Are you reporting a new case? The following documentation provides guidance regarding the process for appeals. Claims must be submitted and received by us within 24 months after the service takes place to be eligible for benefits. Access the most extensive library of templates available. Use this form to submit a claim to be reimbursed for services that are covered under Service Benefit Plan dental benefits. All rights reserved. PDF Provider Phone Numbers In most cases, you can prevent a retroactive denial by paying your premiums on time and/or by promptly notifying the plan or, if applicable, the marketplace of changes in your eligibility status for the plan. Spanish, Localized Call the IVR: 205-220-6765. A secondary plan is one which takes into consideration the benefits of the primary plan before determining benefits available under its plan. 2023, Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association. View the latest providernews. Some information on our site is secure; log in to ensure you're seeing all the news. */ EDI enrollment is NOT required for submission of electronic claims. A powerhouse editor is already at your fingertips supplying you with a range of useful instruments for filling out a Dental Claim Form - Blue Cross And Blue Shield Of Alabama - Bcbsal. If you do not know this information, please contact us at 205-220-7725 or fax your request to 205-220-6354. To determine your premium, call us Drug exceptions timeframes and enrollee responsibilities. We make completing any Dental Claim Form - Blue Cross And Blue Shield Of Alabama - Bcbsal easier. Please review the terms of use and privacy policies of the new site you will be visiting. at 1-855-488-2515 or click the "Get Started" link to compare your plans today. Dental Blue Benefit Summary Plan Benefit In-Network Benefits Dental Blue 2500A Dental Blue 2000A Dental Blue 1500A Dental Blue 1500B Dental Blue 1000A Dental Blue 1000B MAJOR SERVICES (CONTINUED) Major Services - Prosthetic Services to deductibleInlays, onlays, veneers or crowns Fixed or removable bridges Full or . Blue Cross and Blue Shield of Alabama. Highest customer reviews on one of the most highly-trusted product review platforms. function checkChatAvailability(userAction) { if (userAction === 'onclick') { We make it easy to manage your healthcare finances, claims and health information. By clicking "Next", you are acknowledging that you would like to submit your application otherwise, click "Cancel". Dental Claim Form - Blue Cross And Blue Shield Of Alabama - Bcbsal Features expanded pediatric benefits for children up to the end of the month in which the member turns 19. LLC, Internet & Estates, Corporate - Questions? Precertification also does not mean that we have been paid all monies necessary for coverage to be in force on the date that services or supplies are rendered. 2023, Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association. #1 Internet-trusted security seal. Choose a state to see how Blue Cross Blue Shield is working in your community. Blue Cross Blue Shield FEP Dental - Contact Us Dental. It's easy to protect your smile to the fullest with dental coverage that If you purchased an individual plan through the health insurance marketplace and you are receiving advance payments of tax credits and/or cost sharing reductions in accordance with the Affordable Care Act, each of your monthly periodic payments is due on the first day of the month for that coverage period. ProviderAccess Provider News View the latest provider news. My Account, Forms in Dental Blue Plans - bcbsal.org Phone Numbers. Home - provider.bcbsal.org Patient & Claim Payment & Refund Visit our COVID-19 Provider Update Center for the latest information about testing, treatment and telehealth coverage. Adults age 19+. if (jsonStr.Availability === 'YES') { Instructions: 1. We must follow the IROs decision. All Rights Reserved. By clicking "Next", you are acknowledging that you would like to submit your application and continue onto the payment page otherwise, click "Cancel". If we deny your request, you may request an internal appeal and an external review by an impartial third party reviewer, known as an Independent Review Organization (IRO). Medical necessity and prior authorization timeframes and enrollee responsibilities. You are about to leave Blue Cross and Blue Shield of Alabama's website and enter a website operated by HealthEquity. Resources - provider.bcbsal.org 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. BCBS State by State | Blue Cross Blue Shield 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. 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. An EOB is not a bill. Get Started . Node:bclrprvappp1001.corp.bcbsal.org:8080, Pre-Service Review for Out-of-Area Members, PRO-81 Professional Reimbursement Appeal Form, PRO-82 Utilization Management Appeal Form. In certain situations, a claim may be reprocessed and denied retroactively, even after it has been paid. The case number, contract number and/or accident date you've entered does not match our records. . }).then(function(data) { } To continue to this website, click "Accept." Resources - provider.bcbsal.org Each time Blue Cross processes a claim submitted by you or your healthcare provider, we send you an Explanation of Benefits (EOB). If you receive services from an out-of-network provider, these services may not be covered at all under the plan. 