The plan will notify you within the 30-day period that an extension is necessary, with a description of the information needed and why it is needed. You must submit first-level and second-level appeals no more than 180 days after receiving the previous decision. Coverage decisionsA coverage decision is a decision we make about what well cover or the amount well pay for your medical services or prescription drugs. When we make a decision about what services we will cover or how well pay for them, we let you know. Contact informationMedicare Advantage/Medicare Part D Appeals and GrievancesPO Box 1827, MS B32AGMedford, OR 97501, FAX_Medicare_Appeals_and_Grievances@regence.com, Oral coverage decision requests1 (855) 522-8896, To request or check the status of a redetermination (appeal): 1 (866) 749-0355, Fax numbersAppeals and grievances: 1 (888) 309-8784Prescription coverage decisions: 1 (888) 335-3016. State/Alpha Prefix Claims Filing Address Alabama BCBS of Alabama P.O. If you have any questions about specific aspects of this information or need clarifications, please email press@bcbsa.com . 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. 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. 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. If UMP is secondary, you must include a copy of your primary plan's Explanation of Benefits, which lists the services covered and how much the other plan paid. Polski | Regence BlueShield in accordance with the terms of your Provider contract with Regence. 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. Cancel Proceed User name or email Kreyl Ayisyen | ** We respond to medical coverage requests within 14 days for standard requests and 72 hours for expedited requests. PDF Regence Provider Appeal Form All from Regence, a company committed to service, community and this place we call home. 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. The following information must appear on the provider's itemized bill for the plan to consider the claim for payment: a. For any appeals that are denied, we will forward the case file to MAXIMUS Federal Services for an automatic second review. Regence BlueShield of Idaho offers health and dental coverage to 142,000 members throughout the state. 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 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. PDF State Mail to Mailing Address City, State Zip PDF Provider Dispute Resolution Process Contact us as soon as possible because time limits apply. %PDF-1.5 Regence BlueCross BlueShield of Oregon is an independent licensee of the Blue Cross and Blue Shield Association. Learn more about when, and how, to submit claim attachments. % Sign in Lastupdated01/23/2023Y0062_2023_M_MEDICARE. Learn more about our payment and dispute (appeals) processes. P | Claims submission - Regence Rocketreach finds email, phone & social media for 450M+ professionals. Marvin Thomas email address & phone number | Regence Bluecross There are several levels of appeal, including internal and external appeal levels, which you may follow. You can submit feedback about your Medicare health plan or prescription drug plan directly to Medicare. If you buy your prescription drugs at a network pharmacy, your claim will be submitted for you. Learn how to identify our members coverage, easily submit claims and receive payment for services and supplies. Claims edits If you do not submit your claims through Availity Essentials, follow this process to submit your claims to us electronically. 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. 24/7 anonymous hotline: 1 (800) 323-1693 Medicare Part C & D: 1 (800) 633-4227 Online reporting form Ethics & compliance hotline Chronic Obstructive Pulmonary Disease. See how our affordable Regence plans offer coverage, access and convenienceso you can live your best. 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. 636 GRAND AVE DES MOINES, IA 50309 800-245-6105. You can download the appeal form and submit your written appeal by fax or mail: Mail:WSRxS Billing | Life Flight Network 0. . Learn about dental billing information to help ensure your dental claims are processed quickly and correctly. complies with applicable Federal and Washington state civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, gender identity, or sexual orientation. If you have other medical or prescription coverage, Washington State Rx Services Complaint and Appeal Form, WSRxS Multiple Pharmacy Coverage Inquiry Form (Drug Coordination of Benefits). 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 Portugus | If we must request additional information, the processing of your claim may be delayed. This is the customer service number for questions about your health insurance coverage, benefits or treatment. That way, we can verify your account and start helping you as quickly as possible. Don't have a Regence account yet? For member appeals that qualify for a faster decision, there is an expedited appeal process. 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. Get Marvin Thomas's email address (m*****@regence.com) and phone number (253581..) at RocketReach. When a claim for workers compensation is accepted, all services related to that injury or illness are not covered, even if some services are denied by workers compensation. Learn more. If you want a written response, you must request one. Customer Service will help you with the process. 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. We will notify you once your application has been approved or if additional information is needed. Regence Direct Member Reimbursement Form If you have questions about submitting a claim for services outside the U.S., call UMP Customer Service.. Claims determinations The plan will notify you of action taken on a claim within 30 days of the plan receiving it. BCBS State by State | Blue Cross Blue Shield Attn: Appeal UnitPO Box 40168Portland, OR 97240-0168. Choose an option. 3 0 obj Washington State Rx ServicesPO Box 40168Portland, OR 97240-0168. No enrollment needed, submitters will receive this transaction automatically, Web portal only: Referral request, referral inquiry and pre-authorization request, Implementation Acknowledgement for Health Care Insurance. Oregon's Sustainable Cost Growth program, and the ability the state's 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. You can send your appeal online today through DocuSign. TTY/TDD users can call 1-877-486-2048, 24 hours a day/7 days a week. Identify BlueCard members, verify eligibility and submit claims for out-of-area patients. UMP medical plans are administered by Regence BlueShield. Get 5 free searches. Select the area of the map that matches the color of the county where the service was performed. Youll receive notice of the action on your complaint within 30 calendar days of our receiving it. Please do not submit attachments (e.g., X-rays, periodontal chartings) with your pretreatment estimate or initial claims submission. **If you, or your prescribing physician, believe that waiting for a standard decision (which will be provided within 72 hours) could seriously harm your life, health or ability to regain maximum function, you can ask for an expedited decision. Grievances and appeals - Regence Programs View our programs and requirements for radiology, inpatient admissions and patient care management. REGENCE BS OF WASHINGTON. We will ask your permission if we need more time to respond. Coordination of Benefits or Other Party Liability . Media Contact: Audrey Glasby Regence BlueCross BlueShield of Utah Regence . 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. See "Appeals related to eligibility" section of your plan's. You must appeal within 60 days of getting our written decision. 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. Contact Us | Blue Cross Blue Shield 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. Availity and Regence Working with Regence online? The plan must receive all relevant information with the appeal to make sure the most accurate decision is made. You can submit a claim online through your Regence account, or you can fax or mail your claim to Regence. Waiting too long on the phone, waiting room, in the exam room or when getting a prescription, The length of time required to fill a prescription or the accuracy of filling a prescription, Access to health care benefits, including a pre-authorization request denial, Claims payment, handling or reimbursement for health care services, A person who has bought insurance for themselves (also called a contract holder) and any dependents they choose to enroll. For prescription drug coverage, show both plan cards to the pharmacy and make sure they know which plan to bill first. 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 Complete and send your appeal entirely online. PDF Local Blue Cross and Blue Shield Mailing Addresses State/Alpha Prefix To appeal by phone or if you have questions, contact UMP Customer Service at 1 (800) 628-3481 (TRS: 711) Monday through Friday 5 a.m. to 8 p.m. and Saturday 8 a.m. to 4:30 p.m. (Pacific).
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