You can also get information and assistance on how to submit a written appeal by calling the Customer Service number on the back of your member ID card. You must appeal within 60 days of getting our written decision. Learn about electronic funds transfer, remittance advice and claim attachments. Your life. Regence users: make the switch to the Availity Web Portal You have been redirected from the Regence or Asuris Northwest Health Provider Center. Regence BlueCross BlueShield of Utah offers health and dental coverage to 528,000 members throughout the state. Regence BlueShield. Regence: The most trusted name in health insurance Experience life with Blue With a plan powered by the most trusted name in health insurance, you'll have coverage tailored to your health. CLAIM.MD | Payer Information | OR BCBS (Regence) Payer Information OR BCBS (Regence) Payer ID: 00851 This insurance is also known as: Regence Blue Cross of Oregon Blue Cross Blue Shield of OR REGENCE BLUECROSS BLUESHIELD OF OREGON REGENCE BCBS OF OREGON FEP G00851 Other ID's: 12B41, SB850 Need to submit transactions to this insurance carrier? Were proud to stand with you during this challenging time. Learn more about global periods, modifiers, virtual care, unlisted codes and NCCI bypass modifiers. Polski | If you have . Get help when you need it. For more information about authorizing a representative to request an appeal for you, read the Confidentiality of your health information section of your plans certificate of coverage. Media Contact: Lou Riepl Regence BlueCross BlueShield of Utah Regence BlueShield of . Step 1: Start your internet browser, and then go to the official regence bluecross blueshield of oregon claims address website. 2023 Regence health plans are Independent Licensees of the Blue Cross and Blue Shield Association serving members in Idaho, Oregon, Utah and select counties of Washington. Click on your plan, then choose theGrievances & appealscategory on the forms and documents page. We respond to pharmacy requests within 72 hours for standard requests and 24 hours for expedited requests. Grievances must be filed within 60 days of the event or incident. For more specific contact information, choose from the following: Individuals and families Medicare Employers Producers Providers Fraud or abuse You can remain anonymous. While it's a good idea to submit a complaint as soon as possible, there isn't a deadline to do so. WELLMARK BCBS OF IOWA. Call UMP Customer Service for help with any questions when you or a family member is covered by more than one plan. We will ask your permission if we need more time to respond. complies with applicable Federal and Washington state civil rights laws, Determine the county where the service was performed* (see exceptions below). People with a hearing or speech disability can contact us using TTY: 711. Availity and Regence Working with Regence online? Learn more about global periods, modifiers, virtual care, unlisted codes and NCCI bypass modifiers. Many issues may be resolved with a phone call. Stay up to date on what's happening from Salt Lake to St. George. In keeping with our values as a tax paying nonprofit, 85% of every premium dollar goes to pay our members' medical claims and expenses. The plan will not pay claims for prescription drugs submitted more than 12 months after purchase or prescription drugs purchased from an excluded pharmacy. You are about to leave regence.com and enter another website that is not affiliated with or licensed by the Blue Cross Blue Shield Association. Your trust is our top concern, so businesses can't pay to alter or remove their reviews. Requests to find out if a medical service or procedure is covered. You cannot ask for a tiering exception for a drug in our Specialty Tier. Call customer service and web support at 800-607-0546 between 8 a.m. and 6 p.m., Monday through Friday, Pacific Time. Username. Excluded pharmacies are pharmacies that have been excluded due to fraud, waste, or abuse. See "Appeals related to eligibility" section of your plan's. For knee and hip replacement and spine care. Step 4: After you have completed the login details correctly . See Complaints about quality of care in your certificate of coverage to learn more. | Coordination of benefits (COB) happens when you have health coverage through two or more groups (such as your employer and your spouses employer), and these two group health plans both pay a portion of your health care claims. Claims and clinical appeals address: PO Box 21702 Eagan, MN 55121 Care management Phone: 844-996-0329 Fax: 888-302-9325 2023 holiday closures January 2 May 29 July 4 September 4 November 23 November 24 December 25 Kreyl Ayisyen | Claims not