We do not, in any way, encourage or reward UM decision makers for denials of coverage or limits on access to care. About Excellus BlueCross BlueShield: Excellus BlueCross BlueShield (Excellus BCBS, or Excellus) is a non-profit health insurance company headquartered in Rochester, New York. Our online Find a Doctor feature includes participating health care professionals names, addresses and driving directions, specialties, office hours, and much more. The insurance company uses this number to identify your. There are over 50,000 FLRx pharmacies in the United States who will electronically file your prescription claim. If you are unsure of whether your ID number has changed, call Customer Service at the number listed on your ID card. Please note, there may be significant delays with the processing of documents received by mail at this time. When Excellus BCBS is responsible for the design of your Plan, reviews are performed and certified with the New York State Department of Financial Services to ensure compliance with mental health parity laws. Excellus BlueCross BlueShield, a nonprofit independent licensee of the BlueCross BlueShield Association , is part of a family of companies that finances and delivers vital health care services to about 1.5 million people across upstate New York. It is an 8-character numeric or alphanumeric string. We will not provide benefits for any service or treatment that does not meet the guidelines for the diagnosis of your condition. For your privacy and protection, when applying to a job online, never give your social security number to a prospective employer, provide credit card or bank account information, or perform any sort of monetary transaction. Box 21146. Tip: Some insurance carriers use the policy holders social security number as the insurance Certificate Number. Your BCBS ID card has important contact information to help you reach your BCBS company. accepting responsibility for the outcomes of your decisions. We also offer Behavioral Health Case Management services to our members and their families. Be sure to include your ID number on everything you mail to us. Whether it's for a grievance or a medical appeal, the first step in the process is to file your concern with our Customer Service Department. Employee Administration. Note: This information is not intended to provide medical advice or to take the place of medical care, nor can we guarantee that all requests for authorization will be granted. Binghamton, NY 13902-5266. Your BCBS ID card has your member number, and in some cases, your employer group number. any time, you may also file a complaint with the State Department of Health, (800) 206-8125, or the State Department of Insurance, (800 . If my life or my dependents life is in jeopardy, are you allowed by law to give PHI to anyone else? If you have misplaced or havent yet received your BCBS ID card, a temporary ID card may be available online. Once you have submitted the form to the Health Plan, no other action is required on your part. Visit yourlocal BCBS companys websitefor details. Its a coded way of referring to you and the car insurance policy youve purchased The policy number on an insurance card is shorthand. Step 1: Visit the BIR eReg website. If you forget or arent sure what type of health insurance plan you have (like an HMO or PPO), you can find out on your BCBS ID card. An adjustment amount may appear on your next Monthly Health Statement or Explanation of Benefits. Excellus bcbs participating brokers may register for an online account. A completed form directs the provider to seek payment for the service from the Health Plan (your assignment). (EX: State Farm's NAIC # is located in upper left corner of insurance card.) Time-saving fitness tips for real people on the go. Excellus group number on card : The group plan number is the number your employer is given to identify their employee health insurance policy. . Follow this link to Order a Member Card Online. In most other states, they are the same company and formed an association, the Blue Cross Blue Shield Association. To print/view copies of our most frequently used forms, see. Alabama. Some benefits listed below require providers to authorize services. Please note: Medicare cost information may be found at CMS.gov fee schedule search tool. The card you have will even now work. Prior to your care, you or your provider should contact Customer Service to see what the benefits and prior authorization requirements are for your coverage. 