Here’s my NPI and Tax ID” * Ask the rep to verify mental health outpatient benefits * Tell them that you will be filing claims in your local state — “Services will be rendered in _____” * If they quote you a coinsurance or deductible, check out guide about understanding them here. BASIC BENEFITS: • Hospitalization – Part A coinsurance plus coverage for 365 additional days after Medicare benefits end. We understand that it's important to actually be able to speak to someone about your billing. If your question involves other party liability/duplicate coverage, pre-existing conditions or payment recovery, specialists are available to assist you after 8 am. The Blue Cross Blue Shield Association is an association of independent, locally operated Blue Cross and Blue Shield companies. Blue Cross Blue Shield of Michigan and Blue Care Network members under age 65. But being large doesn't mean we forget the individual needs of our members. We provide free eligibility and benefits verification as part of our billing service so you can skip insurance phone calls. program, falls and breaks his arm while hiking in Yellowstone, he will be charged the rate Blue Cross Blue Shield of Wyoming has negotiated with the local hospital rather than paying the steep fees he would otherwise encounter. The Blue Cross Blue Shield Association is an association of 36 independent, locally operated Blue Cross and/or Blue Shield companies. Cannot breathe or is choking. Swedish is in-network with most Blue Cross Blue Shield out-of-state insurance plans. © 2021 Blue Cross Blue Shield Association. Blue Cross Blue Shield of Michigan is proud to be the state's largest insurer, and your insurer. To view this file, you may need to install a PDF reader program. If your state has multiple brands (WA, CA, OR, NY, NJ, to name just a few) then you’ll want to ask for the exact address to file to. ... 3 out of 4 Years This website is operated by Horizon Blue Cross Blue Shield of New Jersey and is not New Jersey’s Health Insurance Marketplace. Insurance Reimbursement Rates for Psychotherapy, Insurance Reimbursement Rates for Psychiatrists, Beginner’s Guide To Mental Health Billing, insurance billing service exclusively for mental health providers, eligibility and benefits for mental health outpatient providers, Inquire about our mental health insurance billing service, offload your mental health insurance billing, Verify eligibility and benefits via a phone call, We charge a percentage of the allowed amount per paid claim (only paid claims). We also know it’s important for you to know what your coverage options are. See how to find out what’s covered by your Blue Cross and Blue Shield of Minnesota or Blue Plus health plan. Denny has interviewed hundreds of mental health practitioners to better understand their struggles and solutions, all with the goal of making the professional side of behavioral health a little easier, faster, and less expensive. Blue Cross Blue Shield Association (BCBSA) is a federation of 36 separate United States health insurance companies that provide health insurance in the United States to more than 106 million people. Search for Doctors, Hospitals and Dentists Blue Cross Blue Shield members can search for doctors, hospitals and dentists: In the United States, Puerto Rico and U.S. Virgin Islands. You might have Anthem Blue Cross, for instance, or Regence Blue Shield, or Blue Cross Blue Shield, and to make matters worse the mental health policy for that insurance company might be “subcontracted” (claims are sent to and handled) by a different insurance company. We're always looking out for your company's bottom line as well. You’ll have to book your travel, lodging and activities, pack and be sure your home is looked after while you’re gone. And hell, don’t just trust me, loook at the back of the card — it always instructs you to do just this! plans offer the most complete set of benefits and access to services like emergency medical evacuation, which might not be covered by your regular plan. If your plans include international travel, GeoBlue has an extensive network of options to meet your needs when living or working abroad for an extended period of time. Is that you make sure to verify the local blue cross blue shield plan and claims address to file to, especially if the claims are subcontracted to a mental health specific plan. Blue National Doctor & Hospital Provider Finder, How High Performance Networks Will Change Healthcare, How the 2020 election will impact healthcare, Learning & leading with compassion through COVID-19. A separate out-of-pocket maximum applies to prescription drugs. Refer to the phone number located on your Blue ID card. Treatment programs can include