MAIL US Corporate Office Address 450 Riverchase Parkway East Birmingham, Alabama 35244 CPT codes, descriptions and data copyright 2022 American Medical Association. Three forms are also available to aid providers in preparing an appeal request. Review Blue Cross and Blue Advantage medical and pharmacy policiesor comment on draft policies. A healthy smile is an important part of your family's overall health. Node:bclrprvappp1002.corp.bcbsal.org:8080 . Select Blue Cross Blue Shield Global or GeoBlue if you have international coverage and need to find care outside the United States. By continuing to use this website, you consent to these cookies. Choose between our 3 dental plans today! Use this form to submit a claim to be reimbursed for paying Medicare Part B premiums. For more information, view our privacy policy. All rights reserved. Thank you for your interest in our Short Term Plan. When you receive services from an in-network provider, your provider will generally file claims for you. Some areas of our site may provide links to other external sites that we don't own, control or influence. } I have reviewed the following treatment plan. Features expanded pediatric benefits for children up to the end of the month in which the member turns 19. Member Services For general inquiries, you can reach us by calling the number below. As a CHA representative, I agree to the payment terms and conditions of Blue Cross and Blue Shield of Alabama and will not collect any checking account, debit card or credit card information on behalf of the consumer for the purchase of health or dental insurance. For example, if an Alabama physician provides services to a member with Blue Cross and Blue Shield of Kansas coverage and a post-service appeal is needed, the physician should fill out the appropriate form from above and submit it to Blue Cross and Blue Shield of Alabama. If you receive out-of-network services for a medical emergency in the emergency room of a hospital, those services will be paid at the applicable in-network coinsurance amounts for benefits described in your benefit booklet, but subject to the out-of-network calendar year deductible.For emergency services for medical emergencies provided within the emergency room department of an out-of-network hospital, the allowed amount will be determined in accordance with the Affordable Care Act. What you need to know about the disease and our commitment to ensuring you have access to the right care at the right time. Thank you for your interest in our Short Term Plan. $129 /month. Call 1-855-890-7416, 8 a.m. - 8 p.m. Central Time, Monday through Friday. Fax (provider credentialing applications and related documents): 205-220-9545. Claim forms must be submitted to: Enjoy smart fillable fields and interactivity. Box 3418, Scranton, PA 18505; Blue Cross Community MMAI (Medicare-Medicaid Plan), c/o Provider Services, P.O. As a CHA representative, I agree to the payment terms and conditions of Blue Cross and Blue Shield of Alabama and will not collect any checking account, debit card or credit card information on behalf of the consumer for the purchase of health or dental insurance. /* You are about to leave Blue Cross and Blue Shield of Alabama's website and enter a website operated by HealthEquity. It includes the date you received the service, the amount billed, the amount covered, the amount we paid and any balance you're responsible for paying the provider. Information on Explanations of Benefits (EOBs). Box 14053 Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association. By clicking "Next", you are acknowledging that you would like to submit your application and continue onto the payment page otherwise, click "Cancel". Access the most extensive library of templates available. Please make sure you select the appropriate form to address your specific need. Claim forms must be submitted to: Blue Cross and Blue Shield of Alabama 450 Riverchase Parkway East Birmingham, Alabama 35244-2858 Grace periods and claims pending policies during the grace period Select the Sign button and create a digital signature. . //show the chat available image Patient. An EOB is an outline of what services you received from a provider and how your benefits were applied to cover those services. checkChatAvailability('onload'); //show the chat un-available image The Blue Cross representative will assist you in developing a Plan of Care - a guide in determining the type and frequency of care services you need. Please note that precertification relates only to the medical necessity of care; it does not mean that your care will be covered under the plan. Quality Care That's Right for YouWhether you need a routine check-up or a specialty procedure, you want the best care you can find.BCBS recognizes doctors and hospitals for their expertise and exceptional quality in delivering care. In some cases, your provider will initiate the precertification process for you. Instructions: 1. Business. Learn more about our Total Care and Blue Distinction Specialty Care designation programs and find a designated doctor or hospital that meets your needs. In the left-hand column, locate the state where services were rendered. CDT codes, descriptions and data copyright 2022 American Dental Association. 