality care while improving quality of life for the members we serve. Please be aware that inquiries and email boxes are not monitored 24/7. External link You are leaving this website/app (site). Box 660027 General Member Service Correspondence. BCBS Provider Phone Number. This practice is called balance billing and is not permitted. Fax to: 1-888-579-7935 052 1366489049; 052; 1366489049 Franciscan PHO Northern IN Hammond; Claims Inquiry Patty Arredondo; Julie Lambertino; 7905 S Calumet Ave Munster; IN 46321 (219) 836-5800 66347 (219) 836-8025 [email protected]; . (out-of-state subscribers) Magellan steps in for our members to help prevent and address the risks of one affecting the other. Select Blue Cross Blue Shield Global or GeoBlue if you have international coverage and need to find care outside the United States. You can download the toolkithere. Fax: 361-852-0624 For Emergency Situations, Always Call 911. Why was my claim denied? Federal Employee Program claims Blue Cross Blue Shield of Michigan P.O. 450 Riverchase Parkway East. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 24 0 R 25 0 R 26 0 R 27 0 R 30 0 R] /MediaBox[ 0 0 792 612] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> FBC HOM 001 F 102022. P.O. Fax: 1-800-424-5881. The ERA or ANSI 835 transaction is a HIPAA-compliant method of receiving claim payment and remittance details. Blue Cross and Blue Shield of Illinois P.O. 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? 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. In addition, some sites may require you to agree to their terms of use and privacy policy. The process typically takes about 3 to 4 weeks to complete the process, so allow ample time to complete your independent testing. Magellan Behavior Health Services coordinates all behavioral health (mental health and chemical dependency) services for Medicaid (STAR), CHIP, and STAR Kids members. We're here to help answer your questions. Claim Status; For Availity-related questions, please visit the Availity Essentials website or contact Availity Essentials Client Service at 1-800-282-4548, 8 a.m. to 8 p.m. To connect with someone on the right team, please choose an option below. Resubmission of Claims: Claims that must be revised and resubmitted after adjudication must be stamped resubmission or otherwise noted on box 22 of the CMS-1500 form. Driving directions. Self-enroll by creating a unique user ID and password. Dallas, TX 75266-0044, Behavioral health services - claims status inquiries, For services managed by BCBSTX: Or call your doctor or therapist for help. Will the timely filing standards be applied to claims I submitted prior to being a Magellan provider?A. Magellan Behavioral Health Providers of Texas, Inc. Request for claim review form and instructions, Wellness and clinical practice guidelines, Independent Diagnostic Testing Facility (IDTF), Intensive Outpatient facility programs (PHP/IOPs). Contact Availity or other electronic connectivity vendor or call Magellan Behavioral Health 1-800-729-2422, Claim filing address for Commercial products, Availity Essentials Availity EFT & ERA Enrollment User Guide. In addition, some sites may require you to agree to their terms of use and privacy policy. 1-800-749-0966 If after reviewing your rates you still believe there is an error, please contact the toll-free number on the member's ID card or the Members Explanation of Benefits, or call your Magellan network representative. BlueCare / TennCare Select Claims Service Center 1 Cameron Hill Circle, Suite 0002 Chattanooga, . Richardson, TX 75082 Become an Anthem provider and join the nation's second- largest health plan-owned behavioral health company, serving more than 13 . Email to submit provider inquiries and questions, Blue Cross and Blue Shield of Texas Magellans Primary Care Physician (PCP) Toolkit. Please provide the Tax Identification Number, NPI, and if applicable, Medicare Numbers for your provider when contacting Network Management. 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 Childrens Health Insurance Program (CHIP), plans covering employees of the state of Texas, school districts, and the University of Texas and Texas A&M systems. DO NOT COMPLETE THIS FORM IF YOU ARE A MAGELLAN COMPLETE CARE MEMBER OR PROVIDER. Because claims mailing addresses are different for different Blue Plan members, using the Claims Routing Tool is the most accurate way to determine a claims mailing address. Copy of an EOP with a date within the timely filing period, Certified or overnight mail receipts dated within the timely filing period, Copy of the claim with Magellan's date stamp within the timely filing period, Copy of 2nd level EDI 277 acceptance reports. 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. (336) 774-5400. BlueCross BlueShield of Tennessee payer ID number: 00390. Box 7355 . We really moved forward together., -Magellan Behavioral Health of Pennsylvania (HealthConnections) member. Paper Claims Address Independence Administrators P.O. 1-361-878-1623 A. Box 629010 El Dorado Hills, CA 95762-9010. 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.). 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). Pharmacy claim submission and Pro- DUR questions ; 24 hours / 7 days a week; Magellan Rx Management Pharmacy Call Center: 1-800-424-5725. For urgent requests only: 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. Corporate Address. endstream endobj 137 0 obj <. Don't have your card? Healthcare providers may submit their requests for prior authorization of healthcare services to Magellan using the Texas Standard Prior Authorization Request Form for Health Care Services.. Contact Magellan Healthcare. 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. Phone: 1-972-766-7100 (page_last_updated 03/2022) Magellan Behavioral Health Providers! 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. As a Magellan network provider, what is my timely filing limit?A. Please select the appropriate version of the form below based on the members you serve. This date is based on the date of the other carriers decision. Contact Us. <>/Metadata 147 0 R/ViewerPreferences 148 0 R>> Utilization Management (Prior Authorizations), STAR Kids Referral and Authorization Process, Value-Added Services for STAR, CHIP and STAR Kids, Quality Improvements (QI) Toolkits and Tip Sheets, Home Delivery Pharmacy (Mail-Order Pharmacy), Medicaid (STAR) and CHIP Prior Authorization Forms, Medical Providers Behavioral Health Toolkit, Magellan HealthCare Provider Focus News and Information, Applied Behavioral Analysis (ABA) Provider FAQ, Medicaid Provider Information on COVID-19 Coverage.
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