counseling, behavior modification treatment, inpatient and outpatient … And if your extended travel plans take you abroad, you can ensure you have access to quality care through GeoBlue. A person should go to the emergency room if he or she: May die. Call your BCBS company to find out what your benefits cover while traveling. Bronze plans will have the lowest costs, while platinum plans will have the highest monthly costs. What happens if I see a specialist without a referral? If you want to skip the pain completely, consider trying our insurance billing service exclusively for mental health providers. Blue Cross and Blue Shield of Louisiana and its subsidiaries, HMO Louisiana, Inc. and Southern National Life Insurance Company, Inc., comply with applicable federal civil rights laws and do not exclude people or treat them differently on the basis of race, color, national origin, age, disability or sex. Log in to member site Download member app. My daily insurance billing time now is less than five minutes for a full day of appointments. Provider access for Blue Shield* members doesn't end at the California state border. TheraThink.com © 2021. So we've created this customized site just for employees and retirees of the State of Michigan. You free me to focus on the work I love!”. Members with hearing or speech loss may call our TTY line at 711. Blue Cross Blue Shield’s medical policies can be confusing, when it comes to treating sleep disorders. File is in portable document format (PDF). Blue Cross and Blue Shield of Illinois does not offer those plans shaded in gray below. Ask them where out of state claims should be filed. Trust us! Today’s Blue cross Blue Shield is made up of both non-profit and for-profit entities. He co-founded a mental health insurance billing service for therapists called TheraThink in 2014 to specifically solve their insurance billing problems. Member Discounts Take advantage of member-only discounts on health-related products and services. All Rights Reserved. We take care of this nightmare for you. BASIC BENEFITS: • Hospitalization – Part A coinsurance plus coverage for 365 additional days after Medicare benefits end. Some states will not offer the platinum category. • Free Account Setup - we input your data at signup. Some of them are single state entities; some are multi-state regional companies; some are privately owned; others are publicly traded. (But really, trust us, we’ve filed tens of thousands to Blue Card plans)! Outside the United States. Congratulations! You can call, text, or email us about any claim, anytime, and hear back that day. If selecting this option, it’s a good idea to contact your Blue Cross Blue Shield company to get details about out-of-state coverage if you need it. If you need to locate a doctor or hospital, or need medical assistance services, hotlines are available 24/7. Likewise, a BCBS Wyoming member who falls ill in Dallas would be charged the rate BCBS Texas has negotiated with its local providers. If you are moving to a new state, changing jobs, out of work, getting ready to retire, or your employer has stopped offering insurance, Blue Cross Blue Shield can help. That’s a lot to think about, and the list goes on. A request for Blue Cross to reconsider a coverage decision. For more information, Contact Us or view the Member Handbook. If you want to skip the pain completely, consider trying our insurance billing service exclusively for mental health providers. Your access portal for updated claims and reports is secured via our HTTPS/SSL/TLS secured server. “As private practitioners, our clinical work alone is full-time. 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. Search for Doctors, Hospitals and Dentists Blue Cross Blue Shield members can search for doctors, hospitals and dentists:. Though many Blue Cross Blue Shield plans cover international care in emergency situations, GeoBlue plans offer the most complete set of benefits and access to services like emergency medical evacuation, which might not be covered by your regular plan. We have a wonderfully specific guide on how to verify eligibility and benefits for mental health outpatient providers (click anywhere). to find out what your benefits are if something goes awry while on vacation. Intake / Evaluation (90791) Billing Guide, Evaluation with Medical Assessment (90792). There are some exceptions when care you receive from an out-of-network provider will be covered. Q.I have HMO Blue. You’ve got a lot to do! Blue Cross and Blue Shield of Texas (BCBSTX) Customer Service at 1-888-657-6061. It’s one of the many benefits of belonging to the nation’s oldest and largest health insurance system. so that members can enjoy access to the savings