Just as important to remember is that if the bcbs patients id card does not show any alpha prefix or numerical suffix, please dont fill in those fields on the claim form. Account prefixes february 11, 2021 prefix group number group name effective product wgb 10030040 aceco precision manufacturing 112016 ppo amt 10034066 advanced health care corporation 712010 ppo. Bcbs prefix list 2021 alpha state lookup bcbs company. If in doubt, always check with blue cross and blue shield of new mexico bcbsnm, as the list of international licensees may change. Bcbs alpha prefix list paapzz2021 medical billing rcm. Bcbs prefix list maa to mzz alpha lookup by state 2021. Provider will enter alpha prefix in a designatedprovider will enter alpha prefix in a designated areas on the local plans web site provider will be routed to the home plans medical policy andor precert requirements providers must have access without logging in on the hplwbithome plans web site. Quickguideidcard april2015 final blue cross blue shield. You will no longer use the commercial payer ids for out of state members with these prefixes. There are two scenarios where that member might need to see a provider in another. Prefix changes the threecharacter prefix is a foundational component of the bluecard program. This list of bcbs prefixes includes both alpha prefixes and alpha numeric prefixes.
All other alpha prefixes not listed above ppo if ppo in suitcase logo. Bcbs prefix list paa to pzz alpha lookup by state 2021. Members who are part of the fep will have the letter r in front of their member id number. Confirm membershiplowes plan members can be identified by the following bcbs alpha prefixes. The main identifier for outofarea members is the alpha prefix. The blue cross and blue shield names and symbols are reg. Blueshield of tennessee that adjudicates the claim according to the members benefits and the. Providers could be seeing a new blue medicare advantage card with a new logo and alpha prefix. Blue cross and blue shield of illinois forwards the claim to bluecross blueshield of tennessee that adjudicates the claim according to the members benefits and the providers arrangement with the illinois plan. Bcbs prefix zaa to zzz alpha list 2021 state lookup. Many of the provisions do not apply to providers in other states.
To increase the number of prefixes available for blue cross and blue shield bcbs plans, prefixes were modified to allow combinations of alpha. It is critical for confirming a members eligibility and benefits. Every blue cross and blue shield plan starts with an alpha prefix. I work in the franklin tn office and have been on the bcbs tn team for a little over a year now, the ids for tennessee can have various 3 letter alpha prefixes but almost always are followed by 9digits we leave the alpha prefix off when entering the members id in image1 unless they are a bluecare or medicaid plan member which always incluced the letter m before the remaining. As information is updated by the blue cross blue shield association andor anthem blue cross and blue shield, we will communicate this information to you via the anthem website at. Presentation title blue cross blue shield of tennessee. Bluecard manual jan2009 blue cross and blue shield of illinois. Ppo in a suitcase logo, for eligible ppo members blank suitcase logo. Premera reference manual premera blue cross blue shield of alaska 023677 092010 identification cards chapter 5 page 1 5 identification id cards description this chapter focuses on information about the members health plan id card. Alpha prefixes identify the blue cross andor blue shield bcbs health care plan to which a. Premera blue cross blue shield of alaska 5 identification id.
You then can access eligibility, benefits and authorizations. The main identifier for out ofarea members is the alpha prefix. Account prefixes february 11, 2021 prefix group number. Bcbst applies to all lines of business unless stated otherwise administrative tricare managed care program update as previously reported october 2007 bluealert, bluecross blueshield of tennessee participated in the bidding process in response to the u. The first two alphabets of the prefix denote the plan and the third alphabet prefix denotes the type of product the insured choose for coverage. Blue cross and blue shield of illinois forwards the claim internally to bluecross blueshield of tennessee, which adjudicates the claim according to the members benefits and the providers.
Bluecross blueshield has taken steps to reduce hospital and medical expenses without compromising access to or quality of care. Once you have located the alpha prefix, you should call bluecard eligibility at 1800676blue 2583 to verify the patients membership and coverage. Health insurance bluecross blueshield of marketplace. Enrollment in hmo louisiana depends on contract renewal. Alpha prefix the threecharacter alpha prefix at the beginning of the members identification number is the key element used to identify and correctly route claims. To access the form and faqs, choose administration and click. Blue cross blue shield of michigan medicare plus blue. Quick guide to member id cards blue cross and blue shield of. The information the prefix contains defines the service relationships and arrangements between the blue planand its subscribers. Provide the members alpha prefix and you will be routed to the. Bcbs alpha prefix list complete aaa to zzz medical. Bcbst applies to all lines of business unless stated otherwise clinical changes to commercial drug formulary effective jan.