2023, Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association. if (jsonStr.Availability === 'YES') { Provider Phone Numbers PEEHIP P.O. With Blue Cross and Blue Shield of Alabama, all of our dental plans include regular dental exams, x-ray and routine cleaning - at no extra cost. Attorney, Terms of Don't have a User ID? }).then(function(data) { Claims Payment Policy & Other Information. Using an electronic vendor approvedwith Blue Cross and Blue Shield of Alabama, submit an electronic claim using a valid Tax ID, Individual NPI and Organizational NPI. To continue to this website, click "Accept." For claim status, eligibility, remittances and referrals, use one of the following methods: Access through your practice management software, Log in to our website, or Call the appropriate number listed below: In-State General Provider Inquiry Participating hospitals: 1-800-760-6852 Participating providers: 1-877-231-7239 Download and complete the appropriate form below, then submit it by December 31 of the year following the year that you received service. If your drug is not covered and you think it should be, you may ask us to make an exception to the drug coverage rules by calling the Customer Service Department number on the back of your ID card. To determine your premium, call us at 1-855-488-2515 or click the "Get Started" link to compare your plans today. Available plans and pricing may vary depending on whether you purchase your plan on or off the Health Insurance Marketplace. Find your smile. Start now! Access a wealth of healthcare resources and tools with MyBlue. the range of plans available toyou. After determining your benefit eligibility, your Lifetime Waiting Period start date will be determined. Download the Medicare Reimbursement Account (MRA) Pay Me Back claim form: Complete the form following the instructions on the front. To save time and incorrect billing process you can check the below table for the insurance numbers along with the respective states of the BCBS. Call the IVR: 205-220-6765. Follow the simple instructions below: The days of distressing complex legal and tax forms have ended. EDI enrollment is NOT required for submission of electronic claims. This link takes you to another website. 2. Dental Expense Claim Author: Blue Cross and Blue Shield of Alabama Subject: Dental Expense Claim Keywords: Dental Expense Claim,dental expense,dental,expense,claim Created Date: Health . View the latest providernews. If you want to stay on the Blue Cross website, click "Cancel.". Box 302150 Montgomery, AL 36130 or 135 South Union Street Montgomery, AL www.rsa.state.al.us Customer Service For general inquiries, please call Blue Cross Blue Shield FEP Dental Customer Service at 1-855-504-BLUE (2583), 8 a.m. - 8 p.m. EST Monday - Friday (TTY 711) You can also submit an online inquiry regarding claims; ID cards; website assistance; grievance or appeal; or fraud, waste, and abuse. Enroll as a Blue Cross provider, update provider information, or begin the credentialing/recredentialing process. Include the date to the document using the Date function. The case number, contract number and/or accident date you've entered does not match our records. You may also visit them online at BCBSAL. Ensures that a website is free of malware attacks. Applicable FARS/DFARS apply. How to file a dental claim with Blue Cross Blue Shield Alabama? USLegal received the following as compared to 9 other form sites. By clicking "Next", you are acknowledging that you would like to submit your application otherwise, click "Cancel". **Dental Blue Plus is a Health Insurance Marketplace plan. } ALL Kids. A retroactive denial is the reversal of a previously paid claim. With Blue Cross and Blue Shield of Alabama, all of our dental plans include regular dental exams, x-ray and routine cleaning - at no extra cost. Forms 10/10, Features Set 10/10, Ease of Use 10/10, Customer Service 10/10. Precertification also does not mean that we have been paid all monies necessary for coverage to be in force on the date that services or supplies are rendered. Register Now. What is the dental number for Blue Cross Blue Shield of Alabama? Us, Delete Provider Enrollment Generally, if precertification is required and not obtained, no benefits will be payable under the plan. A Qualified Health Plan is an