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. These guidelines, in addition to the editor will assist you through the entire procedure. Or mail a paper copy, along with proof that you paid a Medicare Part B premium, to: Complete the form following the instructions on the back. HealthEquity has agreed to follow Blue Cross' privacy and security policies regarding the confidentiality and protection of your personal health information. Blue Cross Blue Shield of Oregon -Regence FEP Claims TLW13 USA Blue Cross Blue Shield of Rhode Island: CB870 W: USA In the left-hand column, locate the state where services were rendered. } else { services, For Small 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. PDF Dental Expense Claim - bcbsal.org Some areas of our site may provide links to other external sites that we don't own, control or influence. To determine your premium, call us at 1-855-488-2515 or click the "Get Started" link to compare your plans today. Include the date to the document using the. var fromUrl =window.location.host; Generally, if precertification is required and not obtained, no benefits will be payable under the plan. Dental Expense Claim Author: Blue Cross and Blue Shield of Alabama Subject: Dental Expense Claim Keywords: Dental Expense Claim,dental expense,dental,expense,claim Created Date: Thank you for your interest in our Short Term Plan. You can use 3 available choices; typing, drawing, or uploading one. Providers - ndbh.com Blue Cross Blue Shield FEP Dental - Forms Payer Name: Blue Cross Blue Shield of Alabama - thePracticeBridge Some areas of our site may provide links to other external sites that we don't own, control or influence. Download your FREE dental guide to learn more about A Blue Cross representative from LifePlans will contact you to discuss your initial needs and to clarify any questions you have about your policy. Blue Cross Blue Shield of Alabama CBAL1: W USA: Blue Cross Blue Shield of Alaska 47570: USA . else You may also visit them online at BCBSAL. Applicable FARS/DFARS apply. I want to purchase services for my organization. What is the fax number for BCBS Alabama appeals? **Dental Blue Plus is a Health Insurance Marketplace plan. Birmingham, Alabama 35244-2858, Grace periods and claims pending policies during the grace period. the page. Expenses will be applied against your Plan of Care and reimbursed accordingly. Check out the changes and updates to our plan in 2023. Call 1-855-488-2515. PDF State Mail to Mailing Address City, State Zip - Pnnl ALL Kids. We use cookies to improve security, personalize the user experience, enhance our marketing activities (including cooperating with our marketing partners) and for other business use. An EOB is a statement that describes what medical treatments and/or services we paid on your behalf, what our payment was and your financial responsibility under the terms of the plan. (For example, if your service was provided on March 5, 2022, you have until December 31, 2023 to submit your claim). 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. Tell us the type of service or supply for which you wish to file a claim (for example, hospital, physician, dentist or pharmacy), and we will send you the proper type of form. Three forms are also available to aid providers in preparing an appeal request. 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 USLegal received the following as compared to 9 other form sites. Outside the United States. Box 3686, Scranton . This link takes you to another website. Your doctor or other prescriber must give us a statement that explains the medical reasons for requesting an exception. By clicking "Next", you are acknowledging that you would like to submit your application otherwise, click "Cancel". Blue Plus **. If you have questions, please contact your local Blue Cross and Blue Shield company. Submit a separate claim for each patient. CDT codes, descriptions and data copyright 2022 American Dental Association. Your member ID card is your key to using your medical plan benefits. } 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. Blue Cross Blue Shield of Alabama. Patient Eligibility and Benefits; Pre-Service Review; Pre-Service Review for Out-of-Area Members . login - provider.bcbsal.org }. Provider Phone Numbers PEEHIP P.O. $('#chat-available').show(); Equal Opportunity Employer AA M/F/Vet/Disability, We are excited to announce that New Directions and Tridiuum have joined forces to become Lucet! From Huntsville to Mobile, we have the best medicare plans Discover all the ways members can earn wellness incentives and rewards for taking an active role in their health. You are about to leave Blue Cross and Blue Shield of Alabama's website and enter a website operated by Prime Therapeutics, LLC. Here are the forms/documents to add locations and make changes to information and other requests. Preservice and concurrent appeals should continue to be submitted to the member's Home Plan. Patient. What you need to know about the disease and our commitment to ensuring you have access to the right care at the right time. Family. Blue Cross and Blue Shield of Alabama enrolls and credentials all individual providers as well as ancillary and facility providers. Using this login enables you to manage the account for your organizations participating members. Claims Administrator Contact Us | Blue Cross Blue Shield Attorney, Terms of Failure to timely pay premium payments is not a special open enrollment event for later coverage under the plan. Name and Address of Carrier . *Subject to your Calendar Year Deductible. 