Lexington, KY 40512. Node:bclrprvappp1001.corp.bcbsal.org:8080, Pre-Service Review for Out-of-Area Members. Home - provider.bcbsal.org Patient & Claim Payment & Refund Visit our COVID-19 Provider Update Center for the latest information about testing, treatment and telehealth coverage. ALL Kids. 2. Blue Cross and Blue Shield of Alabama By clicking "Next", you are acknowledging that you would like to submit your application and continue onto the payment page otherwise, click "Cancel". Please make sure you select the appropriate form to address your specific need. $('#chat-available').show(); Provider Enrollment An EOB is an outline of what services you received from a provider and how your benefits were applied to cover those services. Please review your information to continue. 450 Riverchase Parkway East In some cases, the plan requires that you or your treating provider precertify the medical necessity of your care. Include the date to the document using the Date function. Regular Dental Program P O Box 830389 Birmingham, AL 35283-0389 Dental Expense Claim An Independent Licensee of the Blue Cross and Blue Shield Association TO BE COMPLETED BY SUBSCRIBER 1. I want to purchase services for my organization. *Subject to your Calendar Year Deductible. Only available through. */ Authorization to Release Information Form View PDF. Please attach any additional information and/or medical records at the time of filing the appeal for consideration. Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association. Overseas members must file claim forms for any covered medical or pharmacy servicesreceived outside of the United States. 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. Download your FREE dental guide to learn more about dentists throughout Alabama. If your ID card is not available, you may use one of the Customer Service telephone numbers below. Need to submit a claim? You can take the Blue Health Assessment, check drug costs, change your address, request a member ID card and more. Are you reporting a new case? CPT codes, descriptions and data copyright 2022 American Medical Association. If you receive services from an out-of-network provider, these services may not be covered at all under the plan. 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. } Highest customer reviews on one of the most highly-trusted product review platforms. Blue Cross Blue Shield of Alabama CBAL1: W USA: Blue Cross Blue Shield of Alaska 47570: USA . An EOB is not a bill. . All Rights Reserved. the range of plans available toyou. Submit a separate claim for each member. COB provisions determine which plan is primary and which is secondary. EDI enrollment is NOT required for submission of electronic claims. CPT codes, descriptions and data copyright 2022 American Medical Association. * Sign up today and get a plan that's accepted by over 1,700 All rights reserved. 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. A retroactive denial is the reversal of a previously paid claim. Reimbursement will be sent to claimant; no claims are paid directly to provider. 2023, Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association. Choose a state to see how Blue Cross Blue Shield is working in your community. Drug exceptions timeframes and enrollee responsibilities. Not a provider, but want to search our network?Search for Providers. function() { HealthEquity is our business associate and is an independent company that provides account-based plan services to Blue Cross. Brush up on important dental plan details Download your FREE dental guide to learn more about the range of plans available to you. Preservice and concurrent appeals should continue to be submitted to the member's Home Plan. Already a Blue Cross member and have questions about your current plan? If you want to stay on the Blue Cross website, click "Cancel.". $42 /month. Shop On Exchange Shop Off Exchange HOW TO BUY AN AFFORDABLE CARE ACT (ACA) PLAN Box 3686, Scranton . Health . Patient Consent Form for Provider Submitted Appeals View PDF. Attach pharmacy receipts for covered prescriptions. Access the most extensive library of templates available. From October 1 through February 14, we are available 7 days a week. if (userAction === 'onclick') { Call 1-855-488-2515. Discover all the ways members can earn wellness incentives and rewards for taking an active role in their health. All rights reserved. It's easy to protect your smile to the fullest with dental coverage that CDT codes, descriptions and data copyright 2022 American Dental Association. else Failure to timely pay premium payments is not a special open enrollment event for later coverage under the plan. To continue to the HealthEquity website, click "Accept." 2023 Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue ShieldAssociation. After determining your benefit eligibility, your Lifetime Waiting Period start date will be determined. 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. 