insurance plan that has been certified by the Health Insurance Marketplace and provides essential health benefits, follows established limits on cost sharing and meets other requirements under the Affordable Care Act. Blue Cross and Blue Shield of Alabama will send you a Claims Packet to be completed and returned to us. An EOB is a statement that describes what medical treatments and/or services we paid on your behalf, what our payment was and your financial responsibility under the terms of the plan. 2023, Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association. extra cost. From October 1 through February 14, we are available 7 days a week. else #1 Internet-trusted security seal. If we deny your request, you may request an internal appeal and an external review by an impartial third party reviewer, known as an Independent Review Organization (IRO). If you believe you believe you have overpaid your premium due to our overbilling, please contact us by calling the Customer Service Department number on the back of your ID card. You can use our interactive search to find your local Blue Cross Blue Shield Company's website. Features expanded pediatric benefits for children up to the end of the month in which the member turns 19. Call 1-855-488-2515. 2023 New Directions Behavioral Health. Claim submission is supported for primary, secondary and tertiarypayment. The 34 independent BCBS companies insure more than 107 million members across all 50 states, the District of Columbia, and Puerto Rico 107 M members covered $ 382 M+ invested in community health initiatives 572 K+ Employee volunteer hours If you do not know this information, please contact us at 205-220-7725 or fax your request to 205-220-6354. } Search for Doctors, Hospitals and Dentists Blue Cross Blue Shield members can search for doctors, hospitals and dentists: In the United States, Puerto Rico and U.S. Virgin Islands. A powerhouse editor is already at your fingertips supplying you with a range of useful instruments for filling out a Dental Claim Form - Blue Cross And Blue Shield Of Alabama - Bcbsal. method: "GET", What is the fax number for BCBS of Alabama claims? What is the timely filing limit for BCBS of Alabama corrected claims? 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. Blue Cross and Blue Shield of Alabama enrolls and credentials all individual providers as well as ancillary and facility providers. Failure to timely pay premium payments is not a special open enrollment event for later coverage under the plan. **Dental Blue Plus is a Health Insurance Marketplace plan. In some cases, the plan requires that you or your treating provider precertify the medical necessity of your care. Please review your information to continue. TopTenReviews wrote "there is such an extensive range of documents covering so many topics that it is unlikely you would need to look anywhere else". It is your responsibility to ensure that you or your provider obtains precertification. Your local company can help you to: Change your coverage Estimate the cost of a medical procedure File or check on claim Replace your member ID card Review your balance View your plan details Looking for Insurance? Node:bclrprvappp1001.corp.bcbsal.org:8080, Pre-Service Review for Out-of-Area Members, PRO-81 Professional Reimbursement Appeal Form, PRO-82 Utilization Management Appeal Form. I authorize release of any information relating to this claim. You can file your expenses for reimbursement as frequently as you want. (SLC mailing address ) 61473: USA Blue Cross Blue Shield of North Carolina (Winston Salem mailing addr 61473 . Heres everything you need to know about it. There is a grace period of three months for all monthly premium payments after the initial premium payment. It also tells you how much has been credited toward any required deductible and out-of-pocket maximums. We use cookies to improve security, personalize the user experience, enhance our marketing activities (including cooperating with our marketing partners) and for other business use. Not a provider, but want to search our network?Search for Providers. Outside the United States. Call Customer Service at 1-855-504-BLUE (2583), 8 a.m. - 8 p.m. EST Monday - Friday, or Contact Us for further assistance. allows healthcare providers to submit claims electronically to Blue Crossand Blue Shield of Alabama. This login is for your Employer Account. Medical necessity and prior authorization timeframes and enrollee responsibilities. $('#chat-available').show(); Thank you for your interest in our Short Term Plan. You can also find our claim forms on our website at: Claims must be submitted and received by us within 24 months after the service takes place to be eligible for benefits. You can reach us at the following number: If you are