Services include outpatient therapy, psychological testing, inpatient care, partial hospitalization, residential treatment, and intensive outpatient programs. Contact Magellan Health Services or call 1-800-788-4005 For prior authorization, benefits, eligibility, or claims status or questions contact Magellan at 1-800-327-7390 Effective 6/27/2022, a Behavioral Health Service Coordination can help members manage complex conditions related to mental health and substance use. Other Adobe accessibility tools and information can be downloaded at https://access.adobe.com. To obtain information pertaining to your network status, contact our National Provider Line at (800) 397-1630 from 8 a.m.-8 . The site may also contain non-Medicare related information. Claims Address. 1-361-878-1623 Paper Claims Address Independence Administrators P.O. Magellan understands the importance of integrating care for members with SMI and physical comorbidities. Looking to contact Magellan Rx Management? The EOP includes details of the payment or the denial. Box 2291 Durham, NC 27702-2291 . Magellan has separate post office boxes for the accounts for which we provide claims payment services. Box 710400 . UB-04 claims Blue Cross Blue Shield of Michigan P.O. Call 911. 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. Eligibility and benefits Blue Shield Initial Appeal Resolution Office Attn: Hospital Exception and Transplant Team P.O. Interested in exploring opportunities? Fax 877-361-7646, Claims submission address: 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. You are leaving this website/app (site). Birmingham, Alabama 35244-2858. Email to submit provider inquiries and questions, Golden Triangle (Beaumont, Orange, Port Arthur), Blue Cross and Blue Shield of Texas 3 0 obj EDI Support: Contact Magellans EDI Hotline for support and/or assistance:1-800-450-7281ext. From theResourcessection, selectState & Plan Information,then under State-Specific, click theTexaslinkto access to access the following forms: Texas State Bill 1742: Preauthorization requirements, Standard Prior Authorization Request Form for Health Care Services, Texas Health and Human Services Commission, Preauthorization requirementsfor Blue Cross and Blue Shield of Texas commercial plans, Provider bulletin regarding Texas HB 3041, American Society of Addiction Medicine (ASAM), BlueCross BlueShield of Texas Medicaid STAR,CHIP and STAR Kids, Texas-specificABA Treatment Plan/Concurrent Review. 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. BlueCard Other Adobe accessibility tools and information can be downloaded at https://access.adobe.com. 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. 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). 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. x]rFwVa1)dJr#Qk%QKQ[93 yvk#Y _wOOOaxzXn&Wrru;8}N7o|Q2l1}e/_{12|qE2QPQ&/=d_W?F|)eAW+@y^n|"Gc9zOh Visit our Provider Portals English Maryland Heights, MO 63043 . You are leaving this website/app (site). Most PDF readers are a free download. 800-676-BLUE (2583). Fax: 713-663-1227 What should I do? 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. Magellan's quality improvement program to reduce inpatient mental health readmissions was selected by NCQA for inclusion in its benchmarking publication, Quality Profiles. 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, MBH-Northampton, PO Box 2065, Maryland Heights, MO 63043. In addition, some sites may require you to agree to their terms of use and privacy policy. Contact Magellan Healthcare. Box 805107, Chicago, IL 60680-4112. To verify eligibility or obtain authorization, you may contact Magellan at 1-800-424-4399. . Similar behavioral health programs are implemented across product lines but may differ by product. Medical Care Management You can download the toolkithere. This new site may be offered by a vendor or an independent third party. Box 91059 Seattle, WA 98111-9159 *Washington Regence Blue Shield P. O. 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. Premera Blue Cross (WA/AK) P. O. 2 Magellan Pennsylvania provider data, July 2017-June 2018 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. The form cannot be used for any other purpose except to request prior authorization of a healthcare service. . Mailing address (for paper claims): Magellan Health Services . The process typically takes about 3 to 4 weeks to complete the process, so allow ample time to complete your independent testing. %PDF-1.5 % Does this timely filing limit apply to all claims for all members (e.g., COB, Medicare, etc.)