If there is no alpha prefix, do not create one or use an alpha prefix from another members id card, even one from the same bcbs plan. Beginning in 2018, the blue cross blue shield association bcbsa will issue alphanumeric prefixes to blue plans since the options for 3character all alpha combinations are running low. Provider network mgmt 3tc 801 pine street chattanooga, tennessee 37402 the eft enrollment form and frequently asked questions faqs can be found on the provider page of the company web site. The alpha prefix is critical for the electronic routing of specific hipaa transactions to the appropriate blue plan. Blue cross prefix list updated often the health exhibit. Lowesprior certification required for specialty drugs. Alpha del prefix account name ctrl inst ctrl prof method 801. Bluecross blueshield of tennessee has multiple plans available in each of the states eight service regions. The anthem bluecard program provider manual march 2017 kentucky, inc.
The bluecard program provider manual blue cross and blue. Do not change the sequence of the characters following the alpha prefix. Premera blue cross blue shield of alaska 5 identification. Custom prefixes are available to large groups to assist national accounts with claims routing. This alpha prefix is necessary to correctly route bluecard claims. This means that all bcbs plans and providers must be able to accept a prefix that includes a combination of alpha and numeric characters. An independent licensee of the blue cross and blue shield association. There are total of 649 alpha prefix in bcbs paapzz list and 152 are not assigned prefixes out of 649.
First, look for the threecharacter alpha prefix that precedes the identification number on the members id card. Bluecross blueshield of administrative tennessee, inc. Intraplan blue cross of california members most common prefixes in co. Group number suffix company state blue cross blue shield of. Complete details about these and other utilization management initiatives can be found in this physician manual. Taxonomy codes are required on all mmai, icp and fhp claims. Bluecross blueshield of tennessee is a qualified health plan issuer in the health insurance marketplace. Most members with coverage through a blue cross blue shield plan are assigned a three letter alpha prefix as a part of their unique identification number. This guide offers an overview of blue cross and blue shield bcbs id cards.
Thank you for choosing bluecross blueshield of tennessee. A guide for completing the cms1500 form blue cross and. In the example above, suppose a member has ppo coverage through bluecross blueshield of tennessee. Bcbs prefix zaa zzz list of bcbs prefixes bc prefix. Blue cross prefix list verified the health exhibit. The bluecard program applies to all inpatient, outpatient and professional claims. Below is an example of a bcbs id card with the alpha prefix highlighted. The bluecard program provider manual blue cross blue. Doing so can result in delays in processing the claim or possible denial of services due to incorrect member information. Alpha prefix importance blue cross blue shield of texas. Id cards for the following products and programs do not have an alpha prefix. Claims with these prefixes will be rejected if submitted to the commercial payer id. News from blue cross and blue shield of north carolina winter.
When the service location is required, include the name, address and npi for both the billing provider information and service location. Blue cross and blue shield of illinois forwards the claim internally to bluecross blueshield of tennessee that adjudicates the claim according to the members benefits and the providers arrangement with the illinois plan. The bluecard program provider manual home blue cross. Doctor or hospital, enter your threeletter prefix located on yo. Always include the three letter alpha prefix in the id field when you are filing the claim. Atypical providers who do not have an npi must use another primary identifier, such as federal tax id.
The bluecard program provider manual highmark blue cross. However, some cards may have the bluecross blueshield logo without the specific plan listed e. Local blue cross and blue shield mailing addresses state. It is critical for confirming a patients membership and coverage. Bcbs alpha prefix iaaizz 2021 bcbs alpha prefix haahzz 2020 bcbs prefix list gaagzz 2021 bcbs alpha prefix faafzz2021. Alpha prefix means plan id starts with three alphabets like abc, xyz, etc. Quick guide to blue cross and blue shield member id cards. A correct member identification number includes the alpha prefix first three positions and all subsequent. If you provide care for lowes members who may require specialty drugs, follow these steps to help expedite the claim process. Box 3283 tulsa, ok 741023283 you may also refer to the national uniform claim committees 1500 claim form instruction manual at blue cross and blue shield of oklahoma offers this guide to help you complete the cms1500 0212 form for your patients with blueshield coverage. Submit claims with the alpha prefix information exactly as printed. Ppo preferred provider organization if provider has no ppo contract, provider is reimbursed at the nonppo contract with bluecross blueshield of tennessee. Anthem blue cross and blue shield is the trade name of.
