<> Beaumont, TX 77702-1954 In Texas, Magellan uses the American Society of Addiction Medicine (ASAM) criteria as the basis for the utilization reviews of substance use disorder cases. endobj Predetermination form and Connect with us about any general, media or sales inquiries. Blue Cross Blue Shield members can search for doctors, hospitals and dentists: In the United States, Puerto Rico and U.S. Virgin Islands. Click the link below to find the provider portal for your needs. Mail your payment to the address on your premium invoice or learn about other convenient ways to pay your bill. Are you a member looking to access behavioral health or EAP services sponsored through your employer? Magellan recommends Claims Courier for low volume claim submitters who dont want to use a clearinghouse. For status call: The form cannot be used for any other purpose except to request prior authorization of a healthcare service. Email to submit provider inquiries and questions, Blue Cross and Blue Shield of Texas Find plan-specific and program resourcesfor Texas STAR, STAR Kids and CHIP. Magellan is committed to the fight against the opioid epidemic and other substance use disorders (SUDs) affecting far too many of our family members and friends. Most PDF readers are a free download. Maryland Heights, MO 63043 . 3 0 obj endobj Through the Homeless Outreach Positive Engagement intensive case management program, Magellan has helped 81% of members obtain housing and 61% reduce their number of hospital days.1. Fax: 1-713-663-1227 Email to submit provider inquiries and questions, North Texas Dallas, Fort Worth, East Texas (ExcludesBastrop, Bell, Bosque, Burleson, Burnett, Caldwell, Falls, Fayette, Hays, Hill, Lee, Leon, Limestone, Madison, Milam, McLennan, Robertson, Travis, Wichita and Williamson counties), Blue Cross and Blue Shield of Texas endobj External link You are leaving this website/app (site). A Claims Courier Demo can be accessed at: Claims Courier is a free web-based data entry application. Complete the appropriate claim form - CMS-1500 forms are required for outpatient services and UB-04 forms are required for inpatient services. 2615 Calder St, Suite 700 Attn: Predetermination Dept. Please be aware that inquiries and email boxes are not monitored 24/7. Utilization Management/Medical Management/Case Management. Upon receipt of your message, New Directions will fax or mail you the . What is the appeals process? The toolkit includes coverage and reimbursement options for postpartum depression through Medicaid, CHIP, the Healthy Texas Women Program, the Family Planning Program and other referral options. 136 0 obj <> endobj In addition, some sites may require you to agree to their terms of use and privacy policy. Box 710400 . Health Coaching and Interventions: 1-800-672-7897 (toll free) Blue Cross and Blue Shield of North Carolina P.O. <> Paper Claims must be submitted to the below addresses (claims are not accepted at the Care Management Center in Newtown): MBH-Bucks, PO Box 1715, Maryland Heights, MO 63043, MBH-Cambria, PO Box 2157, Maryland Heights, MO 63043, MBH-Lehigh, PO Box 2127, Maryland Heights, MO 63043, MBH-Montgomery, PO Box 2277, Maryland Heights, MO 63043, MBH-Northampton, PO Box 2065, Maryland Heights, MO 63043. We're here to help answer your questions. 1-800-749-0966 Resubmitted claims should include the Date of Original Submission and Claim number if applicable. Submit completed forms to: In accordance with applicable law, Magellan will pay clean claims within 45 days of the date of receipt. endstream endobj 137 0 obj <. %PDF-1.7 Please emailwomenshealth@hhsc.state.tx.uswith any questions. Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. . Please select the appropriate version of the form below based on the members you serve. The new Texas Clinicians Postpartum Depression Toolkit is intended to be a resource for Texas clinicians on screening, diagnosis and treatment of postpartum depression. Together, we're committed to making a meaningful difference in the health of all Floridians. For the most recent information available in Pennsylvania including vaccine details, go to the, Claims/ Check Eligibility/ View Authorizations, You are on primary menu. Box 272540, Chico CA 959272540 Phone Number: (800) 541-6652 Is Blue Shield MHSA the same as Magellan? Blue Cross and Blue Shield of Texas hbbd```b``A$ Mailing address (for paper claims): Blue Shield of California Mental Health Service Administrator (MHSA) P.O. 1001 E. Lookout Drive. Please provide the Tax Identification Number, NPI, and if applicable, Medicare Numbers for your provider when contacting Network Management. Email to submit provider inquiries, Phone: 1-972-766-1380 Authorization In an effort to make the authorization process easier for our EAP providers, New Directions EAP offers an authorization prompt on its telephone system (800-624-5544, prompt 3). BCBS Provider Phone Number. Services include outpatient therapy, psychological testing, inpatient care, partial hospitalization, residential treatment, and intensive outpatient programs. See first question and answer above. 