2. Provider Enrollment To ask for a formal decision about the coverage if you disagree, print and complete the appropriate form below and fax it to 1-800-693-6703 or mail to Prime Therapeutics LLC, Attention: Part D Appeals Department, 1305 Corporate Center Dr. How to File a Claim Call Preferred Long-Term Care (LTC) Customer Service (1-888-331-4188) to complete the Claims Intake Form over the telephone. Claims Payment Policy & Other Information. Box 3418, Scranton, PA 18505; Blue Cross Community MMAI (Medicare-Medicaid Plan), c/o Provider Services, P.O. All rights reserved. We use cookies on this website to give you the best experience and measure website usage. Applicable FARS/DFARS apply. All rights reserved. Fax (provider credentialing applications and related documents): 205-220-9545. Blue Cross Blue Shield CDT codes, descriptions and data copyright 2022 American Dental Association. You will be going to a new website, operated on behalf of the Blue Cross and Blue Shield Service Benefit Plan by a third party. Use this form to submit a health benefit claim for services that are covered under the Blue Cross and Blue Shield Service Benefit Plan. 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? With Blue Cross and Blue Shield of Alabama, all of our dental plans include regular dental exams, x-ray and routine cleaning - at no extra cost. method: "GET", Call Preferred Long-Term Care (LTC) Customer Service (1-888-331-4188) to complete the Claims Intake Form over the telephone. (You can fill the form in electronically or complete it by hand.). 2023, Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association. In some cases, your provider will initiate the precertification process for you. Our representatives can answer your questions and help you navigate these choices. 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. { HealthEquity has agreed to follow Blue Cross' privacy and security policies regarding the confidentiality and protection of your personal health information. Are you a provider?Click to be directed to our Providers area. $129 /month. Additional details about this and other exception review details can be found in the Claims and Appeals section of your benefit booklet. You can use our interactive search to find your local Blue Cross Blue Shield Company's website. myBlueCross Member Login Contact Us: 1-888-543-9212 (TTY:711) myBlueCross Member Login Call 1-888-543-9212 TTY 711 . Find your plan. Submit a separate claim for each patient. Resources - provider.bcbsal.org For claim status, eligibility, remittances and referrals, use one of the following methods: Access through your practice management software, Log in to our website, or Call the appropriate number listed below: In-State General Provider Inquiry Participating hospitals: 1-800-760-6852 Participating providers: 1-877-231-7239 allows healthcare providers to submit claims electronically to Blue Crossand Blue Shield of Alabama. Choose between our 3 dental plans today! 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. Print and mail the form to the Blue Cross and Blue Shield company in the state that the services were rendered by December 31 of the year following the year you received service. How to file a dental claim with Blue Cross Blue Shield Alabama? It is your responsibility to ensure that you or your provider obtains precertification. $23 /month. Be sure the data you add to the Dental Claim Form - Blue Cross And Blue Shield Of Alabama - Bcbsal is up-to-date and accurate. //show the chat available image Three forms are also available to aid providers in preparing an appeal request. Don't have a User ID? $.ajax({ Upon completion of your Waiting Period, you will be eligible to begin receiving reimbursement of your benefits. Include the date to the document using the Date function. BCBS FEP Dental Claim Form View PDF. Review Blue Cross and Blue Advantage medical and pharmacy policiesor comment on draft policies. Box 3836, Scranton, PA 18505; Blue Cross Medicare Advantage, c/o Provider Services, P.O. HealthEquity is our business associate and is an independent company that provides account-based plan services to Blue Cross. To continue to this website, click "Accept." 2023, BlueCross and BlueShield of Alabama is an independent licensee of the BlueCross and BlueShield Association. Blue Cross and Blue Shield of Alabama will send you a Claims Packet to be completed and returned to us. Call Customer Service at 1-855-504-BLUE (2583), 8 a.m. - 8 p.m. EST Monday - Friday, or Contact Us for further assistance. Some information on our siteis secure; log in to ensure youre seeingall the news. Member Services For general inquiries, you can reach us by calling the number below. Download the overseas medical claim form: I am a Broker or Blue Plan partner that wants to visit the Partner Portal. dental, vision, hearing and fitness benefits at no added cost . Download the Medicare Reimbursement Account (MRA) Pay Me Back claim form: Complete the form following the instructions on the front. Child up to age 19. Mail original claims to the appropriate address as noted below. Information contained in the external sites is not endorsed by BCBSAL. An application, from the Enrollment section, is needed for any provider in the following situations:
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