For providers participating in the blue cross and blue shield of north carolina blue cross nc provider network blue cross nc is pleased to provide the webbased edition of the blue book, our provider reference manual. Each historic provider manual is archived on the scdhhs website during a transition. Notice of nondiscriminationlanguage services if your primary language is not english, language assistance services are available for you, free of charge. Table 1 lists some common situations when a beneficiary has both medicare and other. Find a participating vision provider by using this online tool. To view pdf documents, you will need adobe acrobat reader.
May 15, 2015 page 6 of 118 2015 wellcare south carolina provider manual table of revisions. We understand that maintaining a healthy community starts with providing care to those who need it most. The new manuals are available on this section of the scdhhs website. State of south carolina state health plan benefits. Bcbsnc provides blue esm to providers free of charge. The blue book provider manual blue medicare hmo and blue medicare ppo supplemental guide is a comprehensive reference manual designed to assist you and your office staff by offering the information necessary to effectively understand and administer blue medicare hmo sm and blue medicare ppo sm member health benefit plans, health coaching and. If you have any questions about these materials or about first choice, call provider services at 18007416605.
View all the latest bluecross news announcements and monthly newsletters for providers. First choice by select health of south carolina provides these reference materials to our providers for use when treating first choice members. This manual provides a comprehensive overview of the asd service provider policy and procedure for licensed independent practitioners. Hmo blue texassm quick reference guide blue cross blue. A feeforservice plan fep blue focus with a preferred provider. Add or remove provider secured services users, or change access for existing users. Cpt fivedigit codes, descriptions, and other data are ed 2015 american. Keep track of hipaa 5010 and icd10 updates by visiting the hipaa critical center. For status of claims filed to bcbstx, contact or a web vendor of your choice or call the toll free provider customer service number indicated on the members id card or as listed on the previous pages for the appropriate plan. The manual is organized into the following sections. Jul 1, 2010 the most current version of the provider manual is maintained on the scdhhs continued support of the south carolina medicaid program. The most recentu bl e booksm provider manual blue medicare hmo sm and blue medicare ppo sm supplemental guide, as well as additional policy and resource information, can be found on the blue cross nc website at. Find hipaa compliance and medicare supplement appeal forms.
Jul 25, 2017 aarp medicarerx plans united healthcare pdf download aarp health insurance plans pdf download medicare replacement pdf download sc mediaid reason code cs. Provider blue book blue cross blue shield of north carolina. For immediate assistance, please call us at 8772741715. Professional provider manual an independent licensee of the blue cross blue shield association.
Blue cross community centennial plan blue cross blue shield. Providers who use the forms they download over time should check back. Bluecross blueshield of south carolina may, in some cases, request additional medical records and. This administrative office manual for providers is part of that commitment. When a member receives the vaccine at an innetwork provider, the shp will cover the vaccine and the administration fee in the doctors office. Blue cross and blue shield service benefit plan fep blue opm.
August 2015, effective november 15, 2015 july 31, 2016 a. You will periodically receive updates to this manual. If your primary language is not english, language assistance services are available to you, free of charge. Blue cross and blue shield of north carolina blue cross nc is a medicare. Sample select health physicians request for transfer of member. Attorneys fees and costs the shared fees and costs of the nonbinding mediation and arbitration e. We hope that this manual will make your interaction and collaboration with us as efficient as possible. Description of fee schedule reimbursement methodology policy. Aarp medicarerx plans united healthcare pdf download aarp health insurance plans pdf download medicare replacement pdf download sc mediaid reason code cs. Florida blue may notify providers of updates in a variety of ways, depending upon the nature of the update, including mailings, publication in blueline, our provider newsletter, or posting to our website at to access the provider manual information click the buttons below. The bcbsil provider manuals are comprehensive guides for blue cross community health plans sm, blue cross community mmai medicaremedicaid plan sm, blue cross medicare advantage hmo sm, blue cross medicare advantage ppo sm, blue choice ppo sm, hmo and ppo professional and facility providers. When a contracting provider uses a noncontracting provider either in or out of state to perform a portion of a professional service e. Download provider manuals for professionals, facilities, and others for more on our programs and policies. The purpose of the bcbsaz advantage provider operating guide is to communicate expectations and set forth policies and procedures as an administrative tool for providers and office staff.
It provides you and your office staff with important information as you serve blue cross community centennial members andis incorporated by reference into your new. The purpose of this manual is to provide pertinent information to asd service providers for participation in the south carolina medicaid program. Our provider manuals give an overview of our plans, policies and procedures. Bluecare tennessee provider administration manual mar 1, 2017. The provider manual sets forth the detailed polices, procedures and requirements for the participation of the professional contracting providers under the ppo contracts. Accepts pdf documents created in adobe acrobat version 1. These tools let you quickly and easily send electronic fund transfers, view benefits and see authorizations and claims. Our hope is that blue book will make it easier for you and your staff to collaborate with us in providing excellent service to your blue cross nc patients. If you need assistance using my insurance manager, please call our provider relations and education team at 8002882227, extension 44730. Bluecross blueshield of tennessee statement of purpose. Durable medical equipment bluecross blueshield of south. Anthem blue cross and blue shield provider manual co page 10 of 196 revised.
