Suppose assume claims filed with an incorrect member ID number or BCBS prefix by Provider or Billing companies, then BCBS insurance will deny the claim stating “Incorrect member ID, please submit with an correct member ID number”. Stand-alone dental products, vision and pharmacy when delivered through an intermediary model.īCBS Prefix should be included along with ID number, exactly as it appears on the member ID card when filing the claims to insurance company.BCBS FEP – It’s indicated with letter R followed by the id number.BCBS Prefix:īCBS prefix is a three character prefixes followed by the id number except for the following products and programs. Policy number is a unique number, which is provided to their insured person by respective insurances in order for identification purposes and also for billing the healthcare claims. ![]() BCBS Prefix List Alpha & Alpha Numeric : AAA to AZZīlue Cross Blue Shield Provider Phone Number Blue Cross Blue Shield Federal Phone Number BCBSIL makes no endorsement, representations or warranties regarding third party vendors and the products and services they offer.BCBS prefix List plays a vital role in filing the health care claims properly to the correct BCBS address and also to verify member’s eligibility, health insurance coverage information and to reach the correct BCBS department to check the claim status or disputes of the claim. Availity provides administrative services to BCBSIL. Benefits will be determined once a claim is received and will be based upon, among other things, the member’s eligibility, any claims received during the interim period and the terms of the member’s certificate of coverage applicable on the date services were rendered.Īvaility is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Verification of eligibility and/or benefit information is not a guarantee of payment. Be sure to include your name, direct contact information, tax ID or billing NPI. Questions?Įmail our Provider Education Consultants. Learn more about BlueCardįor Federal Employee Program ® (FEP) members, eligibility and benefits can be obtained by calling 80. Blue Cross Community MMAI (Medicare-Medicaid Plan) SM – 87įor out-of-state Blue Cross and Blue Shield members, call the BlueCard® Eligibility Line at 800-676-BLUE (2583) for eligibility and benefit verifications.Blue Cross Community Health Plans SM (BCCHP) – 87.For additional details, refer to the Eligibility and Benefit IVR Caller Guideįor government programs member information, the provider customer service and eligibility verification phone numbers are as follows: Checking via Telephoneįor most BCBSIL members, if you cannot submit your eligibility and benefit inquiries online, this information can also be easily obtained through our Interactive Voice Response (IVR) automated phone system at 80, available Monday through Friday, 6 a.m. * These benefit categories will only appear if applicable to the services being rendered. Our staff remains available to assist with these benefit inquiries as needed. Preauthorization indicators and contactsįor some patients, your web transactions may instruct you to call BCBSIL Provider Customer Service to obtain benefit details.Out-of-pocket (original and remaining amounts).Deductible (original and remaining amounts). ![]() With Availity’s Eligibility and Benefits Inquiry, users can access printable results that include up to date benefit information. Providers are strongly encouraged to use the Availity ® Essentials or their preferred vendor for eligibility and benefit verifications. When services may not be covered, members should be notified that they may be billed directly. ![]() It’s strongly recommended that providers ask to see the member’s ID card for current information and photo ID in order to guard against medical identity theft. Eligibility and benefit quotes include membership verification, coverage status and other important information, such as applicable copayment, coinsurance and deductible amounts. Patient eligibility and benefits should be verified prior to every scheduled appointment.
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