or believe you may be experiencing a medical emergency,please dial 911 for emergency services.If you or a family member needs immediate assistance, please contact one of our representatives at 800-528-5763. Box 303017 Montgomery, AL 36130-3017. We reference sites that we think might be useful or of interest to you, but we are not responsible for the content or privacy practices used by other site owners. & Estates, Corporate - CDT codes, descriptions and data copyright 2022 American Dental Association. An assessment will be scheduled and performed by a Blue Cross representative to determine if your situation and health needs meet claims benefit eligibility. Download the overseas medical claim form: Include itemized bills for covered services or supplies. These guidelines, in addition to the editor will assist you through the entire procedure. Equal Opportunity Employer AA M/F/Vet/Disability, We are excited to announce that New Directions and Tridiuum have joined forces to become Lucet! Your Lifetime Waiting Period begins after you have been deemed Chronically Ill (or to have a significant Cognitive Impairment) and you have incurred one Qualified Long-Term Care expense. Claims must be submitted and received by us within 24 months after the service takes place to be eligible for benefits. . { Applicable FARS/DFARS apply. With Blue Cross and Blue Shield of Alabama, all of our dental plans include regular dental exams, x-ray and routine cleaning - at no extra cost. As an Alfa representative, I agree to the payment terms and conditions of Blue Cross and Blue Shield of Alabama and will not collect any checking account, debit card or credit card information on behalf of the consumer for the purchase of health or dental insurance. Include proof that you paid a Medicare Part B premium. This link takes you to another website. Get access to thousands of forms. Our representatives can answer your questions and help you navigate these choices. If the out-of-network services are covered, in most cases, you will have to pay significantly more than what you would pay an in-network provider because of lower benefit levels and higher cost sharing. 450 Riverchase Jun 4, 2012 Payers Transitioned to 5010 As of 6/4/2012 Below is a list of the Use professional pre-built templates to fill in and sign documents online faster. You can use 3 available choices; typing, drawing, or uploading one. Reimbursement will be sent to claimant; no claims are paid directly to provider. Need to submit a claim? Three forms are also available to aid providers in preparing an appeal request. Dental. You are about to leave Blue Cross and Blue Shield of Alabama's website and enter a website operated by HealthEquity. You can take the Blue Health Assessment, check drug costs, change your address, request a member ID card and more. var jsonStr = jQuery.parseJSON(data); If you have questions, please contact your local Blue Cross and Blue Shield company. Shop On Exchange Shop Off Exchange HOW TO BUY AN AFFORDABLE CARE ACT (ACA) PLAN window.open('https://cicqaaux.corp.bcbsal.org/I3Root/chatpopup.html?qname=cid_chat&fromUrl='+fromUrl, '', 'width=700, height=600'); Get Started An employee or dependent who loses coverage under Medicaid or a State Children's. Provider Appeals Blue Cross and Blue Shield of Alabama has an established appeals process for providers and physicians. contact your local Blue Cross and Blue Shield company. Planning, Wills Additionally, out-of-network providers have not contracted with us or any Blue Cross and/or Blue Shield plan for negotiated discounts and can bill you for amounts in excess of the allowed amounts under the plan. Be sure the data you add to the Dental Claim Form - Blue Cross And Blue Shield Of Alabama - Bcbsal is up-to-date and accurate. Blue Plus **. ); CDT codes, descriptions and data copyright 2022 American Dental Association. $.ajax({ Additional details about this and other exception review details can be found in the Claims and Appeals section of your benefit booklet. You will be going to a new website, operated on behalf of the Blue Cross and Blue Shield Service Benefit Plan by a third party. If you or your doctor believe there are exigent circumstances that require an expedited review, an expedited exception request can be submitted, and we will give a response within 24 hours. Thank you for your interest in our Short Term Plan. Address: CHIP P.O. Please review the terms of use and privacy policies of the new site you will be visiting. All Rights Reserved. Your doctor or other prescriber must give us a statement that explains the medical reasons for requesting an exception. Blue Cross and Blue Shield of Alabama has an established appeals process for providers and physicians. For standard policies - all Qualified LTC expenses will be paid