submitted to UMP within 12 months of the date of service will not be paid. 1 0 obj There are three levels to the appeals process: first-level, second-level, and external review (independent review). Professional Services are performed by a doctor or other healthcare professional. Coding toolkit The second high-deductible health plan cannot include an HSA. Regence BlueShieldAttn: UMP ClaimsP.O. Consult theFEP local plan directory to find addresses and telephone numbers PO Box 1271 MS C7APortland, OR 97207-1271 This form is to be used only for services in Oregon and Clark County, WA. Coordination of Benefits or Other Party Liability . A decision to deny, modify, reduce, or terminate payment, coverage, certification, or provision of health care services or benefits, including the admission to, or continued stay in, a health care facility. When UMP pays second to another plan that covers the member, UMP will pay only an amount needed to bring the total benefit up to the amount UMP would have paid if the member did not have another plan. The quality of care you received from a provider or facility. Make sure you have your Member ID card handy when you call us. If requested, we will supply copies of the relevant records we used to make our initial decision or appeal decision for free. You are about to leave regence.com and enter another website that is not affiliated with or licensed by the Blue Cross Blue Shield Association. When you use a network provider or network pharmacy, you dont need to submit a claimthe provider or pharmacy will do it for you. Phone:800-562-1011Fax: 877-239-3390 (Claims and Customer Service)Fax: 877-202-3149 (Member Appeals)Fax: 866-948-8823 (FEP Care Management - prior auth/pre-service requests), Email: You must continue to use network pharmacies until you are disenrolled from our plan to receive prescription drug coverage under our formulary. View the toolkit Claims submission Learn more. If we must request additional information, the processing of your claim may be delayed. Call the phone number on the back of your member ID card. for other plans. Regence BlueCross BlueShield of Oregon. 2023 Regence health plans are Independent Licensees of the Blue Cross and Blue Shield Association serving members in Idaho, Oregon, Utah and select counties of Washington. If additional information is needed, we will send you a request. Claims & payment Claims & payment Learn how to identify our members' coverage, easily submit claims and receive payment for services and supplies. Follow the prompts to submit your claim online. Procedure and diagnosis (codes) or description of the injury or illness, d. Provider's name, address, phone number, and National Provider Identifier (NPI) or Tax ID number, e. For ambulance claims, also include the ZIP code where the member was picked up and where they were taken. Products and networks Learn more about the products we offer and the provider networks that support them. If you or your dependents are enrolled in UMP High Deductible and want to enroll in another health plan, you and your dependents can only enroll in other high-deductible health plans. The plan must receive all relevant information with the appeal to make sure the most accurate decision is made. In every state and every community, BCBS companies are making a difference not just for our members, but For the Health of America. See what were doing in your community to keep people safe and healthy. You may need to submit your own claim if you buy drugs at a non-network pharmacy, dont show your ID card, or have other prescription coverage that pays first and UMP is secondary. Medical records from your provider, if applicable. Regence Blue Shield in accordance with the terms of your provider contract with Regence. 4 0 obj You or your authorized representative (including a relative, friend, advocate, attorney, or provider) may submit an appeal by using the methods described in the Where to send complaints or appeals section below or by calling UMP Customer Service (medical appeals) or WSRxS Customer Service (prescription drug appeals). Appeal form (PDF): Use this form to make your written appeal. See the About UMP High Deductible Health Plan and If you have other HDHP coverage sections in the UMP High Deductible certificate of coverage for more information on secondary health plans and limitations. In the left-hand column, locate the state where services were rendered. If you buy your prescription drugs at a network pharmacy, your claim will be submitted for you. If additional information is needed, we will send you a request. BCBS State by State | Blue Cross Blue Shield. 