29-I Licensed Health Facilities provide all Core Limited Health-Related Services. Excellus Group Number On Card : Excellus Group Number On Card : Excellus Bluecross . Your bcbs id card has important contact information to help you reach us. See our Privacy Policy for how we use information. BCBS member ID card will have a suitcase logo at the bottom of card which will also help you to identify patient plan like HMO, PPO, POS etc. Read on to understand more about the components of a Blue Cross Blue Shield insurance card and how to read them. Compound Prescription Drug ClaimOpen a PDF. If you have a non-life threatening condition (e.g., sore throat, cold/flu symptoms, or ankle sprain) we encourage you to obtain care at one of the many Urgent Care Centers in your area. In California, Anthem Blue Cross and Blue Shield are actually different companies and are competitors. He has been instrumental in making his firm as one of the leading organizations in the country in generating sustainable rapid growth of the company while maintaining service excellence to clients. What Happens If I DonT Pay National Insurance Contributions? Whether or not your program requires a referral, it is a good idea to discuss your concerns with your primary care physician who may be able to assist in selecting a mental health specialist. Members or providers can initiate a dispute request via the IDRE portal. Consumer-directed healthcare and healthcare debit cards. Information about services, staff, hours of operation and your benefits, including access to routine services as well as after-hours and emergency services, and members' rights and responsibilities; Participate in decision-making with your physician about your health care; Obtain complete, current information concerning a diagnosis, treatment and prognosis from a provider in terms that you can reasonably be expected to understand; Refuse treatment as allowed by law, and be informed by your physician of the medical consequences; Confidentiality of medical records and information, with the authority to approve or refuse the re-disclosure by us of such information, to the extent protected by law; Receive all information needed to give informed consent for any procedure or treatment; Access to your medical records as permitted by New York State law; Express concerns and complaints about the care and services provided by physicians and other providers, and have us investigate and respond to these concerns and complaints; Candid discussion of appropriate or medically necessary treatment options for your condition, regardless of cost or benefit coverage; Care and treatment without regard to age, race, color, sex or sexual orientation, religion, marital status, national origin, economic status or source of payment; Voice complaints or appeals and recommend changes in benefits and services to staff, administration and/or the New York State Insurance Department or Department of Health, without fear of reprisal; Formulate advance directives regarding your care. Some plans require you to obtain treatment from participating providers in your area. A state search can be done find all the support groups in that state listed by county. (You will see this if you get your plan through work.) Login for 24/7 Support View member cards, benefits and claims, and more! Member Discounts Take advantage of member-only discounts on health-related products and services. 0000020231 00000 n What Is The Difference Between Anthem BCBS And BCBS? BCBS Prefix: BCBS prefix is a three character prefixes followed by the id number except for the following products and programs. Our Behavioral Health Case Managers can assist you with understanding your insurance benefits, understanding your treatment options, locating and connecting with area treatment providers for mental health and substance use treatment and much more. 1932The BlueCross organization was born with the intention of providing hospital prepayment for pennies a day.. For your privacy and protection, when applying to a job online, never give your social security number to a prospective employer, provide credit card or bank account information, or perform any sort of monetary transaction. If you are currently in treatment with your PCP, we can make the change effective on the date of your request. He has held various senior management roles both in the insurance companies and insurance brokers during this span of time. How may I estimate potential out-of-pocket expenses for an out-of-network service? Usually, people get health insurance via, Finding a low-cost health insurance provider is one step toward ensuring that your familys medical needs are addressed within. 0000178480 00000 n Your part ID number interfaces you to your data in our frameworks, and is the thing that suppliers use to ensure you are secured for a treatment or medication when you look for care. In the majority of cases, your health care providers will file claims to us on your behalf. If you have coverage through an employer or group, you may be able to update your policy online (if your employer or group participates in online enrollment). National Institute of Mental Health site provides general mental health and substance use information. 