Thank you for your interest in our Short Term Plan. ALL Kids. Choose between our 3 dental plans today! Submit a separate claim for each member. How to file a dental claim with Blue Cross Blue Shield Alabama? Dental Blue If you use our Care Coordinator services in developing your Plan of Care, and your claim is initiated with Home or Community Services, then your Lifetime Waiting Period will be reduced by half. window.open('https://cicchat.bcbsal.org/I3Root/chatpopup.html?qname=cid_chat&fromUrl='+fromUrl, '', 'width=700, height=600'); If services were rendered in New York or Pennsylvania, then use the state-specific file address PDF. Register With Form - AFP Annual Conference - Association For - An17 Afponline, Identity Call 1-855-890-7416, 8 a.m. - 8 p.m. Central Time, Monday through Friday. If you want to stay on Blue Cross' website, click "Cancel.". Some areas of our site may provide links to other external sites that we don't own, control or influence. How to Submit a Claim - Blue Cross and Blue Shield's Federal Employee (You can fill the form in electronically or complete it by hand.). If your drug is not covered and you think it should be, you may ask us to make an exception to the drug coverage rules by calling the Customer Service Department number on the back of your ID card. if (jsonStr.Availability === 'YES') { #1 Internet-trusted security seal. Family. Include proof that you paid a Medicare Part B premium. 2023, Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association. Phone Numbers. If you want to stay on the Blue Cross website, click "Cancel.". Listed below are claims payment policies and other information for Qualified Health Plans offered by Blue Cross and Blue Shield of Alabama. Dental Blue Benefit Summary Plan Benefit In-Network Benefits Dental Blue 2500A Dental Blue 2000A Dental Blue 1500A Dental Blue 1500B Dental Blue 1000A Dental Blue 1000B MAJOR SERVICES (CONTINUED) Major Services - Prosthetic Services to deductibleInlays, onlays, veneers or crowns Fixed or removable bridges Full or . 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. Register Now. Print and mail the form to the Blue Cross and Blue Shield company in the state that the services were rendered by December 31 of the year following the year you received service. Outside the United States. From October 1 through February 14, we are available 7 days a week. if (userAction === 'onclick') { Your doctor or other prescriber must give us a statement that explains the medical reasons for requesting an exception. 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. Mail original claims to the appropriate address as noted below. As an Alfa 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. English, Download the overseas retail prescription drugclaim form: Three forms are also available to aid providers in preparing an appeal request. 450 Riverchase Parkway East 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. If you do not know this information, please contact us at 205-220-7725 or fax your request to 205-220-6354. dental, vision, hearing and fitness benefits at no added cost . If you receive services from an out-of-network provider, these services may not be covered at all under the plan. 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. Patient & Claim. PDF Dental Payers - Availity Available plans and pricing may vary depending on whether you purchase your plan on or off the Health Insurance Marketplace. Note: If you are a Blue Cross and Blue Shield of Alabama customer and need to reach us by phone, please use the telephone number (s) on the back of your ID card. Provider Enrollment For standard policies - all Qualified LTC expenses will be paid in full until you reach your Maximum Monthly Benefit (31 x your Daily Benefit Amount). **Dental Blue Plus is a Health Insurance Marketplace plan. Liferay.on( PDF Provider Phone Numbers 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 Thank you for your interest in our Short Term Plan. }).then(function(data) { HealthEquity is our business associate and is an independent company that provides account-based plan services to Blue Cross. Need to submit a claim? *Please do not contact LifePlans unless you have already contacted Blue Cross and Blue Shield of Alabama to start your claim. We make it easy to manage your healthcare finances, claims and health information. An EOB is not a bill. For example, if an Alabama physician provides services to a member with Blue Cross and Blue Shield of Kansas coverage and a post-service appeal is needed, the physician should fill out the appropriate form from above and submit it to Blue Cross and Blue Shield of Alabama. HealthEquity has agreed to follow Blue Cross' privacy and security policies regarding the confidentiality and protection of your personal health information. 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. An employee or dependent who loses coverage under Medicaid or a State Children's. Claims must be submitted and received by us within 24 months after the service takes place to be eligible for benefits. HealthEquity has agreed to follow Blue Cross' privacy and security policies regarding the confidentiality and protection of your personal health information. Only available through. Health . A primary plan is one whose benefits for a person's healthcare coverage must be determined first without taking the existence of any other plan into consideration. Call the National Information Center at 1-800-411-BLUE (2583) weekdays from 8 a.m. to 8 p.m. Eastern time. Your Lifetime Waiting Period begins after you have been deemed Chronically Ill (or to have a significant Cognitive Impairment) and you have incurred one Qualified Long-Term Care expense. 