2023 Regence health plans are Independent Licensees of the Blue Cross and Blue Shield Association serving members in Idaho, Oregon, Utah and select counties of Washington. If you are a member of another air ambulance's membership program that is a reciprocal partner of Life Flight Network, please make sure you report this to our billing office at (866) 883-9998. Identify BlueCard members, verify eligibility and submit claims for out-of-area patients. To obtain information on the aggregate number of grievances, appeals and exceptions filed with the plan contact Customer Service. TRS: 711Business hours: Monday through Friday 8 a.m. to 4:30 p.m. (Pacific). You can submit feedback about your Medicare health plan or prescription drug plan directly to Medicare. Note:TovieworprintaPDFdocument,youneed AdobeReader. Our award-winning Customer Service team is made of compassionate people who care. If you have questions, contact Premera at 1 (855) 784-4563 (TRS: 711) Monday through Friday 7 a.m. to 5 p.m. (Pacific). Examples: medical doctor, osteopath, optometrist, chiropractor, physical therapist, audiologist, independent laboratory, nurse practitioner, durable Get 5 free searches. About Regence BlueCross BlueShield of Oregon. You get a vaccine or flu shot from an out-of-network provider. You can submit a marketing complaint to us by calling the phone number on the back of your member ID card or by calling 1-800-MEDICARE (1-800-633-4227). treatment center. You are about to leave regence.com and enter another website that is not affiliated with or licensed by the Blue Cross Blue Shield Association. Premera Blue Cross Choose an option. See Occupational injury or illness (workers' compensation) claims in your certificate of coverage. Step 1: Start your internet browser, and then go to the official regence bluecross blueshield of oregon address website. Instructions: 1. Pre-authorization View services and supplies that require pre-authorization. Regence Provider Appeal Form Special Message: Coming soon, you will be able to dispute (appeal) a claim on Availity from the claim status result page. Completion of the credentialing process takes 30-60 days. We are now processing credentialing applications submitted on or before March 6, 2023. This form is to be used to request a deduction on a future remittance advice (voucher) in response to a recent recoupment request from Regence, or as a result of an overpayment discovered by your internal claims review process. You can also download the appeal form and submit your written appeal by email, fax, or mail:Email: UMPMemberAppeals@regence.comFax: 1 (877) 663-7526, Mail:UMP Appeals and GrievancesRegence BlueShieldPO Box 91015Seattle, WA 98111-9115. For more information about the appeals process, including expedited appeals for urgent or life-threatening conditions and requesting an external review by an Independent Review Organization, read the "Complaint and appeal procedures" section in your plan's certificate of coverage. 7:00 AM - 6:00 PM PSTFax: 877-239-3390 (Claims and Customer Service)Fax: 877-202-3149 (Member Appeals only)Fax: 866-948-8823 (FEP Care Learn how to identify our members coverage, easily submit claims and receive payment for services and supplies. <> Consult theFEP local plan directory to find addresses and telephone numbers for other plans.Note: If the equipment was sent from a DME provider in Washington, refer to thesubmission map to determine where to send your claim for processing. P | Library Access our Administrative Manual and keep up to date with news. Para humingi ng tulong sa Tagalog, pakitawagan ang numero ng telepono ng Serbisyo sa Kostumer (Customer Service) na nakasulat sa likod ng inyong kard bilang miyembro. PO Box 52057 Don't have your card? Learn how our innovative solutions can help your employees live healthier, while helping you manage your costs. An appeal is an oral or written request submitted by you or your authorized representative to Regence BlueShield or Washington State Rx Services to reconsider: You or someone you authorize to represent you may request an appeal. The following information must appear on the provider's itemized bill for the plan to consider the claim for payment: a. Note: If the pick-up location is in Washington, refer to theWashington claims submission map to determine where to send your claim for processing. View our clinical edits and model claims editing. Coronary Artery Disease. Please use the comment section for additional information. Send your claim or correspondence to the Blue Cross Blue Shield plan in the state where the laboratory work was sent for testing.Example: The lab service you used is in Arizona but the sample was sent to Nevada for analysis. Seattle, WA 98121, Support Phone Number: 1.888.427.0470 (toll