Find out More (You can fill the form in electronically or complete it by hand.). 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. Download and complete the appropriate form below, then submit it by December 31 of the year following the year that you received service. For questions about claims payments, health, and dental benefits, or to order insurance cards, please call Blue Cross and Blue Shield of Alabama at 1-800-760-6851. { }. extra cost. Listed below are claims payment policies and other information for Qualified Health Plans offered by 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. Blue Cross and Blue Shield of Alabama will send you a Claims Packet to be completed and returned to us. Node:bclrprvappp1001.corp.bcbsal.org:8080 & Estates, Corporate - CDT codes, descriptions and data copyright 2022 American Dental Association. } HealthEquity has agreed to follow Blue Cross' privacy and security policies regarding the confidentiality and protection of your personal health information. Generally, if precertification is required and not obtained, no benefits will be payable under the plan. }).then(function(data) { 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". Box 3686, Scranton . Questions? Provider. COB provisions determine which plan is primary and which is secondary. CDT codes, descriptions and data copyright 2022 American Dental Association. USLegal received the following as compared to 9 other form sites. If you want to stay on the Blue Cross website, click "Cancel.". function() { 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. 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. Use this form to submit a health benefit claim for services that are covered under the Blue Cross and Blue Shield Service Benefit Plan. Dental. Need to submit a claim? $129 /month. checkChatAvailability('onload'); ALL Kids. Patient Eligibility and Benefits; Pre-Service Review; Pre-Service Review for Out-of-Area Members . What is the fax number for BCBS of Alabama Dental Claims? Blue Cross Blue Shield of Alabama. Already a Blue Cross member and have questions about your current plan? Our representatives can answer your questions and help you navigate these choices. If you use our Care Coordinator services in developing your Plan of Care, and your claim is initiated with Home or Community Services, then your Lifetime Waiting Period will be reduced by half. It is your responsibility to ensure that you or your provider obtains precertification. Please attach any additional information and/or medical records at the time of filing the appeal for consideration. Features expanded pediatric benefits for children up to the end of the month in which the member turns 19. Register With Form - AFP Annual Conference - Association For - An17 Afponline, Identity Access the most extensive library of templates available. This login is for your Employer Account. 2023 Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue ShieldAssociation. You can purchase ACA healthcare plans through a federal marketplace called the Health Insurance Marketplace or outside the Health Insurance Marketplace. Spanish, Localized Review Blue Cross and Blue Advantage medical and pharmacy policiesor comment on draft policies. USLegal fulfills industry-leading security and compliance standards. Blue Cross Community Health Plans, c/o Provider Services, P.O. These guidelines, in addition to the editor will assist you through the entire procedure. You can view your personal EOBs through your MyBlue account. Your member ID card is your key to using your medical plan benefits. 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. Forms, Real Estate Ensures that a website is free of malware attacks. 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. To determine your premium, call us at 1-855-488-2515 or click the "Get Started" link to compare your plans today. Submit a separate claim for each member. If you want to stay on Blue Cross' website, click "Cancel.". Information contained in the external sites is not endorsed by BCBSAL. Fax (provider credentialing applications and related documents): 205-220-9545. Thank you for your interest in our Short Term Plan. Information contained in the external sites is not endorsed by BCBSAL. the page. All rights reserved. Applicable FARS/DFARS apply. { } ); Complete the form following the instructions on the back. var jsonStr = jQuery.parseJSON(data); Some information on our site is secure; log in to ensure you're seeing all the news. var fromUrl =window.location.host; 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. 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. 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. Service, Contact Call the IVR: 205-220-6765. 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. 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. Thank you for your interest in our Short Term Plan. You are about to leave Blue Cross and Blue Shield of Alabama's website and enter a website operated by HealthEquity. From October 1 through February 14, we are available 7 days a week. If you have questions, please contact your local Blue Cross and Blue Shield company. Blue Cross Blue Shield of Alabama CBAL1: W USA: Blue Cross Blue Shield of Alaska 47570: USA . CPT codes, descriptions and data copyright 2022 American Medical Association. Get Started To continue to the HealthEquity website, click "Accept." In some cases, the plan requires that you or your treating provider precertify the medical necessity of your care. 2023 New Directions Behavioral Health. contact your local Blue Cross and Blue Shield company. If you use a provider outside of our network, you'll need to complete and file a claim form to be reimbursed. 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 . else Technology, Power of 2023, Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association. 2023, BlueCross and BlueShield of Alabama is an independent licensee of the BlueCross and BlueShield Association. 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. 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 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 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. 2023, Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association. An application, from the Enrollment section, is needed for any provider in the following situations: window.open('https://cicchat.bcbsal.org/I3Root/chatpopup.html?qname=cid_chat&fromUrl='+fromUrl, '', 'width=700, height=600'); Patient. Claim Statements Reimbursements Contract and Dependent Information Other Insurance Coverage Deductible & Out of Pocket Costs View Benefits and Coverage Resources Review and Pay my Bill ID Cards Forms and Materials Covered Immunizations Health Insurance Basics Policies and Guidelines Preventive Services Caregiver Resources You are about to leave Blue Cross and Blue Shield of Alabama's website and enter a website operated by HealthEquity. //show the chat available image Select Blue Cross Blue Shield Global or GeoBlue if you have international coverage and need to find care outside the United States. The protection of your privacy will be governed by the privacy policy of that site. Patient & Claim. ProviderAccess Provider News View the latest provider news. 