With a plan powered by the most trusted name in health insurance, youll have coverage tailored to your health. Learn more on the HCA website. If you wish to appoint someone to act on your behalf, you must complete an appointment of representative form (PDF) and send it to us with your grievance form (PDF). 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. <>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>>
I . Visit the Regence provider website, regence.com to learn more about: Contact Us View information about who to contact for questions and issues. For information on false claims, see False claims or statements in your certificate of coverage. Regence BlueCross BlueShield of Oregon is an independent licensee of the Blue Cross and Blue Shield Association. Contact us as soon as possible because time limits apply. Regence BlueCross BlueShield of Oregon, headquartered in Portland, has been serving Oregonians since 1941 and now provides more than 974,000 people with comprehensive health insurance solutions. Prescription questions?Call Customer Service and choose the Pharmacy option. Regence BlueShield. THIS AMENDMENT, effective January 01, 2023, hereby amends the Medical Group Agreement ("Agreement" or as otherwise defined in the Agreement) and any and all amendments, addenda, attachments or exhibits thereto by and between Regence BlueCross BlueShield of Oregon (Regence or as otherwise defined in the Agreement and hereafter referred to as If you have questions about eligibility and enrollment:Employees:Contact your payroll or benefits office.SEBB Continuation Coverage members:Call the SEBB ProgramPhone: 1 (800) 200-1004 You can submit feedback about your Medicare health plan or prescription drug plan directly to Medicare. The Centers for Medicare & Medicaid Services values your feedback and will use it to continue to improve the quality of the Medicare program. You can also get information and assistance on how to submit an appeal by calling the Customer Service number on the back of your member ID card. 7:00 AM - 6:00 PM PSTFax: 877-239-3390 (Claims and Customer Service)Fax: 877-202-3149 (Member Appeals only)Fax: 866-948-8823 (FEP Care
Stay up to date on what's happening from Portland to Prineville. 24/7 anonymous hotline: 1 (800) 323-1693 Medicare Part C & D: 1 (800) 633-4227 Online reporting form Ethics & compliance hotline Learn how our innovative solutions can help your employees live healthier, while helping you manage your costs. 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). First- and second-level appeals are part of an internal review process, while independent reviews are part of an external review process. It was formed in 1982 from the merger of its two namesake organizations: Blue Cross was founded in 1929 and became the Blue Cross Association in 1960, while . (Note: Claims received with an ICD-9 code will be rejected with a notice to re-bill using ICD-10.) Regence BlueCross BlueShield of Oregon offers health and dental coverage to 750,000 members throughout the state. They are also available outside these hours with limited services. If you or your dependents have other insurance, you must let UMP Customer Service and Washington State Rx Services know so claims are paid correctly. endobj
Premera Blue Cross Blue Shield of Alaska FEP PO Box 33932 Seattle, WA 98133-0932, Phone:800-562-1011
Asthma. Chronic Obstructive Pulmonary Disease. Regence BlueShield in accordance with the terms of your Provider contract with Regence. Step 1: Start your internet browser, and then go to the official regence bluecross blueshield of oregon address website. You can submit a claim online through your Regence account, or you can fax or mail your claim to Regence. Claims determinationsThe plan will notify you of action taken on a claim within 30 days of the plan receiving it. You may need to submit your own claim if you buy drugs at a non-network pharmacy, dont show your ID card, or have other prescription coverage that pays first and UMP is secondary. The second high-deductible health plan cannot include an HSA. You may need to submit a claim to UMP for payment if: UMP does not cover nor coordinate benefits with workers' compensation claims. Regence BlueCross BlueShield of Oregon Availity Web Portal Support Phone Number 1.800.AVAILITY (1.800.282.4548) (toll free) Support Hours Mon-Fri, 7:00 a.m. to 4:00 p.m. (PT) Site URL http://www.regence.com What's available in the portal On the Availity Web Portal, you can: ** We respond to medical coverage requests within 14 days for standard requests and 72 hours for expedited requests. PO Box 1271 MS C7APortland, OR 97207-1271 This form is to be used only for services in Oregon and Clark County, WA. A list of reciprocal partners as well as membership benefits can be found at lifeflight.org. Learn more about when, and how, to submit claim attachments. 2003 Western Ave # 600, 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. If the decision was after the 60-day timeframe, please include the reason you delayed filing the appeal. Please include the following information when requesting an appeal: The plan will send confirmation when it receives your appeal. You receive services from an out-of-network provider. Phone:800-562-1011Fax: 877-239-3390 (Claims and Customer Service)Fax: 877-202-3149 (Member Appeals)Fax: 866-948-8823 (FEP Care Management - prior auth/pre-service requests), Email:
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. While it's a good idea to submit a complaint as soon as possible, there isn't a deadline to do so. Stay up to date on what's happening from Bonners Ferry to Boise. For more specific contact information, choose from the following: Individuals and familiesMedicareEmployersProducersProviders. 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. We're ready. Consult theFEP local plan directory to find addresses and telephone numbers for other plans.Note: If the laboratory work was sent to Washington for testing or analysis, refer to theWashington claims submission map to determine where to send your claim for processing. If additional information is needed, we will send you a request. We will notify you once your application has been approved or if additional information is needed. You can submit a marketing complaint to us by calling the phone number on the back of your member ID card or by calling 1-800-MEDICARE (1-800-633-4227). View our clinical edits and model claims editing. Complete the Prescription Drug Claim Form and send it with your pharmacy receipts to: Pharmacy Manual ClaimsP.O. Instructions are included on how to complete and submit the form. 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. State/Alpha Prefix Claims Filing Address Alabama BCBS of Alabama P.O. Learn how to identify our members coverage, easily submit claims and receive payment for services and supplies. There are several levels of appeal, including internal and external appeal levels, which you may follow. If your primary plan uses a different mail-order pharmacy, you will have to use your primary plans mail order pharmacy and then submit a claim to Washington State Rx Services. Phoenix, AZ 85072, Retail Pharmacy Program
Any enrollee may appeal a decision made by the School Employees Benefits Board (SEBB) Program regarding SEBB eligibility, enrollment, premium payments, or premium surcharges (if applicable) to the SEBB Appeals Unit. Blue Cross and Blue Shield of Nevada will process the claim. Complete and mail or fax a WSRxS Multiple Pharmacy Coverage Inquiry Form (Drug Coordination of Benefits) to Washington State Rx Services. Media Contact: Audrey Glasby Regence BlueCross BlueShield of Utah Regence . 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
Learn more. If you have . If MAXIMUS disagrees with our decision, we authorize or pay for the requested services within the timeframe outlined by MAXIMUS. Pre-authorization View services and supplies that require pre-authorization. Rev 3/2007 See Complaints about quality of care in your certificate of coverage to learn more. Open 24 hours a day, 7 days a week. Ask your provider. Improving Health State-by-State, For the Health of America. %&xv}`kfg`O>=toy,y_bI)45T\ei@{65z9|i8NhI;nTSp~b5[iN_ pn+JsX;fz|4]R 8ZTJ.#fdP]^RP|z~-3KT\n:)O68m+zm96th+/5O6=%7;s"(CTF
fZTreF`Tzq`a=6>GGW[tXudM+W6`m~yuCCu xd!XDmSdoQ/= y?ck r1rMc.c0>'1|\a{ enTc |GBl]|mCxr,. REGENCE BS OF UTAH. You may send a complaint to us in writing or by calling Customer Service. x][o%~`C?3=k7A I87ggglM"_Unx9d,*Wdx
cwU74/_C&$jTD/ew|/_t_~suJo~/X7/fTjz=u?|1w_k;vZ]!w??!~pw!cw DG6JOw{v?M.>~h9{/|0
_&CrOL%be_/WWc9U~;?#*bX Fz-w~7`e_ :5ZmLme'UFSgs\\@=~!r)Q;ZDf}Z1^W8qw`v0]wcEo5tLBn-4%x\I[s$8eBM:)$2dY9s>E;& If you use mail-order pharmacy and your primary plan uses Costco Mail Order Pharmacy or Postal Prescription Services (PPS) as the network mail-order pharmacy, Costco Mail Order Pharmacy or PPS can process payments for both plans and charge only the remaining unpaid balance. 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. FAQs & Resources *If you are asking for a formulary or tiering exception, your prescribing physician must provide a statement to support your request. Regence BlueShield serves select counties in the state of Washington and is an Independent Licensee of the Blue Cross and Blue Shield Association. Box 890179 Camp Hill, PA 17089 Send your claim or correspondence to the Blue Cross Blue Shield plan in the state where the laboratory work was sent for testing.Example: The lab service you used is in Arizona but the sample was sent to Nevada for analysis. If you buy your prescription drugs at a network pharmacy, your claim will be submitted for you. If services were rendered in New York or Pennsylvania, then use the state-specific file address PDF. 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. Medical records from your provider, if applicable. You will also receive a decision on your appeal within 30 calendar days. complies with applicable Federal and Washington state civil rights laws, Determine the county where the service was performed* (see exceptions below). You must submit first-level and second-level appeals no more than 180 days after receiving the previous decision. For the Health of America. We will notify you if we need more time to respond. UMP medical plans are administered by Regence BlueShield. First, you'll need to gather these documents: An itemized bill from your provider that describes the services and charges. Location. In keeping with our values as a tax paying nonprofit, 85% of every premium dollar goes to pay our members' medical claims and expenses. You must submit prescription drug claims within 12 months of purchase. 