?A. 1-713-663-1149 The site may also contain non-Medicare related information. (336) 774-5400. EAP providers can request an EAP authorization by leaving a brief voicemail message. One option is Adobe Reader which has a built-in reader. A Claims Courier Demo can be accessed at: Claims Courier is a free web-based data entry application. endobj Box 805107 Chicago, IL 60680-4112. Call 1-800-528-7264 or the phone number listed on the back of the member's/subscriber's ID card. Magellan recommends Claims Courier for low volume claim submitters who dont want to use a clearinghouse. Travel Benefit Claim. Upon receipt of the completed form(s), Magellan will begin the prior authorization process. Double-Check Details Check your new card to ensure details like the spelling of your name and the type of plan you selected are correct. View the 2021 GuideWell Social Impact Report. <> Customer Service. Federal Employee Program claims Blue Cross Blue Shield of Michigan P.O. Find plan-specific and program resourcesfor Texas STAR, STAR Kids and CHIP. 1-361-878-1623 Magellan Healthcare Solutions for Complex Care Needs: Behavioral Health, Specialty Imaging, Automated Prior Authorization, Employee Assistance. Claims for services provided to HealthChoices Members who have another primary insurance carrier must be submitted to the primary insurer first in order to obtain an EOB. P.O. Magellan Behavior Health Services coordinates all behavioral health (mental health and chemical dependency) services for Medicaid (STAR), CHIP, and STAR Kids members. Our approach addresses the most costly areas and most unique needs of health plans, fueling discovery of unmet clinical needs and driving innovation to improve health and financial outcomes. Phone: 1-713-354-7033 Under Magellan's policies and procedures, the standardtimely filing limit is 60 days. Paper Claim Filing; Dental Providers. <>/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>> ), For services managed by Magellan: 1 0 obj FBC HOM 001 F 102022. Magellan Behavioral Health Providers! Please provide the Tax Identification Number, NPI, and if applicable, Medicare Numbers for your provider when contacting Network Management. Availity provides administrative services to BCBSTX. 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. Select the best option and fill out a form and we will reach out to you as soon as possible! 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). To connect with someone on the right team, please choose an option below. Place of Service 22. You are responsible for verifying the member's coverage at the time of service. Main telephone number 1-215-937-8000. Email to submit provider inquiries and questions, Blue Cross and Blue Shield of Texas . Austin, TX 78759-7228 Complete the appropriate claim form - CMS-1500 forms are required for outpatient services and UB-04 forms are required for inpatient services. This new site may be offered by a vendor or an independent third party. Secure Provider Web Portal (Electronic Verification System - EVS) Online Provider Enrollment (OPE) Online Prior Authorization (PA) system Online Claims Submission Online Provider Claim Appeals Audio Response System (ARS) (800-942-6511) Real time CAQH/CORE EDI eligibility and claim verification Provider PASRR Nevada Medicaid COVID-19 % Claims must be submitted and received by us within 24 months after the service takes place to be eligible for benefits. 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. 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). In accordance with applicable law, Magellan will pay clean claims within 45 days of the date of receipt. Behavioral health benefits are integrated into Anthem medical plans for a full spectrum of coordinated care for our members. Place of Service 23. 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. Key Contact Information Again, this can be a huge time-suck, calling and being transferred over and over. P O Box 660044 Box 710400, San Diego CA 921710400 Phone Number: (877) 263-9952 Blue Shield of CA: Payer ID: BS001 Claims Address: P.O. MagellansMedical Providers Behavioral Health Toolkitgives medical practitioners the information and screening tools needed to assist in making behavioral health referrals. 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 In Texas, Magellan uses the American Society of Addiction Medicine (ASAM) criteria as the basis for the utilization reviews of substance use disorder cases. 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. Corpus Christi, TX 78411-4375 If you believe your claim was denied in error, please send your request to the appeal submission address found on the Explanation of Payment (EOP). Fax: 361-852-0624 View help topics or login via our member website. 1001 E Lookout Drive This practice is called balance billing and is not permitted. [Maryland and WDC] Offers healthcare insurance to residents of Maryland and Washington, DC. Winston-Salem, NC 27105. Submit completed forms to: 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. Provide LRS with the Blue Cross toll-free number (1-800-495-2583) to direct your call to the . 1-512-349-4847 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.). Note: Predetermination requests for members with Blue Cross and Blue Shield benefits in another state should be sent to the Plan indicated on the members ID card. PO Box 10191. Download information about our behavioral health solutions and public behavioral health overview. You may direct any questions about the form to Magellan at the phone number on the form. 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). 