1-713-663-1149 Eligibility and benefits contact Availity or other electronic connectivity vendor or call 1-800-442-4607*, Behavioral health services mental health and chemical dependency prior authorization and referrals (includes inpatient, residential treatment center (RTC) programs, partial hospitalization and outpatient behavioral health services) call 1-800-528-7264, Behavioral health services claims status inquiries contact Availity or other electronic connectivity vendor or call 1-800-442-4607*, Behavioral health services claim adjustments call 1-800-442-4607, Eligibility and benefits contact Availity or other electronic connectivity vendor or call 1-877-299-2377*, Claim status inquiries contact Availity or other electronic connectivity vendor, Medical Management Correspondence for the Health Insurance Marketplace for Blue Advantage HMO Members, Blue Cross Blue Shield of Texas Or call your doctor or therapist for help. Blue Cross and Blue Shield of Texas Claims submission address: Blue Cross and Blue Shield of Texas P O Box 660044 Dallas, TX 75266-0044. Blue Cross and Blue Shield of Texas, aDivision of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association, PDF File is in portable document format (PDF). To view this file, you may need to install a PDF reader program. P.O. It is important that you review all EOPs promptly. However, if a provider wishes to request a prior authorization by mail or fax using a form, it must be this form as prescribed by the Texas Department of Insurance. If you need to mail claims: Horizon BCBSNJ. Contact Information. Phoenix Corporate Office Street Address. Tricare Phone Number and Claim Address. Learn how to enroll online for EFT and ERA transactions by referring to theAvaility EFT & ERA Enrollment User Guide. Our innovative care coordination, case and utilization management programs, and vast network of behavioral health and specialty providers facilitate improved access to cost-effective and quality care while improving quality of life for the members we serve. You are on primary menu. Availity provides administrative services to BCBSTX. Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association. Most PDF readers are a free download. By enforcing the timely filing requirement in the provider contract, we are able to focus our resources on what our providers have asked us to do - promptly pay claims. Box 32593 Detroit, MI 48232-0593. Still looking for additional help? Information for Brokers, employers, and providers, as well as links to consumer health and wellness sites. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 19 0 R 25 0 R 26 0 R] /MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Or call your doctor or therapist for help. BlueCare Tennessee is an Independent Licensee of the Blue Cross Blue Shield Association. For exceptions to the standard timely filing requirements for specific states and/or plans/programs, refer to your contract withMagellan and/or its affiliates; see theMagellan state-, plan-and EAP-specific handbook supplements; refer to our timely filingexception grid; or consult state and federal laws. BlueCare / TennCare Select Claims Service Center 1 Cameron Hill Circle, Suite 0002 Chattanooga, . This new site may be offered by a vendor or an independent third party. Magellan's Caroline Carney, MD, MSc, FAPM, CPHQ, recently co-chaired the National Quality Forum Committee with funding from the Centers for Medicare & Medicaid Services (CMS) to develop guidance for healthcare stakeholders to successfully implement the Opioids and Behavioral Health Measurement Framework and ultimately help combat the opioid crisis. 1-361-878-1623 APPEALS . Q. I have proof that I submitted the claim within the timely filing limits. Electronic claims filing system, Benefit disclosure information (form available online), Online: Use Availity Attachments application, Mail form to: The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies. The State Health Benefits Program (SHBP) and the School Employees' Health Benefits Program (SEHBP) Program: 1-800-991-5579. In addition, some sites may require you to agree to their terms of use and privacy policy. One option is Adobe Reader which has a built-in reader. Richardson, TX 75082 BCBSTX Behavioral Health Unit PO Box 660241 Dallas, TX 75266-0241 Fax 877-361-7646 Claims submission address: Blue Cross and Blue Shield of Texas P O Box 660044 Dallas, TX 75266-0044 For prior authorization and referrals managed by Magellan: Magellan Behavioral Health Providers of Texas, Inc. 800-729-2422 You are leaving this website/app (site). For urgent requests only: *interactive voice response (IVR) system to access, you must have document control number (claim number), Eligibility and benefits contact your electronic connectivity vendor, Availity or other electronic connectivity vendor or call 1-800-451-0287*. Richardson, TX 75082-4144 You may direct any questions about the form to Magellan at the phone number on the form. Although it is not preferred, providers may also submit paper claims via a CMS-1500 form (Non-Facility-Based Providers) or UB-04 form (Facility-Based Providers). Blue Shield Final Appeal Resolution Office P.O. P O Box 660044 P.O. Claim Status; For Availity-related questions, please visit the Availity Essentials website or contact Availity Essentials Client Service at 1-800-282-4548, 8 a.m. to 8 p.m. This practice is called balance billing and is not permitted. Out-of-network providers will be paid the Medicare-allowed amount less any member cost-sharing. Fax 877-361-7646, Claims submission address: What should I do? Copy of EOP from the medical/health plan vendor substantiating their denial date. Magellan continuously looks at our processes and procedures to improve service and increase efficiencies. 0 Fax: 713-663-1227 Blue Cross Complete claims P.O. Clean claims are defined as claims that can be processed without obtaining any additional information from the provider or from a third party. To view this file, you may need to install a PDF reader program. 1-915-496-6600, press 2 Q. Dallas, TX 75266-0241 P. O. 2 0 obj Driving directions. 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