Provider Contacts | Provider | Premera Blue Cross You must continue to use network pharmacies until you are disenrolled from our plan to receive prescription drug coverage under our formulary. Learn about dental billing information to help ensure your dental claims are processed quickly and correctly. Oregon - Blue Cross and Blue Shield's Federal Employee Program UMP may cover some supplies through the medical benefit and other supplies under the prescription drug benefit. Learn about dental billing information to help ensure your dental claims are processed quickly and correctly. PO BOX 25956 SALT LAKE CITY, UT 84125 800-662-0876. % If requested, we will supply copies of the relevant records we used to make our initial decision or appeal decision for free. You can also download the appeal form and submit your written appeal by email, fax, or mail:Email: UMPMemberAppeals@regence.comFax: 1 (877) 663-7526, Mail:UMP Appeals and GrievancesRegence BlueShieldPO Box 91015Seattle, WA 98111-9115. All claims must be submitted to UMP within 12 months of the date of service or purchase to prevent denial of the claim. If you want a written response, you must request one. If you have other medical or prescription coverage, Washington State Rx Services Complaint and Appeal Form, WSRxS Multiple Pharmacy Coverage Inquiry Form (Drug Coordination of Benefits). Claims payment, processing, or reimbursement for health care services or supplies. Mail or fax both the claim form and the provider's claim document (or bill) to: Regence BlueShieldAttn: UMP ClaimsP.O. endobj <>>> Requests to find out if a medical service or procedure is covered. In addition, you cannot obtain a brand-name drug for the copayment that applies to the generic drug. 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. 6:00 AM - 5:00 PM ASTFax: 877-239-3390 (Claims and Customer Service)Fax: 877-202-3149 (Member Appeals only)Fax: 866-948-8823 (FEP Care <>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> In every state and every community, BCBS companies are making a difference not just for our members, but For the Health of America. Regence BlueShield in accordance with the terms of your Provider contract with Regence. You should wait until the primary plan has paid to submit a secondary claim to UMP, unless the primary plan's processing of the claim is delayed. Regence bluecross blueshield of oregon address If you or your dependents are enrolled in UMP High Deductible and want to enroll in another health plan, you and your dependents can only enroll in other high-deductible health plans. You or your authorized representative (including a relative, friend, advocate, attorney, or provider) may submit an appeal by using the methods described in the Where to send complaints or appeals section below or by calling UMP Customer Service (medical appeals) or WSRxS Customer Service (prescription drug appeals). 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: PDF Member Reimbursement Form If you buy your prescription drugs at a network pharmacy, your claim will be submitted for you. Send your claim or correspondence to the Blue Cross Blue Shield plan in the state from which the durable medical equipment was sent.Example: You live in Seattle and order parts for a wheelchair from a company in Montana. Phoenix, AZ 85072, Retail Pharmacy Program Premera Blue Cross Blue Shield of Alaska - FEP PO Box 33932 Seattle, WA 98133-0932 Phone: 800-562-1011 6:00 AM - 5:00 PM AST Fax: 877-239-3390 (Claims and Customer Service) Fax: 877-202-3149 (Member Appeals only) Fax: 866-948-8823 (FEP Care Management - prior auth/pre-service requests) Email Members: Log in or register - MyBlue Customer eService You can submit your appeal online, by email, by fax, by mail, or you can call using the number on the back of your member ID card. Media Contact: Audrey Glasby Regence BlueCross BlueShield of Utah Regence . PDF Amendment to Regence Bluecross Blueshield of Oregon Medical Group Agreement Your budget. All features have been transitioned to the Availity Provider Portal. If you have questions about eligibility and enrollment:Employees:Contact your payroll or benefits office.SEBB Continuation Coverage members:Call the SEBB ProgramPhone: 1 (800) 200-1004 Be sure to include any other information you want considered in the appeal. Asthma. To obtain information on the aggregate number of grievances, appeals and exceptions filed with the plan contact Customer Service. You cannot ask for a tiering exception for a drug in our Specialty Tier. Claims submission - Regence REGENCE BS OF UTAH. Chronic Obstructive Pulmonary Disease. Lack of information. You can also get information and assistance on how to submit an appeal by calling the Customer Service number on the back of your member ID card. Get help when you need it. Note:TovieworprintaPDFdocument,youneed AdobeReader. Professional Services are performed by a doctor or other healthcare professional. Oregon's Sustainable Cost Growth program, and the ability the state's 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. Premera Blue Cross Blue Shield of Alaska FEP PO Box 33932 Seattle, WA 98133-0932, Phone:800-562-1011 Appropriate staff members who were not involved in the earlier decision will review the appeal. Espaol | Choose an option. For more specific contact information, choose from the following: Individuals and familiesMedicareEmployersProducersProviders. In every state and every community, BCBS companies are making a difference not just for our members, but For the Health of America. 0. The members full name (the name of the employee, retiree, or dependent covered by the plan), The member ID number (starting with a W on your UMP member ID card), The name(s) of any providers involved in the issue you are appealing, A statement describing the issue and your desired outcome, A copy of the Explanation of Benefits, if applicable, or a list of the claim numbers you are appealing. 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. Completion of the credentialing process takes 30-60 days. Is this your business? Regence BlueShield serves select counties in the state of Washington and is an Independent Licensee of the Blue Cross and Blue Shield Association. Regence BlueCross BlueShield of Oregon, headquartered in Portland, has been serving Oregonians since 1941 and now provides more than 974,000 people with comprehensive health insurance solutions. Regence BlueCross BlueShield of Oregon is an independent licensee of the Blue Cross and Blue Shield Association. <> Step 2: Next, locate the "Login" button at the top-right corner. Note: If you submit your claim by mail, be sure to make copies of your documents for your records. 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. Claims edits If you do not submit your claims through Availity Essentials, follow this process to submit your claims to us electronically. Coding toolkit View our clinical edits and model claims editing. 1 0 obj Learn more about our payment and dispute (appeals) processes. PDF Regence Provider Appeal Form | You can download the appeal form and submit your written appeal by fax or mail: Mail:WSRxS You may need to submit a claim to UMP for payment if: UMP does not cover nor coordinate benefits with workers' compensation claims. If you use mail-order pharmacy and your primary plan uses Costco Mail Order Pharmacy or Postal Prescription Services (PPS) as the network mail-order pharmacy, Costco Mail Order Pharmacy or PPS can process payments for both plans and charge only the remaining unpaid balance. Notice will include explanation why an extension is needed and when the plan expects to act on the claim. Products and networks Learn more about the products we offer and the provider networks that support them. Regence BlueCross BlueShield of Utah is an independent licensee of the Blue Cross and Blue Shield Association. Coronary Artery Disease. WELLMARK BCBS OF IOWA. Learn more about informational, preventive services and functional modifiers. If your prescribing physician asks for a faster decision for you, or supports you in asking for one by stating (in writing or through a phone call to us) that he or she agrees that waiting 72 hours could seriously harm your life, health or ability to regain maximum function, we will give you a decision within 24 hours. 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. Programs View our programs and requirements for radiology, inpatient admissions and patient care management.

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