9 (6) 5 (18) 7 (4) 6 (4) 1. This information is also found on the insurance policy, and the insurer uses it to identify a group. Create an Account. I can't see them on my card so where can I find the information? Health benefits and health insurance plans contain exclusions and limitations. To learn about specifics, refer to Mental Health Parity Member Disclosure. Your will also have access to a network of more than 13,000 other doctors, urgent care centers, hospitals and specialists when needed. Excellus paid Christoper Booth, its chief executive officer, $3.2 million , up from $2.9 million in 2018. The IDREs determination is binding on us and the provider. Website - www.cms.gov, Residents of New York state can learn about the eligibility requirements, benefits and services of Medicare plans in the site. If your mental health or chemical dependency benefits have exhausted, you may call one of the agencies below for assistance in obtaining necessary care. The Blue Cross Blue Shield Association is an association of independent, locally operated Blue Cross and Blue Shield companies. NYS Office of Mental Health (OMH) information for children, teens & their families on services to help identify emotional health needs and provide treatment or support. Some programs do not have coverage for outpatient mental health treatment. The negotiation period must be open for 30 days. Visit the Federal No Surprise Bill website for more information about submitting an IDR request. Secular Organizations for Sobriety is an informational site on SOS which is a nonprofit network of autonomous, nonprofessional local groups dedicated solely to helping individuals achieve and maintain sobriety. No, policy number is specifically for your policy , but group number usually refers to your employer or group where youre getting your coverage. Yes, these regulations require that any protected health information about members or their dependents age 18 or older cannot be released, even to family members, without the members authorization. If you still have questions, you should contact the Customer Service department at the telephone number on your member card. Group number on excellus insurance card. Childrens HCBS benefits are designed to offer support and services to children in non-institutionalized settings that enable them to remain at home and in the community. When your BCBS ID card arrives in the mail, take a moment to look for these five things: Check your new card to ensure details like the spelling of your name and the type of plan you selected are correct. 0000002043 00000 n Its anything but difficult to perceive any reason why. As our member, there's no need to worry about your coverage if you get sick or injured while traveling. The five Core Limited Health-Related Services play a vital role in assuring all necessary services are provided in the specified time frames and delivered in a comprehensive and coordinated manner for children/youth in placement. For unresolved negotiations, the provider can submit an Independent Dispute Resolution (IDR) via the IDRE portal. $0 tier 1 generic drugs and select vaccines in most areas. To live free of worry, free of fear, because you have the strength of Blue Cross Blue Shield companies behind you. To obtain a Health Care Proxy form, contact us; Contact one of our service departments to obtain the names, qualifications and titles of providers who are responsible for your care; All information about your health plan, its services and its providers and procedures. Child Welfare Information Gateway offers information, resources, and tools covering topics on child welfare, child abuse and neglect, out-of-home care, adoption, and more. What is group number for Excellus? Check your contract or benefit booklet, talk to your employer group representative or contact us if you are unsure whether or not you need to select a PCP. It contains an explanation to some of the common fields. Al-Anon offers support to friends and families of problem drinkers. Binghamton, NY 13902-5267. The group plan number is the number your employer is given to identify their employee health insurance policy. Wegovy (semaglutide) injection 2.4 mg is an injectable prescription medicine used for adults with obesity (BMI 30) or overweight (excess weight) (BMI 27) who also have weight-related medical problems to help them lose weight and keep the weight off.. Wegovy should be used with a reduced calorie meal plan and increased physical activity. He got licensed as a producer while working at that agency and progressed to serve as an office manager. %PDF-1.4 % On the off chance that you are in an arrangement through your activity or another gathering, it will likewise be recorded on your card. P.O. P.O. If you are not the policyholder, then your card may show your name and the policyholders name in separate fields. Direct Premium Payments Excellus Health Plan. A Behavioral Health Case Manager will be able to assist you during our normal business hours. June 14, 2022; salem witch trials podcast lore BCBS Company. Create an Account