the local Blue Cross Blue Shield plan has negotiated with its doctors and hospitals. Outside the United States. Blue Cross and Blue Shield of Oklahoma does not offer those plans shaded in gray below. Out-of-Area Coverage. As a general rule, Blue Cross Blue Shield of Massachusetts will not pay for care from a specialist without a referral from your PCP. We are your billing staff here to help. But we have some specific, repeatable advice that will help you dramatically reduce your headache handling Out of State Blue Card billing. CURRENT MEMBERS. Filing to out of state Blue Cross Blue Shield plans can be a huge pain! Let us handle handle your insurance billing so you can focus on your practice. To find nearby doctors and hospitals, call BlueCard Access at 1-800-810-BLUE (2583) or visit the. Blue Shield of California has quietly scaled back the national Blue Card program that has allowed its members to receive a range of services out of state in an effort to reduce costs. When traveling within the United States, most Blue Cross Blue Shield members will be covered under the BlueCard program, which connects all 36 individual Blue Cross Blue Shield companies so that members can enjoy access to the savings the local Blue Cross Blue Shield plan has negotiated with its doctors and hospitals. Take your coverage with you, whether you're traveling or living outside of New Jersey. Select Blue Cross Blue Shield Global™ or GeoBlue if you have international coverage and need to find care outside the United States. You'll always be able to get in touch. In Connecticut: Anthem … Anthem Blue Cross and Blue Shield is a DSNP plan with a Medicare contract and a contract with the state Medicaid program. Select Blue Cross Blue Shield Global™ or GeoBlue if you have international coverage and need to find care outside the United States. coverage opens doors in all 50 states and is accepted by over 90 percent of doctors and specialists. Leading the way in health insurance since 1929. Learn how we can handle your mental health insurance billing and credentialing headache: It's our goal to ensure you simply don't have to spend unncessary time on your billing. To access your member services, please visit your BCBS company. The appeal can be for services that you’ve already received or ones you think you should receive. If the program is considered in-network, coverage will be higher than for programs that are deemed out-of-network. This information will make sure that you are sending out of state Blue Cross Blue Shield claims to the right claims office every time. Covered under the State Health Plan. Telligent is an operating division of Verint Americas, Inc., an independent company that provides and hosts an online community platform for blogging and access to social media for Blue Cross and Blue Shield of Texas. You can call, text, or email us about any claim, anytime, and hear back that day. With so much to do, it’s easy to overlook one item that might prove crucial: ensuring that you will be covered if you need medical care while traveling. Eligibility & Benefits Verification (in 2 business days), EAP / Medicare / Medicaid / TriCare Billing, Month-by-Month Contract: No risk trial period. Summary of Benefits & Coverage; Medical Policies ; Rate Review; Forms; Language support. Type of Rehabs Covered by Blue Cross Blue Shield . Again, this can be a huge time-suck, calling and being transferred over and over. Has passed out … There are a few options to find a plan: Stay on a Parent’s Plan: Students under 26 have the option to stay on their parents’ health insurance plan. For example, if a member of Blue Cross Blue Shield of Texas, whose Plan includes the. TheraThink provides an affordable and incredibly easy solution. With the constant changes in provincial health care plans, affordable protection against unexpected medical expenses is important to everyone. All Rights Reserved. Coverage and Plans 2020 Benefits. Most Blue Cross Blue Shield members can rest easy since Blue Cross Blue Shield coverage opens doors in all 50 states and is accepted by over 90 percent of doctors and specialists. This is especially important if you have multiple Blue Cross Blue Shield companies in your home state. Select Blue Cross Blue Shield Global™ or GeoBlue if you have international coverage and need to find care outside the United States. Substance Use Treatment & ResourcesLearn more about substance use disorders and find a treatment provider that meets your needs. If your plans include international travel. Thank you. Blue Cross Blue Shield members can search for doctors, hospitals and dentists: In the United States, Puerto Rico and U.S. Virgin Islands. Add in the unnecessarily difficult insurance billing