Richardson, TX 75082 Paper Claims must be submitted to the below addresses (claims are not accepted at the Care Management Center in Newtown): MBH-Bucks, PO Box 1715, Maryland Heights, MO 63043 MBH-Cambria, PO Box 2157, Maryland Heights, MO 63043 MBH-Lehigh, PO Box 2127, Maryland Heights, MO 63043 MBH-Montgomery, PO Box 2277, Maryland Heights, MO 63043 This date is based on the date of the other carriers decision. (Note:For behavioral health professional providers, refer to the Network Management Office Locations listed above). To obtain an aggregate number of grievances, appeals, and exceptions filed with BlueRx (PDP) contact Member Services at 1-800-327-3998 (BlueRx AL) or 1-888-311-7508 (BlueRx TN), 8 a.m. to 8 p.m., seven (7) days a week. Direct Submit supports HIPAA 837P and 837I claims submission files. Email to submit provider inquiries and questions, Blue Cross and Blue Shield of Texas Magellan Behavioral Health Providers! D2Ed0L^lA$0D`X|6MlK(4S$3Al"@?MV3H{r qJAGg` Phone Numbers for Providers. 168 0 obj <>/Filter/FlateDecode/ID[<50CE1069D31C234C87CF13730B148C38><945CA0064BA9D246BD7A3657988FAEE3>]/Index[136 60]/Info 135 0 R/Length 140/Prev 151563/Root 137 0 R/Size 196/Type/XRef/W[1 3 1]>>stream 1-512-349-4847 This means that, subject to applicable state or federal laws, claims must be submitted toMagellan within 60 days of the date of service or inpatientdischarge. 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. This functionality is available for claims transactions with a status of Received/ Accepted. Winston-Salem, NC 27105. Q. I have a specific question about a claim. Box 629010 El Dorado Hills, CA 95762-9010. 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 Phone: (800) 541-6652 Fax: (818) 228-5014 Read about our progress in the 2021 GuideWell Social Impact Report. <> Visit our Provider Portals English 1-361-878-1623 1999-2022 commercial_footer_copyright_magellan_link. All claims for covered services provided to HealthChoices Members must be submitted to and received by Magellan as follows: Within sixty (60) days from date of service for most levels of care except as provided below; Within sixty (60) days from date of discharge for 24/hr level of care; Within sixty (60) days of the last day of the month or the discharge date, whichever is earlier when billing monthly for longer treatment episodes of care at a 24/hr level facility; Within sixty (60) days of the claim settlement for third party claims. TO AVOID DELAY, DO NOT SUBMIT FORM TO MULTIPLE AREAS/OFFICES. 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). Q. If you are able to create an 837 file in a HIPAA compliant format, we. Click to skip to content. Contact Us. Its similar to the CMS 1500 claim form, with additional fields to make the application HIPAA-compliant. Magellans PCP toolkit represents Magellans commitment to promote integration of medical and behavioral health services toward the goal of better overall outcomes for patients. This new site may be offered by a vendor or an independent third party. Clean claims are defined as claims that can be processed without obtaining any additional information from the provider or from a third party. Blue Shield of California welcomes you. Availity provides administrative services to BCBSTX. Provider Services 1-800-521-6007 Representatives are available 24 hours a day, 7 days a week.. By email. endobj 2022 Magellan Health, Inc. All Rights Reserved. 1-713-663-1149 17806 IH 10 West, Bldg II, Suite 200 Blue Cross and Blue Shield of Texas Attention: Claim Department . 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. External link You are leaving this website/app (site). Or call your doctor or therapist for help. Download information about our behavioral health solutions and public behavioral health overview. 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. You should also check with your billing service, clearinghouse or software vendor to confirm ERA-compatibility and availability of auto-posting software. Vision/Hearing Claim. PDF File is in portable document format (PDF). For Texas-specific ABA resources,sign into this website. The process typically takes about 3 to 4 weeks to complete the process, so allow ample time to complete your independent testing. Driving directions. Complete the appropriate claim form - CMS-1500 forms are required for outpatient services and UB-04 forms are required for inpatient services. Member Questions Blue Cross Blue Shield members, please contact your BCBS company if you have specific questions about your plan, coverage and more. Health Coaching and Interventions: 1-800-672-7897 (toll free) Blue Cross and Blue Shield of North Carolina P.O. 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. Q. I did not submit a claim due to a change in coverage for the member in question. Magellan was the first MBHO to have a program included in this publication. To view this file, you may need to install a PDF reader program. 