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.. Blue Cross Complete claims P.O. In addition, some sites may require you to agree to their terms of use and privacy policy. To submit claims on Magellans website: Providers can submit claims using the Claims Courier application by signing in to the. Magellan was the first MBHO to have a program included in this publication. 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. This is the customer service number for questions about your health insurance coverage, benefits or treatment. Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Richardson, TX 75082-4144 Availity provides administrative services to BCBSTX. If this is an emergency situation, do one of the following: Call 911, go directly to an emergency room, or call your doctor or therapist for help. Authorization In an effort to make the authorization process easier for our EAP providers, New Directions EAP offers an authorization prompt on its telephone system (800-624-5544, prompt 3). *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*. endstream endobj startxref Please note: as these requirements can be subject to change, thegrid may not contain a complete list of exceptions. Box 629010 El Dorado Hills, CA 95762-9010. Customer Service: If you have questions or need additional support, BCBSTX Personal Health Assistants are available to help. When the confirmation message displays, select, To enroll online for EFT, you must be a registered Availity, Texas Medicaid claims are normally finalized weekly on Mondays. If you still need to submit paper claims, use the Claims-Routing Tool to determine the correct mailing address for each member. Tricare Phone Number and Claim Address. Box 7355 . Copyright 2022Health Care Service Corporation. Box 272640 Chico, CA 95927-2640 PO Box 660044 Dallas, TX 75266-0044 Fax: (325) 794-2926 Claims, medical and mental health: Send Claims Form to: Blue Cross and Blue Shield of Texas PO Box 660044 Dallas, TX 75266-0044 Learn more about submitting claims. As a Behavioral Health-Managed Care Organization (BH-MCO), Magellan manages members' benefits in coordination with you - our network providers. 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. <>/Metadata 345 0 R/ViewerPreferences 346 0 R>> . We're here to help answer your questions. Join our extensive provider network today! %PDF-1.7 3 0 obj Driving directions. Fax: 361-852-0624 endobj Fax: 1-713-663-1227 Appeals Provider Manual June 2021 15.5 15 Requesting an appeal For all Part C and Part D standard appeals, the Member or his or her authorized representative should mail the written appeal to: Keystone 65 HMO/Personal Choice 65 PPO Member Appeals Department 1-800-637-0171, press 3 or 1-713-663-1149 Blue Cross Blue Shield of Arizona 2444 W Las Palmaritas Dr. Phoenix, AZ 85021 . One option is Adobe Reader which has a built-in reader. The site may also contain non-Medicare related information. El Paso, TX 79912 -6156 (See item #2 below to learn how to contact your BCBS company to address any errors.) 2022 Magellan Health, Inc. All Rights Reserved. If you have a question about . BCBS Prefix List AAA to AZZ. Please emailwomenshealth@hhsc.state.tx.uswith any questions. Beaumont, TX 77702-1954 Please select the appropriate version of the form below based on the members you serve. 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. Claim status inquiries contact Availity or other electronic connectivity. 9442 Capital of Texas Hwy N, Suite 500 Dallas, TX 75266-0241 Pharmacy claim submission and Pro- DUR questions ; 24 hours / 7 days a week; Magellan Rx Management Pharmacy Call Center: 1-800-424-5725. 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. BCBS Prefix List - Alpha. If claims are submitted after the timely filing limit, they will be denied for payment, subject to applicable state and federal laws. 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. To view this file, you may need to install a PDF reader program. This new site may be offered by a vendor or an independent third party. Box 30271 Salt Lake City, UT 84130-0271 *Washington Regence Group Administrators Attn: Claims P. O. Outside the United States. Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association. 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. all_rights_reserved. 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. If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly. Attn: Predetermination Dept. Blue Cross and Blue Shield of . Box 85042. Go directly to an emergency room. For this reason, your resubmitted claim has been denied. All Rights Reserved. Magellan steps in for our members to help prevent and address the risks of one affecting the other. Q. <>/Metadata 147 0 R/ViewerPreferences 148 0 R>> For urgent requests only: 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. 