in full until you reach your Maximum Monthly Benefit (31 x your Daily Benefit Amount). } else { Provider. Download your FREE dental guide to learn more about Questions? What is the fax number for BCBS of Alabama Dental Claims? Print and mail the form to your local Blue Cross and Blue Shield company by December 31 of the year following the year you received service. I am a Broker or Blue Plan partner that wants to visit the Partner Portal. Using this login enables you to manage the account for your organizations participating members. Complete the form following the instructions on the back. Guarantees that a business meets BBB accreditation standards in the US and Canada. function() { We use cookies on this website to give you the best experience and measure website usage. All rights reserved. Payer Name: Blue Cross Blue Shield of Alabama Payer ID: 510 Enrollment Required (ENR): Yes Type / Model: Commercial/Par State: AL Professional (CMS1500)/Institutional (UB04) [Hospitals] Real Time Eligibility (RTE): NO Real Time Claim Status (RTS): NO Electronic Remittance Advice (835) [ERA]: YES Secondary Electronic Claims (SEC): YES Using an electronic vendor approved with Blue Cross and Blue Shield of Alabama, submit an electronic claim using a valid Tax ID, Individual NPI and Organizational NPI. Blue Cross and Blue Shield of Alabama. What is the fax number for BCBS Alabama appeals? Phone Numbers. You can purchase ACA healthcare plans through a federal marketplace called the Health Insurance Marketplace or outside the Health Insurance Marketplace. *Subject to your Calendar Year Deductible. (You can fill the form in electronically or complete it by hand.). window.open('https://cicchat.bcbsal.org/I3Root/chatpopup.html?qname=cid_chat&fromUrl='+fromUrl, '', 'width=700, height=600'); USLegal has been awarded the TopTenREVIEWS Gold Award 9 years in a row as the most comprehensive and helpful online legal forms services on the market today. Submit a separate claim for each patient. 450 Riverchase Parkway East Each time Blue Cross processes a claim submitted by you or your healthcare provider, we send you an Explanation of Benefits (EOB). Blue Cross and Blue Shield of Alabama will send you a Claims Packet to be completed and returned to us. An EOB is not a bill. Claims Administrator Use this form to submit a health benefit claim for services that are covered under the Blue Cross and Blue Shield Service Benefit Plan. Box 3686, Scranton . Drug exceptions timeframes and enrollee responsibilities. Theft, Personal 2023 Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue ShieldAssociation. The first column represents the states of the US and the second column is the insurance name and the Third column represents the Phone number. Information contained in the external sites is not endorsed by BCBSAL. Already a Blue Cross member and have questions about your current plan? }); Patient Consent Form for Provider Submitted Appeals View PDF. function checkChatAvailability(userAction) { the page. }. { You may access the Nondiscrimination and Accessibility notice, Navigate & Connect: Simplifying access to behavioral healthcare. services, For Small Blue Cross and Blue Shield of Alabama Preferred Long-Term Care Customer Service: 1-888-331-4188 or 1-205-733-7019, Blue Cross and Blue Shield of Alabama Preferred Long-Term Care Customer Accounts: 1-205-220-4503, LifePlans Claims Services:* 1-800-525-7279 extension 273, LifePlans Provider Pathway:* 1-800-886-7404 or. Technology, Power of By clicking "Next", you are acknowledging that you would like to submit your application and continue onto the payment page otherwise, click "Cancel". Some areas of our site may provide links to other external sites that we don't own, control or influence. English Espaol. Submit a separate claim for each patient. Check out the changes and updates to our plan in 2023. If you pay a monthly payment later than the first day of the coverage period to which it applies, but before the end of the grace period for the coverage period, any claim you submit for benefits will be placed in a pending status (suspended) on the first day of the second month of the grace period and then processed by the plan only when all periodic monthly payments due during the grace period are received. Print and complete the form according to instructions on the front. You are about to leave Blue Cross and Blue Shield of Alabama's website and enter a website operated by Prime Therapeutics, LLC. Use this form to submit a claim to be reimbursed for services that are covered under Service Benefit Plan dental benefits. Brush up on important dental plan details Download your FREE dental guide to learn more about the range of plans available to you. . FSAFEDS (Reimbursement Options) Form Visit Page. Someone will get