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. 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. We reference sites that we think might be useful or of interest to you, but we are not responsible for the content or privacy practices used by other site owners. 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. In some cases, the plan requires that you or your treating provider precertify the medical necessity of your care. There is a grace period of three months for all monthly premium payments after the initial premium payment. 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. An application, from the Enrollment section, is needed for any provider in the following situations: This function gets loaded when everything, including the portlets, is on Contact Us | Alabama Department of Public Health (ADPH) Shop On Exchange Shop Off Exchange HOW TO BUY AN AFFORDABLE CARE ACT (ACA) PLAN You are about to leave Blue Cross and Blue Shield of Alabama's website and enter a website operated by HealthEquity. . Node:bclrprvappp1001.corp.bcbsal.org:8080, Pre-Service Review for Out-of-Area Members. 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 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. Reimbursement will be sent to claimant; no claims are paid directly to provider. As an Alfa 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. Call the IVR: 205-220-6765. If you want to stay on the Blue Cross website, click "Cancel.". To ask for a formal decision about the coverage if you disagree, print and complete the appropriate form below and fax it to 1-800-693-6703 or mail to Prime Therapeutics LLC, Attention: Part D Appeals Department, 1305 Corporate Center Dr. How to File a Claim Call Preferred Long-Term Care (LTC) Customer Service (1-888-331-4188) to complete the Claims Intake Form over the telephone. 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. 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. By clicking "Next", you are acknowledging that you would like to submit your application and continue onto the payment page otherwise, click "Cancel". Home - provider.bcbsal.org You can file your expenses for reimbursement as frequently as you want. extra cost. Find out More A Qualified Health Plan is an insurance plan that has been certified by the Health Insurance Marketplace and provides essential health benefits, follows established limits on cost sharing and meets other requirements under the Affordable Care Act. The case number, contract number and/or accident date you've entered does not match our records. 1.833.663.8713 Other ways to connect By mail Credence Blue Cross and Blue Shield 450 Riverchase Parkway East Birmingham, Alabama 35244 Physicians and providers Credence Blue Cross and Blue Shield 450 Riverchase Parkway East Birmingham, Alabama 35244 This link takes you to another website. Blue Cross Blue Shield FEP Dental - Forms */ Payer Name: Blue Cross Blue Shield of Alabama - thePracticeBridge We use cookies to improve security, personalize the user experience, enhance our marketing activities (including cooperating with our marketing partners) and for other business use. In certain situations, a claim may be reprocessed and denied retroactively, even after it has been paid. Call Customer Service at 1-855-504-BLUE (2583), 8 a.m. - 8 p.m. EST Monday - Friday, or Contact Us for further assistance. Find your smile. Blue Cross Blue Shield FEP Dental - Contact Us Additional details about this and other exception review details can be found in the Claims and Appeals section of your benefit booklet. MAIL US Corporate Office Address 450 Riverchase Parkway East Birmingham, Alabama 35244 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. CPT codes, descriptions and data copyright 2022 American Medical Association. Brush up on important dental plan details Download your FREE dental guide to learn more about the range of plans available to you. method: "GET", Technology, Power of Us, Delete BCBS FEP Dental Claim Form View PDF. dentists throughout Alabama. All rights reserved. By clicking "Next", you are acknowledging that you would like to submit your application otherwise, click "Cancel". Download the overseas medical claim form: Questions? To continue to this website, click "Accept." Each time Blue Cross processes a claim submitted by you or your healthcare provider, we send you an Explanation of Benefits (EOB). Node:bclrprvappp1002.corp.bcbsal.org:8080, Pre-Service Review for Out-of-Area Members, Anesthesia Sedation for Dental or Oral Surgery Procedures, Notification of Noncovered Dental Services, Predetermination of Benefits for Veneers and Anterior Crowns. Enroll as a Blue Cross provider, update provider information, or begin the credentialing/recredentialing process. Drug exceptions timeframes and enrollee responsibilities. You can view your personal EOBs through your MyBlue account. Fax (provider credentialing applications and related documents): 205-220-9545. Patient Consent Form for Provider Submitted Appeals View PDF. To continue to the HealthEquity website, click "Accept."