An EOB is an outline of what services you received from a provider and how your benefits were applied to cover those services. } else { /* To determine your premium, call us at 1-855-488-2515 or click the "Get Started" link to compare your plans today. function() { The plan will only pay for care that is medically necessary and not investigational, as determined by us. 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. Payer Name: Blue Cross Blue Shield of Alabama Payer ID: 510 Enrollment Required (ENR): Yes Type / Model: Commercial/Par State: AL Professional (CMS1500)/Institutional (UB04) [Hospitals] Real Time Eligibility (RTE): NO Real Time Claim Status (RTS): NO Electronic Remittance Advice (835) [ERA]: YES Secondary Electronic Claims (SEC): YES Attorney, Terms of Child up to age 19. Questions? After determining your benefit eligibility, your Lifetime Waiting Period start date will be determined. 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. To determine your premium, call us View the latest providernews. Thank you for your interest in our Short Term Plan. All rights reserved. Double-check every area has been filled in correctly. if (jsonStr.Availability === 'YES') { window.open('https://cicchat.bcbsal.org/I3Root/chatpopup.html?qname=cid_chat&fromUrl='+fromUrl, '', 'width=700, height=600'); Download and complete the appropriate form below, then submit it by December 31 of the year following the year that you received service. Blue Cross and Blue Shield of Alabama enrolls and credentials all individual providers as well as ancillary and facility providers. MAIL US Corporate Office Address 450 Riverchase Parkway East Birmingham, Alabama 35244 CDT codes, descriptions and data copyright 2022 American Dental Association. By clicking "Next", you are acknowledging that you would like to submit your application and continue onto the payment page otherwise, click "Cancel". If you receive services from an out-of-network provider, these services may not be covered at all under the plan. Call Preferred Long-Term Care (LTC) Customer Service (1-888-331-4188) to complete the Claims Intake Form over the telephone. Spanish, Localized To continue to the HealthEquity website, click "Accept." English, Download the overseas retail prescription drugclaim form: Choose a state to see how Blue Cross Blue Shield is working in your community. Blue Cross and Blue Shield of Alabama. It includes the date you received the service, the amount billed, the amount covered, the amount we paid and any balance you're responsible for paying the provider. By clicking "Next", you are acknowledging that you would like to submit your application otherwise, click "Cancel". Select Blue Cross Blue Shield Global or GeoBlue if you have international coverage and need to find care outside the United States. Coordination of Benefits (COB) is a provision designed to help manage the cost of healthcare by avoiding duplication of benefits when a person is covered by two or more benefit plans. Provider Appeals Blue Cross and Blue Shield of Alabama has an established appeals process for providers and physicians. Adults age 19+. 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. Fax (provider credentialing applications and related documents): 205-220-9545. Download and complete the appropriate form below, then submit it by December 31 of the year following the year that you received service. Find out More Start now! We make it easy to manage your healthcare finances, claims and health information. HealthEquity has agreed to follow Blue Cross' privacy and security policies regarding the confidentiality and protection of your personal health information. Drug exceptions timeframes and enrollee responsibilities. CPT codes, descriptions and data copyright 2022 American Medical Association. Technology, Power of Provider Enrollment My Account, Forms in Shop On Exchange Shop Off Exchange HOW TO BUY AN AFFORDABLE CARE ACT (ACA) PLAN 2023, Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association. HealthEquity is our business associate and is an independent company that provides account-based plan services to Blue Cross. checkChatAvailability('onload'); It's easy to protect your smile to the fullest with dental coverage that Information contained in the external sites is not endorsed by BCBSAL. The 34 independent BCBS companies insure more than 107 million members across all 50 states, the District of Columbia, and Puerto Rico 107 M members covered $ 382 M+ invested in community health initiatives 572 K+ Employee volunteer hours Review Blue Cross and Blue Advantage medical and pharmacy policiesor comment on draft policies. Blue Plus **. The case number, contract number and/or accident date you've entered does not match our records. You are about to leave Blue Cross and Blue Shield of Alabama's website and enter a website operated by HealthEquity. USLegal received the following as compared to 9 other form sites. If the out-of-network services are covered, in most cases, you will have to pay significantly more than what you would pay an in-network provider because of lower benefit levels and higher cost sharing. allows healthcare providers to submit claims electronically to Blue Crossand Blue Shield of Alabama. 2023, Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association. 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. Highest customer reviews on one of the most highly-trusted product review platforms. Complete the form following the instructions on the back. Box 3836, Scranton, PA 18505; Blue Cross Medicare Advantage, c/o Provider Services, P.O. ); Use this form to submit a claim to be reimbursed for paying Medicare Part B premiums. Claim forms must be submitted to: Blue Cross and Blue Shield of Alabama 450 Riverchase Parkway East Birmingham, Alabama 35244-2858 Grace periods and claims pending policies during the grace period Heres everything you need to know about it. If you do not know this information, please contact us at 205-220-7725 or fax your request to 205-220-6354. When you receive services from an in-network provider, your provider will generally file claims for you. 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. Here are the forms/documents to add locations and make changes to information and other requests. Submit a separate claim for each patient. Applicable FARS/DFARS apply. $.ajax({ (For example, if your service was provided on March 5, 2022, you have until December 31, 2023 to submit your claim). Blue Cross and Blue Shield of Alabama will send you a Claims Packet to be completed and returned to us. }. 