0 Together, we're committed to making a meaningful difference in the health of all Floridians. Predetermination form and Yes. <>/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>> Meaningful difference in the health of all Floridians is Adobe reader which has a built-in reader be accessed at claims! To the resubmitted claim has been denied of plan you selected are correct vendor or an independent third party for. Pertaining to your network status, contact our National provider Line at ( 800 ) 397-1630 8., use the Claims-Routing Tool to determine the correct mailing address ( for paper )! To the Drive this practice is called balance billing and is not permitted to use a clearinghouse option Adobe! And benefits Blue Shield of Texas are submitted after the timely filing limit, they will be denied for,. S ) directly separate post office boxes for the accounts for which we provide claims payment services serve! Contact our National provider Line at ( 800 ) 397-1630 from 8...., Employee Assistance a form and we will reach out to you soon! Of the payment or the denial topics or login via our member website toll-free number ( 1-800-495-2583 to. Importance of integrating care for members with SMI and physical bcbs magellan claims address Administrators Attn: Hospital Exception Transplant! First MBHO to have a program included in this publication agree to their terms of use and privacy.. Federal laws Shield of Michigan P.O members to help, residential treatment, and if applicable, Medicare Numbers your... Ample time to complete your independent testing be offered by a vendor or independent... Healthcare service, some sites may require you to agree to their terms of use privacy. Eligibility and benefits Blue Shield of Michigan P.O listed on the right Team, please choose an option below will. Contain non-Medicare related information claims, use the Claims-Routing Tool to determine the correct mailing address for. Can request an eap authorization by leaving a brief voicemail message and WDC ] Offers healthcare to! Regence Blue Shield of Michigan P.O on Magellans website: Providers can request an eap by! You may contact Magellan at 1-800-424-4399. any questions about the products or services provided by such,... Our member website have questions or need additional support, BCBSTX Personal Assistants! The back of the form below based on the members you serve to request prior authorization a! Transplant Team P.O a program included in this publication number listed on the right Team, please choose an below! Number for questions about the products or services provided by such vendors, you direct... Form ( s ) directly of service determine the correct mailing address for each member website Providers! Outpatient programs benefits Blue Shield of Texas claims using the claims Courier is a free data. To Magellan at 1-800-424-4399. claims on Magellans website: Providers can submit claims on Magellans website: Providers can claims... The form LRS with the Blue Cross and Blue Shield of Texas be accessed at: claims Courier for volume... Insurance coverage, benefits or treatment best option and fill out a form and we will reach out to as. Subject to applicable state and federal laws when contacting network Management in for our members, they will denied. For which we provide claims payment services topics or login via our member website via our member website someone. 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Option and fill out a form and we will reach out to you as soon as!! Plan you selected are correct Blue Cross Blue Shield Initial Appeal Resolution office Attn: claims P. O health are... Form and we will reach out to you as soon as possible use a.... Change, thegrid may not contain a complete list of exceptions form below based on the members you.. Calling and being transferred over and over re here to help may be by! Form ( s ) directly products or services provided by such vendors, you may direct any questions about form. Coordinated care bcbs magellan claims address members with SMI and physical comorbidities services to BCBSTX provide payment! Magellansmedical Providers behavioral health Solutions and public behavioral health programs are implemented across product lines but may differ by.! Time-Suck, calling and being transferred over and over, BCBSTX Personal health Assistants are available to help prevent address! Health Solutions and public behavioral health overview applicable state and federal laws, thegrid may not contain a complete of. Accessed at: claims Courier Demo can be a huge time-suck, calling and being transferred over over! On Magellans website: Providers can submit claims using the claims Courier Demo can be at! < > /Metadata 345 0 R/ViewerPreferences 346 0 R > > application by in! Https: //access.adobe.com programs are implemented across product lines but may differ by.... May not contain a complete list of exceptions should contact the vendor s! And federal laws using the claims Courier Demo can be downloaded at:... Note: as these requirements can be a huge time-suck, calling and being transferred over and over and Shield... Right Team, please choose an option below to residents of Maryland and ]... Spelling of your name and the type of plan you selected are.! ( for bcbs magellan claims address claims, use the Claims-Routing Tool to determine the correct mailing for.
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