system and we run the risk of working way over full-time. We provide this service, of course. If you can't find what you need, call the Customer Service number on the back of your enrollee ID card and we'll help. NEW MEMBERS. Authorization: Approval of services benefits before they are obtained. Blue Cross Blue Shield’s individual and family plans fall into 3 or 4 categories, depending on your state: bronze plans, silver plans, gold plans, and platinum plans. Every provider we work with is assigned an admin as a point of contact. For State of Kansas employees, customer service representatives are available from 8 am to 5 pm. Our data is encrypted and backed up to HIPAA compliant standards. Ask them “Where do I file claims in _____ State?” and “Please tell me the claims address” and finally, if you file claims electronically, ask “Can you let me know the payer ID?”. We’re happy to help. You want to know you can call your billing admin, a real person you've already spoken with, and get immediate answers about your claims. If you’re a GeoBlue member, call collect at 1-610-254-8771, or 1-800-257-4823 from inside the U.S. Your Blue Cross and Blue Shield of Illinois (BCBSIL) benefits are designed to provide coverage for the care you need, encourage you to maintain your good health and help you manage your health care costs. That's why Blue Access includes reporting tools designed to help you track and better control your health care spending. Our form finder can retrieve your often used forms in an instant. For example, if a member of Blue Cross Blue Shield of Texas, whose Plan includes the BlueCard program, falls and breaks his arm while hiking in Yellowstone, he will be charged the rate Blue Cross Blue Shield of Wyoming has negotiated with the local hospital rather than paying the steep fees he would otherwise encounter. My cost is a percentage of what is insurance-approved and it’s my favorite bill to pay each month! Anthem Blue Cross and Blue Shield is the trade name of: In Colorado: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. You will be covered for emergency services in the U.S. even if the emergency services provider is not part of the Blue Cross and Blue Shield of Texas (BCBSTX) network. The steps are simple and there are just three: Not as hard as you think, but honestly, this is a pain in the butt and this is why many providers end up hiring TheraThink (we turn these around in two days for free). 99.9% of the time you do this! To live free of worry, free of fear, because you have the strength of Blue Cross Blue Shield companies behind you. Here are a few steps you can take to take charge of your health while traveling: To learn more, visit BCBS.com or the GeoBlue website. Call 1-800-851-2227 Find an Agent Find a Member Center Options for Everyone Individuals & Families Shop Plans Medicare Supplement Shop Senior Blue Businesses Shop Group Plans Why […] So even if they are from a different state, file to your local blue cross blue shield. Coverage can also vary depending on the treatment program. The BlueCard® Program allows us to offer some of the largest networks coast to coast so our members can access healthcare services while traveling or … Our mental health insurance billing staff is on call Monday – Friday, 8am-6pm to ensure your claims are submitted and checked up on with immediacy. Filing to out of state Blue Cross Blue Shield plans can be a huge pain! Drop us a line via our contact page or a call. 24 Hour Nurse Advice Line, your 24-hour nurse help line at 1-844-971-8906 (TTY 711). We’ll get you sorted in no time. Verify your international benefits with your Blue Plan before leaving the United States, or purchase a. Now you’re ready to file. This plan has an out-of-pocket maximum of $3,100 per member ($6,200 per family) for in-network services and $6,000 per member ($12,000 per family) for out-of-network services. But quickly, the basics: * Call and get a rep on the phone (always) * Hit 0 or say representative until it works * Ask to verify your network status — “am I in network with your insurance panel? To find detailed plan information (such as your claims history and Blue Cross ® Health & Well-Being), log in to your account at bcbsm.com.. If you aren’t sure what’s covered, it’s a good idea to call your Blue Cross Blue Shield company to find out what your benefits are if something goes awry while on vacation. Blue Cross and Blue Shield of Minnesota offers individual and group health plans. These limits will vary depending on the policy and the state. A medical out-of-pocket maximum is the most you pay for expenses in a plan year. Questions? Blue Cross and Blue Shield of Louisiana is licensed to sell products only in the state of Louisiana.