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. (You can fill the form in electronically or complete it by hand.). It is your responsibility to ensure that you or your provider obtains precertification. Blue Cross Community Health Plans, c/o Provider Services, P.O. To continue to the HealthEquity website, click "Accept." An assessment will be scheduled and performed by a Blue Cross representative to determine if your situation and health needs meet claims benefit eligibility. All rights reserved. Blue Plus **. Upon completion of your Waiting Period, you will be eligible to begin receiving reimbursement of your benefits. You can file your expenses for reimbursement as frequently as you want. 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. 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 302150 Montgomery, AL 36130 or 135 South Union Street Montgomery, AL www.rsa.state.al.us Customer Service ); Dental. If you are a contracted health plan partner, then you have a dedicated account manager you can call upon at any time for any reason. English, Download the overseas retail prescription drugclaim form: Spanish, Localized **Dental Blue Plus is a Health Insurance Marketplace plan. In that case, you will be responsible for all charges billed to you by the out-of-network provider. Outside the United States. **Dental Blue Plus is a Health Insurance Marketplace plan. Applicable FARS/DFARS apply. Blue Cross and Blue Shield of Alabama Provider Directory > Claims Issues > or call 877-231-7239 or 205-220-6899 for eSolutions New Directions AL_ProviderRelations@ndbh.com or call 888-611-6285 < Back 2023, Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association. Use this form to submit a health benefit claim for services that are covered under the Blue Cross and Blue Shield Service Benefit Plan. What you need to know about the disease and our commitment to ensuring you have access to the right care at the right time. 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". Double-check every area has been filled in correctly. Blue Cross Blue Shield of Alabama. Blue Cross and Blue Shield of Alabama will send you a Claims Packet to be completed and returned to us. Experience a faster way to fill out and sign forms on the web. To continue to this website, click "Accept." 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. Please review the terms of use and privacy policies of the new site you will be visiting. HealthEquity has agreed to follow Blue Cross' privacy and security policies regarding the confidentiality and protection of your personal health information. By clicking "Next", you are acknowledging that you would like to submit your application otherwise, click "Cancel". This link takes you to another website. My Account, Forms in gives you access to exams, X-rays and routine cleaningsat no method: "GET", If you want to stay on Blue Cross' website, click "Cancel.". Include proof that you paid a Medicare Part B premium. For more information about the appeals process, see the following: Providers are required to file all post-service appeals to their local Blue Cross Plan regardless of the member's Home Plan. var jsonStr = jQuery.parseJSON(data); If you use a provider outside of our network, you'll need to complete and file a claim form to be reimbursed. Our representatives can answer your questions and help you navigate these choices. 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. Available plans and pricing may vary depending on whether you purchase your plan on or off the Health Insurance Marketplace. }. Claim submission is supported for primary, secondary and tertiarypayment. When we receive an electronic claim, you will automatically be set up as an out-of-state provider in our systemand can register to use our provider website,ProviderAccess: Once you have registered for ProviderAccess, you can also use on our online claim entry application,eClaims, to submit claims to us: Resources for Out-of-State Dental Providers: CPT codes, descriptions and data copyright 2022 American Medical Association. What is the fax number for BCBS Alabama appeals? You should be sure to check with your provider to confirm whether precertification has been obtained. Technology, Power of Download and complete the appropriate form below, then submit it by December 31 of the year following the year that you received service. For more information, view our privacy policy. To ask for a formal decision about the coverage if you disagree, print and complete the appropriate form below and fax it to 1-800-693-6703 or mail to Prime Therapeutics LLC, Attention: Part D Appeals Department, 1305 Corporate Center Dr. How to File a Claim Call Preferred Long-Term Care (LTC) Customer Service (1-888-331-4188) to complete the Claims Intake Form over the telephone. Print and complete the form according to instructions on the front. 2023, BlueCross and BlueShield of Alabama is an independent licensee of the BlueCross and BlueShield Association. Thank you for your interest in our Short Term Plan. By clicking "Next", you are acknowledging that you would like to submit your application and continue onto the payment page otherwise, click "Cancel". In certain situations, a claim may be reprocessed and denied retroactively, even after it has been paid. Node:bclrprvappp1001.corp.bcbsal.org:8080 How to file a dental claim with Blue Cross Blue Shield Alabama? 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. } You can use our interactive search to find your local Blue Cross Blue Shield Company's website.
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