The notice goes on to say that practices that object to this change can file a written appeal with the company within 30 days of receiving the notice and attempt to negotiate the timely filing limit. This means all claims submitted on or after Octowill be subject to a ninety (90) day timely filing requirement. 1, 2019, your Anthem Blue Cross and Blue Shield (Anthem) Provider Agreement(s) will be amended to require the submission of all commercial and Medicare Advantage professional claims within ninety (90) days of the date of service. The company has reportedly notified all practices that have non-Medicare or Medicare Advantage contracts with them that:Įffective for all commercial and Medicare Advantage Professional Claims submitted to the plan on or after Oct. If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly.If you have a contract with one of Anthem’s commercial or Medicare Advantage plans, your window to timely file a claim may be shrinking. BCBSIL makes no endorsement, representations or warranties regarding any products or services provided by third party vendors such as Availity. Availity provides administrative services to BCBSIL. Mental, Behavioral and Neurodevelopmental DisordersĪvaility is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals.Asthma and Asthma-Associated Conditions.We’ve put together some documentation and coding tip sheets for the following conditions: High quality documentation and complete, accurate coding can help capture our members’ health status and promote continuity of care. For complete details, refer to the BlueCard Program Manual.The three-character prefix preceding the member’s ID number is critical for proper routing of BlueCard claims.The program allows you to submit claims for members from other BCBS Plans to the Illinois Plan.To confirm receipt and adjudication progress, check claim status.īlueCard is a national program that enables members of one Blue Cross and Blue Shield (BCBS) Plan to obtain health care services while traveling or living in another BCBS Plan’s service area.Blue Cross Medicare Advantage, c/o Provider Services, P.O.Blue Cross Community MMAI (Medicare-Medicaid Plan), c/o Provider Services, P.O.Blue Cross Community Health Plans, c/o Provider Services, P.O.Mail original claims to the appropriate address as noted below. There are different addresses for Blue Cross Community Health Plans SM, Blue Cross Community MMAI (Medicare-Medicaid Plan) SM and Blue Cross Medicare Advantage SM claims. If necessary, government programs paper claims may be submitted. Box 805107, Chicago, IL 60680-4112.Įlectronic claim submission is preferred, as noted above. If necessary, commercial paper claims may be submitted as follows: For UB-04 (Institutional) claims, visit National Uniform Billing Committee (NUBC)Įlectronic claim submission is preferred, as noted above.For CMS-1500 (Professional) claims, visit National Uniform Claim Committee (NUCC).Please refer to the following websites for assistance with proper completion of paper claim forms: Electronic reports are generated and sent automatically to confirm receipt and identify any errors that need to be rectified prior to adjudication and payment.Claims may be submitted one-at-a-time by entering information directly into an online claim form on the vendor portal or batch claims may be submitted via your Practice Management System (check with your software vendor to ensure compatibility).Advantages include greater security and accuracy of data, along with faster processing and payment.For vendor options and information, refer to the Electronic Commerce page. You or your billing agent will need to utilize a third-party claims clearinghouse vendor such as Availity ® Essentials to submit electronic Professional and Institutional claims (ANSI 837P and 837I transactions) to BCBSIL. For additional information, including Timely Filing Requirements, Coordination of Benefits (COB), Medicare Crossover process and more, please refer to the BCBSIL Provider Manual. This section provides a quick introduction to filing claims with BCBSIL.
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