Table of contents blue cross blue shield of michigan. It is a comprehensive reference guide for our products, valueadded programs and services. This bimonthly publication provides news, suggestions and tools that make it easier for you to do business with humana. Institutional claim payers list 0309 2015 mar 9, 2015 aarp medicare supplement plans medicare network, former payer id. Plan id cards issued starting may 1, 2015, also show the healthy michigan. Blue cross complete provider manual pdf blue cross blue shield. Introduction bluecross blueshield of tennessee, inc.
Welcome to the florida blue manual blue cross and blue shield of florida, inc. Provider manual for physicians, hospitals and healthcare providers july 9, 2019. Bluecross blueshield of tennessee provider administration manual 12 i. State health plan shp medical providers cover the shingles vaccine as an innetwork pharmacy benefit through bluecross blueshield of south carolina. We cannot guarantee the availability or quality of your viewing experience on an unsupported browser. Find innetwork providers and facilities for your patient. Blue dot changes identify revisions to the manual significant revisions to the blue cross complete provider manual are identified on the affected pages by means of a blue dot. The comprehensive source of policies and procedures. Aarp health insurance plans pdf download medicare replacement pdf download aarp medicarerx plans united healthcare pdf download medicare benefits pdf download medicare coverage pdf download medicare part d pdf download medicare part b pdf download.
Claims for billable services provided to plan members must be submitted. Learn more about what you can expect working with us. Latest provider news about policies and procedures. Blue cross and blue shield of kansas is the largest health insurer in the state of kansas. Medical record transfer policy for primary carespecialists. Changes to the blue cross manual occurring since the previous. Any section of this manual may be updated at any time. Mar, 2015 in december 2008, the north carolina department of health and human services dhhs awarded a contract to computer sciences corporation csc. It will also help you guide through eligibility verification, precertification and claims filing. Provider blue book blue cross blue shield of north. The manual is available to providers for download to.
Anthem provides health care professionals with supporting resources to help your relationship with us run as smoothly as possible. The bluecard program provider manual blue cross blue shield. Medical providers arkansas blue cross and blue shield. The bcbsil provider manual is a comprehensive guide for ppo, hmo and bluechoice select professional and facility providers.
Download a hard copy pdf of the providerpharmacy directory. The following information is provided to assist your plan with provider education about bluecard and interplan business. Enter the word or phrase that is being searched for. Blue cross nc is pleased to provide the webbased edition of the blue book, our provider reference manual. The manual is organized into the following sections for your convenience. My insurance manager bluecross blueshield of south carolina. Provider manual blue medicare hmosm and blue medicare pposm. Provider administrative office manual june 2019 updated june 12, 2019 1 2019 provider office manual introduction established in 1946 in greenville, sc, bluecross blueshield of south carolina is a mutual insurance company now headquartered in columbia, sc.
We offer innovative kansas health insurance coverage, caring customer service, and a full range of health and wellness initiatives for individuals and businesses. Mar, 2015 in december 2008, the north carolina department of health and human services dhhs awarded a contract to computer sciences corporation csc to develop and implement a nc. This manual is designed to provide information and guidelines for facilities, practitioners and other providers who participate in one or more of the bluecross blueshield of tennessee commercial provider networks listed below. If you have never registered, you will need to create a profile. This guide is not meant to be allinclusive and is subject to change. Jan 17, 2018 north carolina medicaid provider manual. Standalone dental and prescription drugs for outofarea subscribers should be submitted directly to the subscribers home plan. We have major offices in columbia, florence, surfside beach, greenville.
Medicare card codes electronic payer id for sc medigap. We would like to show you a description here but the site wont allow us. Were sorry, but this tool does not support your browser. If you choose to access other websites from this website, you agree, as a condition of choosing any such link or access, that arkansas blue cross and blue shield abcbs is not and shall not be responsible or liable to you or to others in any way for your decision to link to such other websites. Wellcare of south carolina partners with providers to develop and deliver highquality, costeffective health care solutions. It will also help you guide through eligibility verification, precertification and claims filing processes for outofarea members. Blue network psm preferred blue network ssm select medicare advantage see section xxiv. Complete provider manual pdf claim filing manual pdf updates and changes. Answers to almost every administrative question available in the provider administration manual and latest newsletters. These manuals set forth the detailed policies, procedures. Ncmmis provider claims and billing assistance guide nctracks. The south carolina department of health and human services scdhhs reorganized its medicaid provider manuals to give them a fresh look, and a userfriendly approach to accessing information. Anthem blue cross and blue shield provider and facility manual.
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