Contact us - Regence Uniform Medical Plan (UMP) is a self-insured Preferred Provider Organization (PPO) medical plan offered through the Washington State Health Care Authority. Regency Blue Cross Blue Shield Of Oregon (541) 772-8906 Visit Website Map & Directions 2057 Commerce Dr Medford, OR 97504 Write a Review. Click on it. Learn about Regence Lewiston, ID office. TTY users should call, 1-800-325-0778; or your Medicaid Office. MAXIMUS will review the file and ensure that our decision is accurate. If you do not obtain your physician's support, we will decide if your health condition requires a fast decision. Call UMP Customer Service for help with any questions when you or a family member is covered by more than one plan. First, you'll need to gather these documents: An itemized bill from your provider that describes the services and charges. Premera Blue Cross Your life. Customer Service will help you with the process. Regence BlueShield - FEPPO Box 31207Salt Lake City, UT 84131, (Attended sleep study at outpatient part of a hospital, home hospice, organ/tissue transplants, clinical trials. Attn: Member Appeals Address: 200 SW Market St Portland, OR, 97201-5715 United States See other locations Phone: Website: www.regence.com Employees (this site): Actual Employees (all sites): Actual Revenue: Modelled Year Started: Incorporated: ESG ranking: ESG industry average: What is D&B's ESG Ranking? 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. | Care Management Programs. endobj An appeal is a request from a member, or an authorized representative, to change a decision we have made about: Other matters included in your plan's contract with us or as required by state or federal law, Someone who has insurance through an employer, and any dependents they choose to enroll. You get a vaccine or flu shot from an out-of-network provider. The member can appeal, or a representative the member chooses, including an attorney or, in some cases, a doctor. Waiting too long on the phone, waiting room, in the exam room or when getting a prescription, The length of time required to fill a prescription or the accuracy of filling a prescription, Access to health care benefits, including a pre-authorization request denial, Claims payment, handling or reimbursement for health care services, A person who has bought insurance for themselves (also called a contract holder) and any dependents they choose to enroll. In addition, you cannot obtain a brand-name drug for the copayment that applies to the generic drug. Search jobs. Complete the Prescription Drug Claim Form and send it with your pharmacy receipts to: Pharmacy Manual ClaimsP.O. Your budget. BCBS State by State | Blue Cross Blue Shield endobj I . If the decision was after the 60-day timeframe, please include the reason you delayed filing the appeal. 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. Learn how our innovative solutions can help your employees live healthier, while helping you manage your costs. x][o%~`C?3=k7A I87ggglM"_Unx9d,*Wdx cwU74/_C&$jTD/ew|/_t_~suJo~/X7/fTjz=u?|1w_k;vZ]!w??!~pw!cw DG6JOw{v?M.>~h9{/|0 _&CrOL%be_/WWc9U~;?#*bX Fz-w~7`e_ :5ZmLme'UFSgs\\@=~!r)Q;ZDf}Z1^W8qw`v0]wcEo5tLBn-4%x\I[s$8eBM:)$2dY9s>E;& Select a State. Please do not submit attachments (e.g., X-rays, periodontal chartings) with your pretreatment estimate or initial claims submission. Choose the right company to process your complaints and appeals: To appeal online, sign in to your Regence account, select Programs & Resources, and select Appeals. Circumstances beyond the plans control. Out-of-network providers may submit a claim on your behalf. For knee and hip replacement and spine care. See how our affordable Regence plans offer coverage, access and convenienceso you can live your best. 2023 Regence BlueShield. Procedure and diagnosis (codes) or description of the injury or illness, d. Provider's name, address, phone number, and National Provider Identifier (NPI) or Tax ID number, e. For ambulance claims, also include the ZIP code where the member was picked up and where they were taken. Claims not submitted to UMP within 12 months of the date of service will not be paid. If you are a member of another air ambulance's membership program that is a reciprocal partner of Life Flight Network, please make sure you report this to our billing office at (866) 883-9998. CLAIM.MD | Payer Information | OR BCBS (Regence) Payer Information OR BCBS (Regence) Payer ID: 00851 This insurance is also known as: Regence Blue Cross of Oregon Blue Cross Blue Shield of OR REGENCE BLUECROSS BLUESHIELD OF OREGON REGENCE BCBS OF OREGON FEP G00851 Other ID's: 12B41, SB850 Need to submit transactions to this insurance carrier? Please include the following information when requesting an appeal: The plan will send confirmation when it receives your appeal. See what were doing in your community to keep people safe and healthy. PDF Provider Dispute Resolution Process complies with applicable Federal and Washington state civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, gender identity, or sexual orientation. You can submit a marketing complaint to us by calling the phone number on the back of your member ID card or by calling 1-800-MEDICARE (1-800-633-4227). Your provider must submit all clinically relevant information to the plan by phone or fax. 2003 Western Ave # 600, medical equipment supplier, ambulance services, applied behavior analysis services (ABA) or clinical social worker. Username. 