back to you within two business days. if (userAction === 'onclick') { As an Alabama Health Guidance representative, I agree to the payment terms and conditions of Blue Cross and Blue Shield of Alabama and will not collect any checking account, debit card or credit card information on behalf of the consumer for the purchase of health or dental insurance. Blue Cross and Blue Shield of Alabama The plan will only pay for care that is medically necessary and not investigational, as determined by us. Some information on our site is secure; log in to ensure you're seeing all the news. (You can fill the form in electronically or complete it by hand.). Adults age 19+. Preservice and concurrent appeals should continue to be submitted to the member's Home Plan. Spanish, Localized An application, from the Enrollment section, is needed for any provider in the following situations: Register With Form - AFP Annual Conference - Association For - An17 Afponline, Identity As an Alabama Health Guidance representative, I agree to the payment terms and conditions of Blue Cross and Blue Shield of Alabama and will not collect any checking account, debit card or credit card information on behalf of the consumer for the purchase of health or dental insurance. Only available through. Service, Contact A primary plan is one whose benefits for a person's healthcare coverage must be determined first without taking the existence of any other plan into consideration. * Sign up today and get a plan that's accepted by over 1,700 BCBS FEP Dental Claim Form View PDF. Call the National Information Center at 1-800-411-BLUE (2583) weekdays from 8 a.m. to 8 p.m. Eastern time. Email the Sales Call Center (AdviseMe@bcbsal.org) anytime. Box 3836, Scranton, PA 18505; Blue Cross Medicare Advantage, c/o Provider Services, P.O. LLC, Internet 2023, Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association. HealthEquity is our business associate and is an independent company that provides account-based plan services to Blue Cross. Here are the forms/documents to add locations and make changes to information and other requests. $23 /month. If your ID card is not available, you may use one of the Customer Service telephone numbers below. Node:bclrprvappp1002.corp.bcbsal.org:8080, Pre-Service Review for Out-of-Area Members, Anesthesia Sedation for Dental or Oral Surgery Procedures, Notification of Noncovered Dental Services, Predetermination of Benefits for Veneers and Anterior Crowns. Choose a state to see how Blue Cross Blue Shield is working in your community. Call 1-855-488-2515. For Indemnity policies - you will be paid your applicable Daily Benefit Amount. To continue to this website, click "Accept." All rights reserved. The following documentation provides guidance regarding the process for appeals. Get your online template and fill it in using progressive features. English, Download the overseas retail prescription drugclaim form: In these cases, you are responsible for payment to the provider. $('#chat-available').hide(); at 1-855-488-2515 or click the "Get Started" link to compare your plans today. Information contained in the external sites is not endorsed by BCBSAL. Your member ID card is your key to using your medical plan benefits. Lexington, KY 40512. When we receive an electronic claim, you will automatically be set up as an out-of-state provider in our system and can register to use our provider website, ProviderAccess: Once . Node:bclrprvappp1001.corp.bcbsal.org:8080 dentists throughout Alabama. Mail original claims to the appropriate address as noted below. CPT codes, descriptions and data copyright 2022 American Medical Association. All rights reserved. Tell us the type of service or supply for which you wish to file a claim (for example, hospital, physician, dentist or pharmacy), and we will send you the proper type of form. With US Legal Forms the entire process of completing official documents is anxiety-free. Please attach any additional information and/or medical records at the time of filing the appeal for consideration. To continue to the HealthEquity website, click "Accept." Are you reporting a new case? If your provider does not file your claim for you, you can call our Customer Service Department at the number on the back of your ID card and ask for a claim form. 13. $42 /month. Liferay.on( Blue Cross Blue Shield of Alabama. A secondary plan is one which takes into consideration the benefits of the primary plan before determining benefits available under its plan. Submit a separate claim for each patient. In that case, you will be responsible for all charges billed to you by the out-of-network provider. If you want to stay on Blue Cross' website, click "Cancel.". Node:bclrprvappp1001.corp.bcbsal.org:8080, Pre-Service Review for Out-of-Area Members.
