UMP medical plans are administered by Regence BlueShield. Complete the Prescription Drug Claim Form and send it with your pharmacy receipts to: Pharmacy Manual ClaimsP.O. For more specific contact information, choose from the following: Individuals and families Medicare Employers Producers Providers Fraud or abuse You can remain anonymous. You receive services from an out-of-network provider. For more information about the appeals process, including expedited appeals for urgent or life-threatening conditions and requesting an external review by an Independent Review Organization, read the "Complaint and appeal procedures" section in your plan's certificate of coverage. 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. When we make a decision about what services we will cover or how well pay for them, we let you know. Stay up to date on what's happening from Portland to Prineville. Your trust is our top concern, so businesses can't pay to alter or remove their reviews. 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: A retroactive decision to deny coverage based on eligibility. Select the area of the map that matches the color of the county where the service was performed. Sign in Find helpful phone, fax and email information for assistance. Blue Cross Blue shield claim submission address | Medical Billing and MAXIMUS Federal Services is a contracted provider hired by the Center for Medicare and Medicaid Services (also known as CMS) and has no affiliation with us. View our clinical edits and model claims editing. UMP may cover some supplies through the medical benefit and other supplies under the prescription drug benefit. <>>> endobj Blue Cross and Blue Shield of Nevada will process the claim. 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. The member can appeal, or a representative the member chooses, including an attorney or, in some cases, a doctor. For more specific contact information, choose from the following: Individuals and familiesMedicareEmployersProducersProviders. Premera Blue Cross For services outside this area, please contact customer service directly at 1 (800) 365-3155 as your claim will require special handling. Be on the lookout for future communications with more information about this exciting enhancement for submitting claim appeals through Availity. 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). In the left-hand column, locate the state where services were rendered. Customer Service will help you with the process. Box 30805 Salt Lake City, UT 84130- 0805 *Pennsylvania BCNEPA P.O. The plan must receive all relevant information with the appeal to make sure the most accurate decision is made. <>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> TRS: 711Business hours: Monday through Friday 8 a.m. to 4:30 p.m. (Pacific). You have the right to file a grievance, or complaint, about us or one of our plan providers for matters other than payment or coverage disputes. Your provider should supply clinically relevant information, such as medical records for services denied based on medical necessity or for other clinical reasons. The Centers for Medicare & Medicaid Services values your feedback and will use it to continue to improve the quality of the Medicare program. We're ready. | 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. PO BOX 21267 SEATTLE, WA 98111 800-845-0377. endobj 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. See Complaints about quality of care in your certificate of coverage to learn more. For prescription drug coverage, show both plan cards to the pharmacy and make sure they know which plan to bill first. | Members: Log in/register at MyBlue Customer eService, Regence Blue Cross Blue Shield of Oregon - FEPPO Box 31105Salt Lake City, UT 84131, Regence Blue Cross Blue Shield of Oregon - FEPPO Box 1269Portland, OR 97207. There are several levels of appeal, including internal and external appeal levels, which you may follow. Our award-winning Customer Service team is made of compassionate people who care. 0. . If you have questions about submitting a claim for services outside the U.S., call UMP Customer Service. If services were rendered in New York or Pennsylvania, then use the state-specific file address PDF. The quality of care you received from a provider or facility. %PDF-1.5 PO BOX 25956 SALT LAKE CITY, UT 84125 800-662-0876. If an initial phone call does not resolve your complaint, you may submit your complaint over the phone or by email, fax, or mail. Availity and Regence Working with Regence online? If you have any questions about specific aspects of this information or need clarifications, please email press@bcbsa.com . Stay up to date on what's happening from Bonners Ferry to Boise. To obtain information on the aggregate number of grievances, appeals and exceptions filed with the plan contact Customer Service. Send your claim or correspondence to the Blue Cross Blue Shield plan in the state where the ambulance picked up the patient.Example: An ambulance picks up the patient in Oregon and transports her to a care facility in Washington. You can submit a claim online through your Regence account, or you can fax or mail your claim to Regence. You have the right to make a complaint if we ask you to leave our plan. Regence BlueShield - FEPPO Box 31207Salt Lake City, UT 84131, (Attended sleep study at outpatient part of a hospital, home hospice, organ/tissue transplants, clinical trials. 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. Step 4: After you have completed the login details correctly . If the decision was after the 60-day timeframe, please include the reason you delayed filing the appeal. See "Appeals related to eligibility" section of your plan's. If additional information is needed, we will send you a request. CLAIM.MD | Payer Information | OR BCBS (Regence) WELLMARK BCBS OF IOWA. Make sure you submit your complaint to the right company (see below). <> That way, we can verify your account and start helping you as quickly as possible. You can submit feedback about your Medicare health plan or prescription drug plan directly to Medicare. Identify BlueCard members, verify eligibility and submit claims for out-of-area patients. Blue Cross Blue Shield Association (BCBS, BCBSA) is a federation, or supraorganization, of, in 2022, 34 independent and locally operated BCBSA companies that provide health insurance in the United States to more than 115 million people. Billing | Life Flight Network Your life. Regence BlueShield in accordance with the terms of your Provider contract with Regence. Dental billing. Mail or fax both the claim form and the provider's claim document (or bill) to: Regence BlueShieldAttn: UMP ClaimsP.O. Regence Lewiston, ID Office | Glassdoor For the Health of America. If additional information is needed, we will send you a request. Learn more about our customized editing rules, including clinical edits, bundling edits, and outpatient code editor. REGENCE BS OF UTAH. P | PDF Member Reimbursement Form You must submit first-level and second-level appeals no more than 180 days after receiving the previous decision. Contact us as soon as possible because time limits apply. Call the phone number on the back of your member ID card. Regence Blue Shield in accordance with the terms of your provider contract with Regence. Find the correct address listed under the type of service received (see explanation). REGENCE BS OF WASHINGTON. Polski | Yelp users haven't asked any questions yet about Regence Blue Cross Blue Shield of Oregon. % PO Box 1271 MS C7APortland, OR 97207-1271 This form is to be used only for services in Oregon and Clark County, WA. Your life. Search jobs. 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. In keeping with our values as a tax paying nonprofit, 85% of every premium dollar goes to pay our members' medical claims and expenses. 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;& Claims Submission Map | FEP | Premera Blue Cross The ambulance claim will be processed by Blue Cross Blue Shield of Oregon. 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 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.
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