Tips for success always use the alpha prefix on the members current id card. Anthem blue cross and blue shield is the trade name of rocky mountain hospital and medical service, inc. Bluecard manual jan2009 blue cross and blue shield of. The bluecard program provider manual blue cross blue shield. Quickguideidcard april2015 final blue cross blue shield of. This manual is designed to assist you with education about bluecard and interplan business.
Id cards from these licensees will also contain threecharacter alpha prefixes and may or may not have one of the benefit product logos referenced in the following sections. Blue cross blue shield bcbs plans across the country and in more than 200. The alpha prefix identifies the bcbs plan or national account to which the member belongs. Provider enters alpha prefix at bluecross blueshield of tennessee website. Bcbs prefix list caa to czz alpha lookup by state 2021. Blue cross blue shield of michigan medicare plus blue ppo sm manual blue cross blue shield of michigan revised october 1, 2012 for use by michigan providers only. Quick guide to blue cross and blue shield member id cards april 2015 3 alpha prefixes most bcbsbranded id cards display a threecharacter alpha prefix in the first three positions of the members id number. Apr 30, 2008 the htf prefix is associated with the harford account with anthem 800. A single source that crosswalks every bcbs alpha prefix to the home plan, in both searchable online format and downloadable in excel. Quick guide to blue cross blue shield of tennessee. The majority of bluebranded id cards display a threecharacter alpha prefix in the first three positions of the. Please follow the instructions on the back of the id card. Box 995 birmingham, al 35298 arkansas arkansas bcbs po box 2181 little rock ar 72203 2181 arizona bcbs of arizona po box 2924 phoenix, az 85062 2924 california bc of california po box 60007.
Participating members can be identified by the alpha prefix xyo that appears on their blue cross blue shield of michigan medicare advantage ppo member. Government programs claims handling and postadjudication. The alpha prefix identifies the blue plan or national account to which the member belongs. Registered marks blue cross and blue shield association. When the claim is finalized, the tennessee plan issues an explanation. Bcbs ny empire alpha prefix tww insurance for time warner employees mental health benefits are through united behavioral health ubh 8005828220.
Claims for all subscribers if the id number does not include an alpha prefix, you will need to contact the home plan directly. May 27, 2010 lowes is a blue cross and blue shield national account, with medicalppoplan members in every state. The 3character prefix has historically been an alpha prefix with all alpha characters. After rendering services, the provider in illinois files a claim locally with blue cross and blue shield of illinois. Blue cross and blue shield of illinois forwards the claim internally to bluecross blueshield of tennessee that adjudicates the claim according to the members benefits and the. Jan 03, 2021 bcbs alpha prefix faafzz2021 bcbs prefix list eaaezz2021 bcbs alpha prefix daadzz 2021 bcbs alpha prefix caaczz 2021 bcbs alpha prefix baabzz 2021 bcbs alpha prefix xaaxzz2021 bcbs alpha prefix zaazaa 2021 bcbs alpha prefix yaayzz2021 bcbs alpha prefix vaavzz2021 bcbs alpha prefix waawzz2021 bcbs alpha prefix uaa. In missour this manual is designed to assist you with education about bluecard and interplan business. Continue to update alpha prefix for bcbs virginia it looks and sounds great for many peoples news policy number on insurance card blue cross blue shield alpha prefix for bcbs of illinois bcbs alpha prefixes list related keywords bcbs alpha idcard provider finder labor accounts bcbs alpha continue to update alpha prefix for bcbs virginia you can see all these awesome informations information. Quick guide to blue cross and blue shield member id cards july 2015 3 introduction blank suitcase alpha prefixes most bcbsbranded id cards display a threecharacter alpha prefix in the first three positions of the members id number.
News from blue cross and blue shield of north carolina. Be sure and use the correct alpha prefix and member id numbers. Local blue cross and blue shield mailing addresses last update 102420 state alpha prefix claims filing address alabama bcbs of alabama p. Hmo louisiana is a subsidiary of blue cross and blue shield of louisiana, independent licensees of the blue cross and blue shield association. Apr 30, 2008 bcbs md alpha prefix gei insurance for geico employees mental health authorizations are obtained from magellan 80024570. Alpha prefix the threecharacter alpha prefix at the beginning of the members id number is the key element used to identify and correctly route outofarea claims. When the claim is finalized, the tennessee plan issues an. Anthem has added a new blue medicare advantage alpha prefix of j2h. Blue cross and blue shield of texas will be your one point of contact for most of your claimsrelated questions.
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