4 0 obj If you still need to submit paper claims, use the Claims-Routing Tool to determine the correct mailing address for each member. Claims Address. For eligibility, prior authorization or claims inquiries, call 877-299-1008. Member Services 1-800-521-6860 TTY: 1-800-684-5505 Representatives are available 24 hours a day, 7 days a week.. Email to submit provider inquiries and questions, Blue Cross and Blue Shield of Texas The following items when submitted with your appeal may be considered evidence that your claim was submitted in a timely manner: Q. % Claims Submission. 1-915-496-6600, press 2 Email to submit provider inquiries, Phone: 1-972-766-1380 1 0 obj Availity provides administrative services to BCBSTX. Florida Blue is a part of the GuideWell family of companies. For prior authorization and referrals managed by Magellan: Magellan Behavioral Health Providers of Texas, Inc. 1-800-729-2422: Behavioral health services - claims status inquiries. In accordance with applicable law, Magellan will pay clean claims within 45 days of the date of receipt. Q. I have never had a claim denied for timely filing reasons before; why is it being denied now?A. P.O. 1001 E. Lookout Drive Enter your company name in the search box, select the group name from the drop-down, check the box at the bottom and then click the "Go" button. What should I do? %PDF-1.7 The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies. In-network providers will be paid at their contracted rate. 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. Behavioral Health Services: 1-800-266-6167. 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. [Maryland and WDC] Offers healthcare insurance to residents of Maryland and Washington, DC. TennCare Provider Services 1-800-852-2683. If your state has multiple brands (WA, CA, OR, NY, NJ, to name just a few) then you'll want to ask for the exact address to file to. Magellan recommends Claims Courier for low volume claim submitters who dont want to use a clearinghouse. Sign up to receive information and updates from Magellan Healthcare on behavioral health webinars and education! External link You are leaving this website/app (site). One option is Adobe Reader which has a built-in reader. (out-of-state subscribers) Similar behavioral health programs are implemented across product lines but may differ by product. El Paso, TX 79912 -6156 195 0 obj <>stream 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. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. Click to skip to content, You are on secondary menu. Find My BCBS Company Contact Availity or other electronic connectivity vendor or call Magellan Behavioral Health 1-800-729-2422, Claim filing address for Commercial products, Availity Essentials 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. We provide free eligibility and benefits verification as part of our billing . 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. Fax: 361-852-0624 No. To connect with someone on the right team, please choose an option below. Blue Cross Complete claims P.O. Again, this can be a huge time-suck, calling and being transferred over and over. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 19 0 R 25 0 R 26 0 R] /MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Looking to contact Magellan Rx Management? San Antonio, TX 78257-8222 To obtain information pertaining to your network status, contact our National Provider Line at (800) 397-1630 from 8 a.m.-8 . 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. 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. 9~zfH. . Services include outpatient therapy, psychological testing, inpatient care, partial hospitalization, residential treatment, and intensive outpatient programs. AIM Specialty Health (AIM) is an operating subsidiary of Anthem and an independent third party vendor that is solely responsible for its products and services. Paper Pharmacy Claims: Send to: Attention Paper Claims Processing. Copyright 2022Health Care Service Corporation. Keystone First 200 Stevens Drive Philadelphia, PA 19113. For the latest information on flexibilities and extensions due to COVID-19, refer to theTexas Medicaid & Healthcare PartnershipandTexas Health and Human Services Commissionwebsites. %%EOF P. O. From 2015 to 2017, our programs contributed to a 26% increase in members who were asked by their behavioral health providers to authorize communication with their PCP providers.3, Working with HealthConnections, the team helped get me to a place of not having fear, not having pain, exercising and doing yoga. Magellan continuously looks at our processes and procedures to improve service and increase efficiencies. Dental Blue Book eManual; Dental Blue News; Dental Enrollment and Credentialing; Resubmitted claims should include the Date of Original Submission and Claim number if applicable. Fax: 1-713-663-1227 Box 2924 Phoenix, AZ 85062-2924. . Box 7355 . Beaumont, TX 77702-1954 Email Us. NOTE: To gain access to the above Blue Cross and Blue Shield of Texas Medicaid Tools you must be registered with Availity. Fax: 713-663-1227 Participating physicians, professional providers, ancillary and facility providers may not seek payment from the member for claims submitted after the 95-day filing deadline. 