View your Summary of Benefits and Coverage Find a doctor, estimate medical cost and track your deductible and spending How Do I Get A Live Person At Blue Cross Of Illinois? Their mission is to advocate for children and families in need of care and to promote safe and stable environments. In the event that you are a current part and your arrangement doesnt transform, you wont get another card. Youll need the Subscriber information and premium amount due for the bill youre paying. Forgot Password? excellus policy number on card. A health insurance card is an important piece of documentation issued to you when you enroll in a health insurance policy. Children's Bureau offers a variety of resources aimed to protect vulnerable children through prevention, treatment, training and advocacy. Weve been there for you, providing quality health care solutions for more than 75 years ! NAMI offers local support groups. Excellus bluecross blueshield is an hmo plan and ppo plan with a medicare contract. View or Pay Bills, Setup AutoPay and more. All rights reserved. Insights, information and powerful stories on how Blue Cross Blue Shield companies are leading the way to better healthcare and health for America. You can find your policy number on your insurance card or on bills and statements . Who besides me can gain access to my claims, benefits and other Protected Health Information (PHI)? You can discover your part ID number on your part ID card, which you ought to get via the post office not long after you pursue one of our arrangements. Depression and Bipolar Support Alliance (DBSA) offers local support groups that can be searched by state. You may also submit your grievance or request for appeal in writing. Chemical Dependency benefits are for the treatment of drug and/or alcohol problems. If you purchase your coverage directly from us, please call us at the number listed on your member card. Excellus Group Number On Card / Excellus Group Number On Card - Nys Medicaid Managed Care . What do I do if my benefits are exhausted for mental health or alcohol/substance use services? A few cards are independent check cards that spread qualified cash based expenses, while others likewise fill in as a wellbeing plan part ID card. Billing Office Phone: 801-587-6303 or 800-862-4937 Schedule an Online Billing Consult Tips for a Successful Online Billing Consult The New York Consumer Guide to Health Insurers is available from the New York State Insurance Department. Filing claims with the correct local Plan and including, at minimum, the required elements to ensure timely and correct processing, such as: Current member card number. If your doctor agrees to these conditions, you will receive the covered services as if they were being provided by a participating provider. Your bcbs id card has important contact information to help you reach us. How do I find my Blue Cross Blue Shield Policy number? Phone - 1-800-342-9871 Most managed care plan members must have a referral from their PCP prior to seeking emergency room care if the condition does not appear to be for an emergency medical condition. For Claims, Benefits, Prescriptions, and All Other Questions: Call 1-800-499-1275, Monday - Thursday 8 a.m. to 7 p.m., Fridays 9 a.m. to 6 p.m. Medicare Members: Call 1-877-883-9577, Monday - Friday 8 a.m. to 8 p.m. Email Us: Our representatives will respond within one business day. 0000008291 00000 n 0000001434 00000 n Federal Employee Program (FEP) individuals ID cards dont have a three-character alpha prefix. 2023 Blue Cross Blue Shield Association. Pay Now online, its easy and secure Use a credit card or debit card (MasterCard, Discover, Visa). Health Insurance Plans | Excellus BlueCross BlueShield COVID-19: Stay informed on vaccines, testing coverage and more Your Member Account It's here when you need it. It does not operate in Florida. Find excellus login, bill payment and customer support information . If you are unable to submit your documentation electronically, you may continue to submit your documentation via mail to the address on the back of your member card. Your card contains key information about your health insurance coverage that is required when you need care or pick up a prescription at the pharmacy. 