If you want more information on how to obtain prior authorization, please call Customer Service at 800-638-0449. Blue Cross Blue Shield Federal Phone Number. Claims - SEBB - Regence Prior Authorized determinations are not a guarantee of benefit payment unless: A physician, Womens Health Care Provider, nurse practitioner, naturopath, clinical social worker, physician assistant, psychologist, dentist, or other practitioner who is professionally licensed by the appropriate governmental agency to diagnose or treat an injury or illness and who provides Covered Services within the scope of that license. There is a lot of insurance that follows different time frames for claim submission. For inquiries regarding status of an appeal, providers can email. Can't find the answer to your question? Regence BlueCross BlueShield of Oregon Clinical Practice Guidelines for Mail your claim and supporting document(s) to the address below: Alternatively, you may send the information by fax to, Have your knowledge and agreement while receiving the Service, Be prescribed and approved by your Provider; and. Preferred Retail: A Network Pharmacy that allows up to a 90-day supply of maintenance prescriptions and access to up to a 30-day supply of short-term prescriptions. Proving What's Possible in Healthcare 10700 Northup Way, Suite 100 Bellevue, WA 98004 Including only "baby girl" or "baby boy" can delay claims processing. You may send a complaint to us in writing or by calling Customer Service. regence blue shield washington timely filing Assistance Outside of Providence Health Plan. All hospital and birthing center admissions for maternity/delivery services, Inpatient rehabilitation facility admissions, Inpatient mental health and/or chemical dependency services, Procedures, surgeries, treatments which may be considered investigational. You must appeal within 60 days of getting our written decision. RGA's self-funded employer group members may utilize our Participating and Preferred medical and dental networks. The 35 local member companies of the Blue Cross Blue Shield Association are the primary points of contact for Service Benefit Plan members. Chronic Obstructive Pulmonary Disease. If you are deaf, hard of hearing, or have a speech disability, dial 711 for TTY relay services. Wellmark BCBS of Iowa and South Dakota timely filing limit for filing an initial claims: 180 Days from the Date of service. Appropriate staff members who were not involved in the earlier decision will review the appeal. Box 1388 Lewiston, ID 83501-1388. www.or.regence.com. If a provider or capitated entity fails to submit a dispute within the required timeframes, the provider or capitated entity: Waives the right for any remedies to pursue the matter further Regence Medical Policies Services that involve prescription drug formulary exceptions. Lastupdated01/23/2023Y0062_2023_M_MEDICARE. You cannot ask for a tiering exception for a drug in our Specialty Tier. That's why Anthem uses Availity, a secure, full-service web portal that offers a claims clearinghouse and real-time transactions at no charge to healthcare professionals.