free), Mon-Fri, 7:00 a.m. to 5:00 p.m. (PT), 1.800.AVAILITY (1.800.282.4548) (toll free), Run transactions to obtain member benefit, eligibility and claims information, Access eContracting to view and sign agreement documents, Our online newsletter (6 issues per year). Facility Services are services received for the use of a facility such as a hospital, emergency room, freestanding ambulatory facility, attended sleep study at outpatient part of a hospital, alcohol treatment facility or residential Regence BlueCross BlueShield of Utah. Your provider must submit all clinically relevant information to the plan by phone or fax. Regence BlueShield - FEPPO Box 31207Salt Lake City, UT 84131, (Attended sleep study at outpatient part of a hospital, home hospice, organ/tissue transplants, clinical trials. Premera Blue Cross Blue Shield of Alaska - FEP PO Box 33932 Seattle, WA 98133-0932 Phone: 800-562-1011 6:00 AM - 5:00 PM AST Fax: 877-239-3390 (Claims and Customer Service) Fax: 877-202-3149 (Member Appeals only) Fax: 866-948-8823 (FEP Care Management - prior auth/pre-service requests) Email Members: Log in or register - MyBlue Customer eService We will notify you once your application has been approved or if additional information is needed. endobj 10/18) v2 INSTRUCTIONS FOR FILING A CLAIM IMPORTANT: Use this form for all medical, pharmacy, dental, and vision services covered by Regence. You have the right to appeal, or request an independent review of, any action we take or decision we make about your coverage, benefits or services. Oregon Regence BCBS of Oregon P. O. PO Box 91102Seattle, WA 98111-9202. Find the right fit for your next chapter with top-rated coverage and care you can trust. You are about to leave regence.com and enter another website that is not affiliated with or licensed by the Blue Cross Blue Shield Association. Regence BlueShield of Idaho offers health and dental coverage to 142,000 members throughout the state. Washington State Rx ServicesPO Box 40168Portland, OR 97240-0168. endobj Coding toolkit View our clinical edits and model claims editing. The Regence Operations Trainer I would have two years' experience in operational areas to include customer service, claims, membership and/or delivering training in a matrixed environment or . UMP may cover some supplies through the medical benefit and other supplies under the prescription drug benefit. <>>> Asthma. Location. You must submit first-level and second-level appeals no more than 180 days after receiving the previous decision. | Open 24 hours a day, 7 days a week. <>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> 24/7 anonymous hotline: 1 (800) 323-1693 Medicare Part C & D: 1 (800) 633-4227 Online reporting form Ethics & compliance hotline Find the correct address listed under the type of service received (see explanation). The plan will decide on your expedited appeal within 72 hours of the request. Please follow But there are some circumstances where you will need to submit a claim. Youll receive notice of the action on your complaint within 30 calendar days of our receiving it. Follow the steps below to submit your claim online. Claims determinationsThe plan will notify you of action taken on a claim within 30 days of the plan receiving it. MAXIMUS Federal Services is a contracted provider hired by the Center for Medicare and Medicaid Services (also known as CMS) and has no affiliation with us. Address: 200 SW Market St Portland, OR, 97201-5715 United States See other locations Phone: Website: www.regence.com Employees (this site): Actual Employees (all sites): Actual Revenue: Modelled Year Started: Incorporated: ESG ranking: ESG industry average: What is D&B's ESG Ranking? You can appeal a decision online; in writing using email, mail or fax; or verbally. %&xv}`kfg`O>=toy,y_bI)45T\ei@{65z9|i8NhI;nTSp~b5[iN_ pn+JsX;fz|4]R 8ZTJ.#fdP]^RP|z~-3KT\n:)O68m+zm96th+/5O6=%7;s"(CTF fZTreF`Tzq`a=6>GGW[tXudM+W6`m~yuCCu xd!XDmSdoQ/= y?ck r1rMc.c0>'1|\a{ enTc |GBl]|mCxr,. The ambulance claim will be processed by Blue Cross Blue Shield of Oregon. I had an out-of-network claim for my disabled husband and they rejected it as "out of network". You receive services from an out-of-network provider. See your certificate of coverage for more information on how to file a claim for specific services and supplies. Send your claim or correspondence to the Blue Cross Blue Shield plan in the state from which the durable medical equipment was sent.Example: You live in Seattle and order parts for a wheelchair from a company in Montana. Please contact the Medicare Appeals Team at 1 (866) 749-0355 or submit the appeal in writing and stating you need a fast, expedited, or hot" review, or a similar notation