0000018476 00000 n Your group number will appear on your premium bills, and you'll use it for electronic and Web enrollment activity. However, your number should remain the equivalent if your arrangement doesnt change. Your BCBS ID card has your member number, and in some cases, your employer group number. Be an active partner in the effort to promote and restore health by: openly sharing information about your symptoms and health history with your physician; becoming informed about your diagnosis, recommended treatment and anticipated or possible outcomes; following the plans of care you have agreed to (such as taking medicine and making and keeping appointments); returning for further care, if any problem fails to improve; and. We cant tell you whom to select, but we do offer tools to help you decide which practitioner is right for you. <]>> Generate a fresh credit card number by clicking refresh button. If you want to figure out how to read a Blue Cross Blue Shield insurance card then you have come to the right place. If you have an HMO, your card may also list the physician or group youve selected for primary care. Anthem Blue Cross is a for profit company in California, and Blue Shield is a non-profit. What is the member number on an insurance card? 0000023807 00000 n Its imperative to take your part ID card with you when you look for care, so your PCPs office has your protection data. 0000002910 00000 n CareerBuilder TIP. Log in or Download the App Plans for Everyone $0 and low-cost health plans with extras - individual, family, and Medicare. Do not pay any bills received from your provider while a surprise bill is being evaluated. These services are available to all Medicaid eligible children under the age of 21 who meet medical necessity criteria. You can sign in to your Blue Access for Members account on the official Blue Cross Blue Shield website, www.bcbstx.com, and see your arrangement data under the My Coverage tab. Each of the three are sorts of assessment supported records frequently offered by the parts manager to pay for qualified costs not secured by the wellbeing plan. The New York State Partnership for Long Term Care is a unique program that combines private long term care insurance and Medicaid to help New Yorkers prepare financially for the possibility of needing nursing home or home care. Medical necessity must be determined by a licensed practitioner for Core Limited Health Related Services at time of admission before services are delivered. We have policies for families, children, full-time students, seniors, and for people on low or fixed incomes. That is why it is very important for you to have your Excellus BlueCross BlueShield member card with you at all times. While a PCP can handle most health care needs, there may be situations where the specialized knowledge of an OB/GYN provider is required. Health Plans for Self-Employed Individuals, Children and Family Treatment and Support Services (CFTSS), Children's Home and Community Based Services, Alternative Services and Settings- In Lieu of Services, Physical Therapy (PT), Occupational Therapy (OT), and Speech Therapy (ST), Find Your Doctor, Hospital or Other Provider, Substance Use and Mental Health Services Administration (SAMHSA), Substance Use and Mental Health Services Administration, American Academy of Child and Adolescent Psychiatry (AACAP), Depression and Bipolar Support Alliance (DBSA), National Council on Alcoholism and Drug Dependence, Free, confidential support for anyone in suicidal crisis or emotional distress, Call or text 988 to reach the 988 Lifeline, Available 24/7 with language assistance offered, Free, confidential support for mental and substance use disorders, For calls, dial 988 and press 1 to be connected with the Veterans Crisis Lifeline, Free, confidential support for Veterans, service members, and their loved ones, Medicaid Treatment Planning and Discharge Planning, Clinical Consultation/Supervision Services, VFCA Medicaid Managed Care Liaison/Administrator, Children and Family Treatment Supports and Services (CFTSS). 0000007549 00000 n 29-I Licensed Health Facilities provide a range of services to children in foster care including early childhood and special education services, adoption services as well as preventive, physical and behavioral health services. 0000018093 00000 n Please contact us at the number listed on your subscriber Member Card if you receive any additional bills. Find a plan that works in your service area. We also offer Behavioral Health Advocacy services to our members and providers when a request for treatment has been denied. Some benefits listed below require providers to authorize services. John has diverse experience in corporate & consumer insurance services, across a range of vocations. Call: 1-800-650-4359 (TTY711), Closed: Thanksgiving, Day after Thanksgiving, Christmas Eve, Christmas Day, New Years Eve, New Years Day. You can view this report online at www.dfs.ny.gov/consumers/health_insurance/health_insurance_complaint_rankings or use the addresses below to request a printed copy: * If requesting by email or mail, please provide Your Name, Address, City/State/ZIP. 2020 Insurance Noon LLC. To make recommendations regarding the organization's members' rights and responsibilities. 