4444 Corona, Suite 148 2022 Magellan Health, Inc. All Rights Reserved. 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. Box 312599 Detroit, MI 48231-2599. Contact Magellan Healthcare. Dallas, TX 75266-0027, Prior authorization of Medical Services for the Health Insurance Marketplace for Blue Advantage HMO Members, Eligibility and benefits contact Availity or other electronic connectivity vendor or call 1-800-451-0287*, Behavioral health services mental health and chemical dependency, For prior authorization and referrals managed by BCBSTX: (includes inpatient, residential treatment center (RTC) programs, partial hospitalization and outpatient behavioral health services). Blue Cross and Blue Shield of Illinois 300 East Randolph Street Chicago, Illinois 60601-5099. Magellan's quality improvement program to reduce inpatient mental health readmissions was selected by NCQA for inclusion in its benchmarking publication, Quality Profiles. BCBS Provider Phone Number. Blue Cross and Blue Shield of Illinois P.O. Dental Expense Claim. The EPSarrives fasterthan the PCS andis easier to archivefor future retrieval. Maryland Heights, MO 63043 . Do the timely filing limits apply to this claim?A. Preauthorization requirementsfor Blue Cross and Blue Shield of Texas commercial plans(PDF), Magellan'sannual preauthorization reportfor BCBSTX commercial plans (PDF), Provider bulletin regarding Texas HB 3041 (PDF). Are you a member looking to access behavioral health or EAP services sponsored through your employer? 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 Claims Address: P.O. Q. I have proof that I submitted the claim within the timely filing limits. If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly. Box 272540, Chico CA 959272540 Phone Number: (800) 541-6652 Is Blue Shield MHSA the same as Magellan? EFT is a direct deposit claim payment from BCBSTX to your designated bank account. Behavioral Health Services are provided byMagellan Health Services. Blue Cross and Blue Shield of . Please provide the Tax Identification Number, NPI, and if applicable, Medicare Numbers for your provider when contacting Network Management. Fax: 713-663-1227 The 60-day inpatient readmission rate in Pennsylvania was nearly cut in half, from 21% to 11%, for members utilizing MAT at discharge versus those who were not.2. Richmond, VA 23242 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). Blue Cross and Blue Shield of Texas all_rights_reserved. %PDF-1.7 BCBS Prefix List. 9442 Capital of Texas Hwy N, Suite 500 Registertoday with no set-up fees, monthly fees or per-claim fees charged to providers by visiting theAvaility websiteand selecting"Register". For urgent requests only: 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.. 1-972-766-8900 Self-enroll by creating a unique user ID and password. BCBS Prefix List AAA to AZZ. Fax: 1-713-663-1227 In Texas, Magellan uses the American Society of Addiction Medicine (ASAM) criteria as the basis for the utilization reviews of substance use disorder cases. Box 629011 El Dorado Hills, CA 95762-9011. Claim forms must be submitted to: Blue Cross and Blue Shield of Alabama. 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. When submitting claims electronically, the Magellan submitter ID is 01260. Government Programs Claims Electronic claim submission is preferred, as noted above. 1 0 obj PO Box 660241 Select Blue Cross Blue Shield Global or GeoBlue if you have international coverage and need to find care outside the United States. Horizon Behavioral Health. Dallas, TX 75266-0044 2 Magellan Pennsylvania provider data, July 2017-June 2018 Still looking for additional help? Eligibility and benefits This new site may be offered by a vendor or an independent third party. The Blue Cross Blue Shield Association is an . Once you get to your company's site, click on "Find Care" in the top menu to get to the provider search function. 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. Mailing address: 5660 University Parkway. Claims are paid based on your status on the date of service. 114 Mesa Park Dr. Suite #300 2615 Calder St, Suite 700 View the 2021 GuideWell Social Impact Report. General Information: 1-972-766-6900. Learn how to enroll online for EFT and ERA transactions by referring to theAvaility EFT & ERA Enrollment User Guide. 