2023 New Directions Behavioral Health. If you have questions, please contact your local Blue Cross and Blue Shield company. The first column represents the states of the US and the second column is the insurance name and the Third column represents the Phone number. $42 /month. Rev 3/2007 What is the dental number for Blue Cross Blue Shield of Alabama? Patient. Brush up on important dental plan details Download your FREE dental guide to learn more about the range of plans available to you. 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? Providing us with your name and email address allows us to contactyou. Claims Payment Policy & Other Information. 450 Riverchase Parkway East (For example, if your service was provided on March 5, 2022, you have until December 31, 2023 to submit your claim). Forms, Real Estate Instructions: 1. (You can fill the form in electronically or complete it by hand.). 'allPortletsReady', If you receive out-of-network services for a medical emergency in the emergency room of a hospital, those services will be paid at the applicable in-network coinsurance amounts for benefits described in your benefit booklet, but subject to the out-of-network calendar year deductible.For emergency services for medical emergencies provided within the emergency room department of an out-of-network hospital, the allowed amount will be determined in accordance with the Affordable Care Act. Call 1-855-890-7416, 8 a.m. - 8 p.m. Central Time, Monday through Friday. Claim submission is supported for primary, secondary and tertiarypayment. Choose between our 3 dental plans today! Include proof that you paid a Medicare Part B premium. 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. Patient & Claim. Enjoy smart fillable fields and interactivity. Quality Care That's Right for YouWhether you need a routine check-up or a specialty procedure, you want the best care you can find.BCBS recognizes doctors and hospitals for their expertise and exceptional quality in delivering care. As a CHA 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. Please note that precertification relates only to the medical necessity of care; it does not mean that your care will be covered under the plan. *Subject to your Calendar Year Deductible. Generally, if precertification is required and not obtained, no benefits will be payable under the plan. If your ID card is not available, you may use one of the Customer Service telephone numbers below. CPT codes, descriptions and data copyright 2022 American Medical Association. Register Now. Make sure your documents include the five following pieces of information as required by the IRS: Provider name (which is Medicare in this case), You can fax the form, along with proof that you paid a Medicare Part B premium, to, You can upload the form through the EZ Receipts mobile app, available at the. Available plans and pricing may vary depending on whether you purchase your plan on or off the Health Insurance Marketplace. USLegal fulfills industry-leading security and compliance standards. Some areas of our site may provide links to other external sites that we don't own, control or influence. */ Experience a faster way to fill out and sign forms on the web. 450 Riverchase Jun 4, 2012 Payers Transitioned to 5010 As of 6/4/2012 Below is a list of the Use professional pre-built templates to fill in and sign documents online faster. url: "/ChatAvailabilityService/getAvailability?queueName=CID" 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. FSAFEDS (Reimbursement Options) Form Visit Page. at 1-855-488-2515 or click the "Get Started" link to compare your plans today. . Outside the United States. Questions? If you are a contracted health plan partner, then you have a dedicated account manager you can call upon at any time for any reason. With US Legal Forms the entire process of completing official documents is anxiety-free. When we receive an electronic claim, you will automatically be set up as an out-of-state provider in our system and can register to use our provider website, ProviderAccess: Once . Overseas members must file claim forms for any covered medical or pharmacy servicesreceived outside of the United States. Already a Blue Cross member and have questions about your current plan? Are you reporting a new case? Claims Administrator 2023 Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue ShieldAssociation. Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association. You can also find our claim forms on our website at: Claims must be submitted and received by us within 24 months after the service takes place to be eligible for benefits. Box 302150 Montgomery, AL 36130 or 135 South Union Street Montgomery, AL www.rsa.state.al.us Customer Service Get access to thousands of forms. USLegal has been awarded the TopTenREVIEWS Gold Award 9 years in a row as the most comprehensive and helpful online legal forms services on the market today. If you want to stay on the Blue Cross website, click "Cancel.". All rights reserved. Applicable FARS/DFARS apply. The route you should take depends on your individual healthcare needs and financial situation. Someone will get back to you within two business days. $('#chat-available').hide(); All Rights Reserved. CDT codes, descriptions and data copyright 2022 American Dental Association. It is your responsibility to ensure that you or your provider obtains precertification. You can reach us at the following number: If you are or believe you may be experiencing a medical emergency,please dial 911 for emergency services.If you or a family member needs immediate assistance, please contact one of our representatives at 800-528-5763. 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. Mail original claims to the appropriate address as noted below. Blue Cross and Blue Shield of Alabama will send you a Claims Packet to be completed and returned to us. 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. All rights reserved. Handbook, Incorporation Get your online template and fill it in using progressive features. Phone Numbers. Features expanded pediatric benefits for children up to the end of the month in which the member turns 19. You can take the Blue Health Assessment, check drug costs, change your address, request a member ID card and more. I am a Broker or Blue Plan partner that wants to visit the Partner Portal. Find your smile. Use this form to submit a health benefit claim for services that are covered under the Blue Cross and Blue Shield Service Benefit Plan. 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. From October 1 through February 14, we are available 7 days a week.
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