0000018400 00000 n Key takeaways: At the pharmacy, your health insurance often covers vaccines, while your prescription drug insurance covers your medications. Because of HIPAA, we cannot release any information regarding your policy, claims or benefits without your express permission. Your doctor must also agree to provide us necessary medical information related to your care and adhere to our policies and procedures, including those for assuring quality of care, obtaining preauthorization, authorizations, and a treatment plan approved by us. Your member card, coverage and claims. If you have an emergency medical condition, you should go directly to the nearest emergency room. Excellus group number on card : The prefix is a key to ensuring prompt payment. Contact us at the phone number on your member card for personalized care. Almost all private insurance policies require the insured person to pay a co-pay when visiting a doctor or any other health care provider. If you need to file a claim choose from one of the following options: Excellus BlueCross BlueShield provides a process to follow if you and/or your health care provider disagree with our decision to deny services. Group Administration. Please contact customer services. If you would rather speak to us directly, please contact our Customer Service department at the number listed on the back of your Member card. He saw firsthand the good that insurance consumers experienced by having the proper protection. It indicates which processor will handle your claim. Call: 1-877-222-1240 (TTY 711) Hours: 8 a.m. - 4:30 p.m. Monday - Friday. Vision ClaimOpen a PDF. Our Behavioral Health Advocate is available to assist you and your provider in understanding the denial decision as well as with the process for pursuing appeals, and in identifying participating providers. Providers have the right to charge you for a missed appointment if that is their standard office policy. If you have a question about a claim, you do not need to call Excellus, you can call our Health Care Fund Medical Claims Service Unit at 1-800-959-9497. Health Insurance Tools; Health Care Coverage 1-on-1 Videos; Understanding Insurance. You can find us in the guide under the name Excellus BlueCross BlueShield. Plan number: health insurance companies have many plan options. Medicaid Managed Care children must be under 21 years old and determined eligible to receive HCBS services through clinical evaluation and documentation of need in a personalized plan of care. Essential Plan: The information you're accessing may not be provided by Excellus BCBS. Copyright 2023, Excellus BlueCross BlueShield, a nonprofit independent licensee of the Blue Cross Blue Shield Association. So, without much further ado, let us dive right in! If you or a loved one have questions or need assistance please reach out to one of our Behavioral Health Case Managers who can be reached at 1-844-694-6411. Aetna is the brand name used for products and services provided by one or more of the aetna group of companies, including aetna life insurance company and its affiliates (aetna). . Other Limited Health-Related Services do not include: surgical services, nursing services, dental services, orthodontic care, general hospital services including emergency care, birth center services, emergency intervention for major trauma, treatment of life-threatening or potentially disabling conditions. You will need to attach an itemized bill from the provider who rendered services to you. If you purchased your insurance through the health exchange you might not have a group number. How do I request new or additional member cards? What happens after I submit a Surprise Bill Certification Form? While your BCBS ID card probably wont get as much use as those different things, it ought to be treated similarly. The group number can be letters, numbers, or spaces. Insurance company name. 0000017683 00000 n 0000013174 00000 n (See item #2 below to learn how to contact your BCBS company to address any errors.). Blue Choice Option is a Medicaid Managed Care program sponsored by New York State. Compare New Plan Rates and Benefits. All rights reserved. Call the number on your Member Card for personalized care. Be that as it may, when the party gets administrations outside his/her BCBS Plan administration territory or area, supplier repayment for secured administrations depends on the Medicare-permitted sum, aside from on account of PPO network-sharing courses of action. Information for Pharmacies. Surprise Bills subject to the New York State Mandate. Website - www.health.ny.gov, The OASAS HOPEline offers help 24 hours/7 days/365 days a year for alcoholism, drug use and problem gambling. Member or subscriber: This is the person who pays for the plan. . Billing address for non-group premium payments* Blue Cross Non-group premium PO Box 371314 . At any time, you may also file a complaint with the State Department of Health, (800) 206-8125, or the State Department of Insurance, (800) 342-3736. The system includes 37 independent, locally operated companies across the U.S. In these cases, we will not release more information than necessary. . The Rx PCN is an identification number used to route pharmaceutical transactions.
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