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. Claims determinationsThe plan will notify you of action taken on a claim within 30 days of the plan receiving it. The members full name (the name of the employee, retiree, or dependent covered by the plan), The member ID number (starting with a W on your UMP member ID card), The name(s) of any providers involved in the issue you are appealing, A statement describing the issue and your desired outcome, A copy of the Explanation of Benefits, if applicable, or a list of the claim numbers you are appealing. TRS: 711Business hours: Monday through Friday 8 a.m. to 4:30 p.m. (Pacific). Sign in to your Regence account. Allied professionals, including behavioral health, vision, chiropractic and other complementary service providers: Contact your allied provider relations representatives & consultants. In every state and every community, BCBS companies are making a difference not just for our members, but For the Health of America. Coordination of benefits (COB) happens when you have health coverage through two or more groups (such as your employer and your spouses employer), and these two group health plans both pay a portion of your health care claims. Blue cross blue shield address Medicaid Address and phone number - List 1 Medicaid claim submission address - List 2 Medicare . 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. Attn: Appeal UnitPO Box 40168Portland, OR 97240-0168. You must appeal within 60 days of getting our written decision. Learn more about global periods, modifiers, virtual care, unlisted codes and NCCI bypass modifiers. If you have questions about submitting a claim for services outside the U.S., call UMP Customer Service. Mail or fax both the claim form and the provider's claim document (or bill) to: Regence BlueShield Attn: UMP Claims P.O. As a nonprofit independent licensee of the Blue Cross and Blue Shield Association, Regence is part of a . Consult theFEP local plan directory to find addresses and telephone numbers
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. Other specialized services (home hospice, organ/tissue transplants, and clinical trials). But there are some circumstances where you will need to submit a claim. For more information about dual coverage, read the If you have other medical coverage (or UMP High Deductible "If you have other HDHP coverage") section in your plans certificate of coverage. Once that review is done, you will receive a letter explaining the result. These forms explain what information should be included with your appeal and list the address and fax number of where to send your appeal. Regency Blue Cross Blue Shield Of Oregon (541) 772-8906 Visit Website Map & Directions 2057 Commerce Dr Medford, OR 97504 Write a Review. All claims must be submitted to UMP within 12 months of the date of service or purchase to prevent denial of the claim. You must continue to use network pharmacies until you are disenrolled from our plan to receive prescription drug coverage under our formulary. An appeal for services related to the Centers of Excellence Program must be submitted within 180 days after you receive notice of the denial to Premera.Submit appeals to: Mail:Premera Blue Cross To send an electronic claim, use the Availity clearinghouse with payer ID HMA01. 2 0 obj
The Regence Operations Trainer I would have two years' experience in operational areas to include customer service, claims, membership and/or delivering training in a matrixed environment or . You should wait until the primary plan has paid to submit a secondary claim to UMP, unless the primary plan's processing of the claim is delayed. Regence BlueCross BlueShield of Utah Deutsch |
Make sure you have your Member ID card handy when you call us. To obtain information on the aggregate number of grievances, appeals and exceptions filed with the plan contact Customer Service. 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. Some of the limits and restrictions to prescription drug coverage will apply when UMP pays second to another plan. Centers of Excellence and Washington State Prescription Services do not provide BlueCross BlueShield services and are separate companies solely responsible for their products/services. Be sure to include any other information you want considered in the appeal. If your prescribing physician asks for a faster decision for you, or supports you in asking for one by stating (in writing or through a phone call to us) that he or she agrees that waiting 72 hours could seriously harm your life, health or ability to regain maximum function, we will give you a decision within 24 hours. Coordination of Benefits, Medicare crossover and other party liability or subrogation. All features have been transitioned to the Availity Provider Portal. |
MAXIMUS will review the file and ensure that our decision is accurate. Learn more about our payment and dispute (appeals) processes. PO Box 91102Seattle, WA 98111-9202. Send to Regence Blue Shield in accordance with the terms of your provider contract with Regence. If you have any questions about your member appeal process, call our Customer Service department at the number on the back of your member ID card. Completion of the credentialing process takes 30-60 days. 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. We are now processing credentialing applications submitted on or before March 6, 2023. 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. Washington State Rx ServicesPO Box 40168Portland, OR 97240-0168. 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. Regence BlueShieldAttn: UMP ClaimsP.O. You have other insurance that pays first and UMP is secondary. Usually we will send you an Explanation of Benefits (EOB) statement or a letter explaining our decision about a pre-authorization request. To see if you qualify for Extra Help, call: 1-800-633-4227. CLAIM.MD | Payer Information | OR BCBS (Regence) Payer Information OR BCBS (Regence) Payer ID: 00851 This insurance is also known as: Regence Blue Cross of Oregon Blue Cross Blue Shield of OR REGENCE BLUECROSS BLUESHIELD OF OREGON REGENCE BCBS OF OREGON FEP G00851 Other ID's: 12B41, SB850 Need to submit transactions to this insurance carrier?
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