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. Regence Bluecross Blueshield of Oregon - Dun & Bradstreet | Rocketreach finds email, phone & social media for 450M+ professionals. Learn more about when, and how, to submit claim attachments. Notice will include explanation why an extension is needed and when the plan expects to act on the claim. You must submit first-level and second-level appeals no more than 180 days after receiving the previous decision. Contact us as soon as possible because time limits apply. Make sure you contact the right company (see below). Regence BlueShield serves select counties in the state of Washington and is an independent licensee of the Blue Cross and Blue Shield Association. See your certificate of coverage for more information on how to file a claim for specific services and supplies. You have other insurance that pays first and UMP is secondary. Medical records from your provider, if applicable. We're ready. Regence Blue Shield of Idaho - FEPPO Box 30270Salt Lake City, UT 84131-0207. Espaol | Programs View our programs and requirements for radiology, inpatient admissions and patient care management. Regence users: make the switch to the Availity Web Portal You have been redirected from the Regence or Asuris Northwest Health Provider Center. Though it is not required, you may want to include the UMP Appeals and Grievance form (for medical services) or the Washington State Rx Services Complaint and Appeal Form (for prescription drugs) with your appeal. 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. 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. To obtain information on the aggregate number of grievances, appeals and exceptions filed with the plan contact Customer Service. There are three levels to the appeals process: first-level, second-level, and external review (independent review). Oregon's Sustainable Cost Growth program, and the ability the state's But there are some circumstances where you will need to submit a claim. For more information about the appeals process, including expedited appeals for urgent or life-threatening conditions and requesting an external review by an Independent Review Organization, read the "Complaint and appeal procedures" section in your plan's certificate of coverage. An appeal for services related to the Centers of Excellence Program must be submitted within 180 days after you receive notice of the denial to Premera.Submit appeals to: Mail:Premera Blue Cross Regence BlueShieldAttn: UMP ClaimsP.O. Regence bluecross blueshield of oregon address You can submit a claim online through your Regence account, or you can fax or mail your claim to Regence. Those documents will include the specific rules, guidelines or other similar criteria that affected the decision. In every state and every community, BCBS companies are making a difference not just for our members, but For the Health of America. Regence BlueCross BlueShield of Utah. Send to Regence Blue Shield in accordance with the terms of your provider contract with Regence. View the toolkit Claims submission Step 4: After you have completed the login details correctly . 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. See Complaints about quality of care in your certificate of coverage to learn more. PO BOX 25956 SALT LAKE CITY, UT 84125 800-662-0876. We are now processing credentialing applications submitted on or before March 6, 2023. Claims determinationsThe plan will notify you of action taken on a claim within 30 days of the plan receiving it. 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. 636 GRAND AVE DES MOINES, IA 50309 800-245-6105. Management - prior auth/pre-service requests), Email: Members: Log in/register at MyBlue Customer eService, Regence BlueShield - FEPPO Box 21709Seattle, WA 98111. Subscribe to online communications receive newsletters and important news via email. You can submit feedback about your Medicare health plan or prescription drug plan directly to Medicare. Use the appeal form below. Claims and clinical appeals address: PO Box 21702 Eagan, MN 55121 Care management Phone: 844-996-0329 Fax: 888-302-9325 2023 holiday closures January 2 May 29 July 4 September 4 November 23 November 24 December 25
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