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. if (userAction === 'onclick') { By clicking "Next", you are acknowledging that you would like to submit your application otherwise, click "Cancel". Shop On Exchange Shop Off Exchange HOW TO BUY AN AFFORDABLE CARE ACT (ACA) PLAN Please review your information to continue. 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. * Sign up today and get a plan that's accepted by over 1,700 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. 2. Attach pharmacy receipts for covered prescriptions. By clicking "Next", you are acknowledging that you would like to submit your application otherwise, click "Cancel". Download and complete the appropriate form below, then submit it by December 31 of the year following the year that you received service. 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). Preservice and concurrent appeals should continue to be submitted to the member's Home Plan. . After determining your benefit eligibility, your Lifetime Waiting Period start date will be determined. An EOB is an outline of what services you received from a provider and how your benefits were applied to cover those services. 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 Node:bclrprvappp1001.corp.bcbsal.org:8080, Pre-Service Review for Out-of-Area Members. Overseas members must file claim forms for any covered medical or pharmacy servicesreceived outside of the United States. Health . I have reviewed the following treatment plan. We make completing any Dental Claim Form - Blue Cross And Blue Shield Of Alabama - Bcbsal easier. All rights reserved. To determine your premium, call us Box 3418, Scranton, PA 18505; Blue Cross Community MMAI (Medicare-Medicaid Plan), c/o Provider Services, P.O. Box 302150 Montgomery, AL 36130 or 135 South Union Street Montgomery, AL www.rsa.state.al.us Customer Service (For example, if your service was provided on March 5, 2022, you have until December 31, 2023 to submit your claim). Download your FREE dental guide to learn more about **Dental Blue Plus is a Health Insurance Marketplace plan. Blue Plus **. The following documentation provides guidance regarding the process for appeals. Expenses will be applied against your Plan of Care and reimbursed accordingly. FSAFEDS (Reimbursement Options) Form Visit Page. at 1-855-488-2515 or click the "Get Started" link to compare your plans today. If you receive services from an out-of-network provider, these services may not be covered at all under the plan. (For example, if your service was provided on March 5, 2022, you have until December 31, 2023 to submit your claim). if (jsonStr.Availability === 'YES') { Equal Opportunity Employer AA M/F/Vet/Disability, We are excited to announce that New Directions and Tridiuum have joined forces to become Lucet! Member Services For general inquiries, you can reach us by calling the number below. Rev 3/2007 dental, vision, hearing and fitness benefits at no added cost . $('#chat-available').show(); When you receive services from an in-network provider, your provider will generally file claims for you. The following documentation provides guidance regarding the process for appeals. dentists throughout Alabama. I authorize release of any information relating to this claim. Additional details about this and other exception review details can be found in the Claims and Appeals section of your benefit booklet. 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. 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. It's easy to protect your smile to the fullest with dental coverage that Address: CHIP P.O. Find your smile. Call Customer Service at 1-855-504-BLUE (2583), 8 a.m. - 8 p.m. EST Monday - Friday, or Contact Us for further assistance. Heres everything you need to know about it. Handbook, Incorporation View the latest providernews. Check out the changes and updates to our plan in 2023. Liferay.on( If you do not know this information, please contact us at 205-220-7725 or fax your request to 205-220-6354. To continue to the HealthEquity website, click "Accept." Choose a state to see how Blue Cross Blue Shield is working in your community. (You can fill the form in electronically or complete it by hand.). 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. For more information, view our privacy policy. Node:bclrprvappp1002.corp.bcbsal.org:8080 . By clicking "Next", you are acknowledging that you would like to submit your application and continue onto the payment page otherwise, click "Cancel". Blue Cross and Blue Shield of Alabama will send you a Claims Packet to be completed and returned to us. 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. 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. Questions? 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 Blue Cross and Blue Shield of Alabama enrolls and credentials all individual providers as well as ancillary and facility providers. We use cookies on this website to give you the best experience and measure website usage. It also tells you how much has been credited toward any required deductible and out-of-pocket maximums. What is the fax number for BCBS of Alabama claims? //show the chat un-available image Claim entry screens are divided into five categories: Patient, Claim Information, LineInformation, Other Insurance and Adjustments. We will give you a response within 72 hours of receiving all information we need to make a decision for a standard review. What is the fax number for BCBS Alabama appeals? With US Legal Forms the entire process of completing official documents is anxiety-free. A healthy smile is an important part of your family's overall health. Make sure your documents include the five following pieces of information as required by the IRS: Provider name (which is Medicare in this case), You can fax the form, along with proof that you paid a Medicare Part B premium, to, You can upload the form through the EZ Receipts mobile app, available at the. 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. Box 303017 Montgomery, AL 36130-3017. Applicable FARS/DFARS apply. window.open('https://cicqaaux.corp.bcbsal.org/I3Root/chatpopup.html?qname=cid_chat&fromUrl='+fromUrl, '', 'width=700, height=600'); What is the dental number for Blue Cross Blue Shield of Alabama? Submit a separate claim for each patient. 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? Provider Appeals Blue Cross and Blue Shield of Alabama has an established appeals process for providers and physicians. Medical necessity and prior authorization timeframes and enrollee responsibilities. If you fail to pay in full all periodic monthly payments due and payable before the end of the grace period for those coverage periods, your coverage under the plan will be retroactively canceled back to the last day of the first month of the grace period. 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. $23 /month. 2023, Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association. Authorization to Release Information Form View PDF. 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. 2023, BlueCross and BlueShield of Alabama is an independent licensee of the BlueCross and BlueShield Association. Box 3836, Scranton, PA 18505; Blue Cross Medicare Advantage, c/o Provider Services, P.O.
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