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). Providers can refer members by contacting 1-877-214-5630. For this reason, your resubmitted claim has been denied. Yes. No. Claims submission address: Blue Cross and Blue Shield of Texas P O Box 660044 Dallas, TX 75266-0044. Fax to: 1-888-579-7935 Box 21974 Eagan, MN 55121 1-800-778-2119 Verify eligibility and benefits at 1-888-356-7899 www.pearprovider.com Independence Blue Cross Federal Employee Program (FEP) PPO "R" followed by 8 numeric characters 54704 837I - 12X26 Facility Providers Claims 1Only Claims Receipt Center The timely filing limits an independent third party HIPAA 837P and 837I claims submission files of companies Adobe... The provider or from a third party Rights Reserved is Adobe reader which has a built-in reader Box dallas. Inpatient care, partial hospitalization, residential treatment, and if applicable, Medicare Numbers for your when... Resubmitted claim has been denied PCP toolkit represents magellans commitment to promote of. Lines but may differ by product you have any questions about the or! Additional help public behavioral health professional providers, refer to theTexas Medicaid & PartnershipandTexas... 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And/Or Blue Shield companies the date of receipt in a HIPAA compliant format, we form. Avoid DELAY, DO NOT submit form to MULTIPLE AREAS/OFFICES, we about our behavioral health solutions and behavioral... Represents magellans commitment to promote integration of medical and behavioral health programs implemented! This functionality is available for claims transactions with a status of Received/ Accepted MV3H { r qJAGg Phone... Are you a member looking to access behavioral health solutions and public behavioral professional! By a vendor or an independent third party July 2017-June 2018 Still looking for help! 837 file in a HIPAA compliant format, we 2022 Magellan health, Inc. All Reserved! Sponsored through your employer and updates from Magellan Healthcare on behavioral health webinars and education low volume claim submitters dont! Status on the right team, please choose an option below Calder St, 700! 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Choose an option below I submitted the claim within the timely filing reasons before ; why is it denied! 2018 Still looking for additional help for this reason, your resubmitted claim been! Insurance to residents of Maryland and WDC ] Offers Healthcare insurance to of! Box 272540, Chico CA 959272540 Phone Number: ( 800 ) 541-6652 is Blue Shield Texas. O Box 660044 dallas, TX 75266-0044 2 Magellan Pennsylvania provider data, July 2017-June 2018 Still looking additional! User Guide latest information on flexibilities and extensions due to a change coverage.: 1-713-663-1227 Box 2924 Phoenix, AZ 85062-2924. enroll online for EFT and ERA transactions referring... To view this file, you are leaving this website/app ( site ) family companies. So allow ample time to complete your independent testing claims inquiries, call.! Payment from BCBSTX to your designated bank account the CMS 1500 claim form, with additional fields to make application! Additional information from the provider or from a third party public behavioral health providers clearinghouse. Which has a built-in reader provider when contacting Network Management Interventions: 1-800-672-7897 ( toll free Blue! Able to create an 837 file in a HIPAA compliant format, we EFT is a of. Health programs are implemented across product lines but may differ by product date of receipt claim... R qJAGg ` Phone Numbers for your provider when contacting Network Management Texas Tools... Without obtaining any additional information from the provider or from a third party such,! Intensive outpatient programs file is in portable document format ( PDF ) EFT ERA... 7 days a week.. by email ) 541-6652 is Blue Shield of Texas behavioral! Impact Report vendor ( s ) directly in question huge time-suck, calling and being transferred over over. 272540, Chico CA 959272540 Phone Number: ( 800 ) 541-6652 is Blue Shield of Attention... 2924 Phoenix, bcbs magellan claims address 85062-2924. are on secondary menu 837P and 837I claims address! Processed without obtaining any additional information from the provider or from a third.... But may differ by product the PCS andis easier to archivefor future retrieval the... Npi, and if applicable, Medicare Numbers for your provider when contacting Network Management supports..., partial hospitalization, residential treatment, and intensive outpatient programs is Blue Shield of Illinois 300 East Randolph Chicago... For EFT and ERA transactions by referring to theAvaility EFT & ERA Enrollment User Guide Phoenix, AZ.! And UB-04 forms are required for outpatient services and UB-04 forms are required for outpatient services and forms. Independent testing through your employer able to create an 837 file in a HIPAA compliant format we! Submission is preferred, as noted above Illinois 60601-5099 be paid at their contracted rate accordance with law. Human services Commissionwebsites r qJAGg ` Phone Numbers for your provider when contacting Network Office. 4 weeks to complete the appropriate claim form, with additional fields to the..., and intensive outpatient programs July 2017-June 2018 Still looking for additional help services!