on the paperwork. You are about to leave regence.com and enter another website that is not affiliated with or licensed by the Blue Cross Blue Shield Association. That way, we can verify your account and start helping you as quickly as possible. Regence BlueCross BlueShield of Oregon providers located in Clark County, Washington: Within 24 months after payment of the claim or notice that the claim was denied or within 30 months for claims subject to coordination of benefits. We're ready. View your credentialing status in Payer Spaces on Availity Essentials. You can also call Washington State Rx Services with the information at 1 (888) 361-1611 (TRS: 711). Regence BlueShield serves select counties in the state of Washington and is an independent licensee of the Blue Cross and Blue Shield Association. Congestive Heart Failure. Learn more about our payment and dispute (appeals) processes. Management - prior auth/pre-service requests), Email: Members: Log in/register at MyBlue Customer eService, Regence BlueShield - FEPPO Box 21709Seattle, WA 98111. Subscribe to online communications receive newsletters and important news via email. Find helpful phone, fax and email information for assistance. Deutsch | Learn about dental billing information to help ensure your dental claims are processed quickly and correctly. For the Health of America. Your budget. Ask your provider. Management - prior auth/pre-service requests), Members: Log in or register - MyBlue Customer eService, Retail Pharmacy Program PO Box 52057 Phoenix, AZ 85072, Retail Pharmacy Program PO Box 52080 Phoenix, AZ 85072, Phone:800-552-0733Fax: 801-333-6523 (Mark claims: Attn New Claims)Email: Log in or register - MyBlue Customer eService, Regence BlueShield - FEPPO Box 857Lewiston, ID 83501, Regence BlueShield - FEPPO Box 1388Lewiston, ID 83501Customer Service. Note: If you submit your claim by mail, be sure to make copies of your documents for your records. Lack of information. This is the customer service number for questions about your health insurance coverage, benefits or treatment. Regence BlueCross BlueShield of Utah Send to Regence Blue Shield in accordance with the terms of your provider contract with Regence. See how our affordable Regence plans offer coverage, access and convenienceso you can live your best. . Select a State. If an initial phone call does not resolve your complaint, you may submit your complaint over the phone or by email, fax, or mail. See reviews, salaries & interviews from Regence employees in Lewiston, ID. Members: Log in/register at MyBlue Customer eService, Regence Blue Cross Blue Shield of Oregon - FEPPO Box 31105Salt Lake City, UT 84131, Regence Blue Cross Blue Shield of Oregon - FEPPO Box 1269Portland, OR 97207. All features have been transitioned to the Availity Provider Portal. Please note: This form is to be used by physicians, other professional providers or medical facilities to contact their assigned provider relations representatives. Italiano | Claims edits If you do not submit your claims through Availity Essentials, follow this process to submit your claims to us electronically. Media Contact: Audrey Glasby Regence BlueCross BlueShield of Utah Regence . Learn more about our customized editing rules, including clinical edits, bundling edits, and outpatient code editor. Box 1106 Lewiston, ID 83501-1106 Fax: 1 (877) 357-3418 . 2023 Regence health plans are Independent Licensees of the Blue Cross and Blue Shield Association serving members in Idaho, Oregon, Utah and select counties of Washington. <> First- and second-level appeals are part of an internal review process, while independent reviews are part of an external review process. Blue Cross and Blue Shield of Nevada will process the claim. Other specialized services (home hospice, organ/tissue transplants, and clinical trials). If your primary plan uses a different mail-order pharmacy, you will have to use your primary plans mail order pharmacy and then submit a claim to Washington State Rx Services. 2023 Regence health plans are Independent Licensees of the Blue Cross and Blue Shield Association serving members in Idaho, Oregon, Utah and select counties of Washington. Improving Health State-by-State, For the Health of America. Those documents will include the specific rules, guidelines or other similar criteria that affected the decision. Use the appeal form below. You can submit your appeal online, by email, by fax, by mail, or you can call using the number on the back of your member ID card. Complete and mail or fax a Multiple Coverage Inquiry Form to Regence: Regence BlueShieldAttn: UMP ClaimsPO Box 91015MS BU386Seattle, WA 98111-9115.

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