Box 272630 Because claims mailing addresses are different for different Blue Plan members, using the Claims Routing Tool is the most accurate way to determine a claims mailing address. Find a Provider Contact Us Blue Shield of CA: Payer ID: BS001 Claims Address: P.O. You can now file disputes, attach supporting documents, and retrieve letters for submitted disputes online! Mailing address (for paper claims): Blue Shield of California Mental Health Service Administrator (MHSA) P.O. If you are an Ancillary provider who is interested in joining our network, you can submit a Letter of Interest by the following methods: By mail: Blue Shield of California Promise Health Plan Claims mailing addresses | Blue Shield of CA Provider Health . Enter the claim number associated with your dispute to start the process. Mental Health Service Administrator (MHSA) Network. Providers can easily start the dispute process using the online form. Access commonly requested forms for patient care activities, credentialing, and more. All rights reserved. Disputes related to demonstrable and unfair payment patterns must be submitted within the timeframes indicated above, based on the date of the most recent action or inaction by Blue Shield. Look for the chat icon at the bottom right corner of the screenon any page of this website. As private practitioners, our clinical work alone is full-time. Circumstances reasonably beyond the control of the provider that prevent the timely submission of a claim are considered "good cause". Administrative. The Children's Behavioral Solutions (CBS) team empowers healthcare providers and agencies to make the most appropriate referrals for children who need personalized behavioral health treatment. Eligibility & Benefits Verification (in 2 business days), EAP / Medicare / Medicaid / TriCare Billing, Month-by-Month Contract: No risk trial period. Available for commercial, Shared Advantage, and BlueCard. Request help with your log in, registration or other technical problems. Blue Shield will not require the provider to resubmit claim information or supporting documentation that has been previously received as part of the claims adjudication process. If you need information about eligibility, benefits or claims, or want to submit or review an authorization, the best way to get up-to-date information is through our on-line resources. The BlueCard Program links Blue plans across the United States and abroad through a single electronic network for claims processing and reimbursement. Blue Shield of California Click continue to proceed with verification. Discover all the ways members can earn wellness incentives and rewards for taking an active role in their health. To file a dispute online, youll need a claim number or multiple claim numbers if youre bundling claims, an email where we can reach you, and relevant supporting documents. If you are in-network with Magellan, you are in-network with Blue Shield MHSA. Phone: (800) 541-6652 Blue Shield of California Promise Health Plan Provider Services: Monday through Friday, 6 a.m. to 6:30 p.m. P.O. Providers and facilities that fail to comply will be suppressed from our directories. Find information about Promise Medi-Cal and Cal MediConnect, our policies, procedures and programs. El Dorado Hills, CA 95762. Box 272540,Chico CA 959272540 Phone Number: (800) 541-6652. At Magellan Healthcare, we recognize the unique challenges of the 21st century. Listed below, by county, are the addresses of medical foundations with which Blue Shield is affiliated. 46692 MONTESA. Blue Shield/Blue Shield Promise network referrals. We understand that it's important to actually be able to speak to someone about your billing. Use the Find-a-Doctor tool to verify provider participation in one of our plan networks. Blue Shield of California Promise Health Plan members, View Maternity program information and sign-up instructions for members, Behavioral Health Care Management Referral Form, Information about behavioral health conditions, Screening tools and clinical practice guidelines, Behavioral health provider lists for referrals, Blue Shield drug formulary and medication information, Blue Shield mental health service administrator for HMO and PPO commercial plan members. If a provider or capitated entity fails to submit a dispute within the required timeframes, the provider or capitated entity: In instances where the provider's contract specifies timeframes that are greater than those in Blue Shield's Provider Dispute Resolution Process, the provider's contract takes precedence. 601 Potrero Grande Dr. Regional Offices are open for appointments. Grievance Resolution Department You can take the Blue Health Assessment, check drug costs, change your address, request a member ID card and more. Alzira, Valencia, Valencia, Spain - City, Town and Village of the world California Physicians Service DBA Blue Shield of California 1999-2023. Blue Shield will verify with the member that the provider has been authorized to submit a dispute (member grievance) on the member's behalf. PDF California Quick Reference Guide - Magellan Provider Call(877) 263-9952 to inquire about your network status with MHSA. Add in the unnecessarily difficult insurance billing system and we run the risk of working way over full-time. All rights reserved. Clinical. Box 629010 Providers or capitated entities who disagree with Blue Shield's initial determination may pursue the matter further by submitting a final dispute within 65 working days of Blue Shields initial determination, or the time specified in the providers contract, whichever is greater. Mental Health Services Act (MHSA) - DHCS Explore the PCP Behavioral Health Toolkit at any time to find these resources: If you have questions about managing or coordinating behavioral health care needs for your patients with coverage under one of Blue Shields HMO or PPO commercial plans, and you dont find what you need in the PCP Behavioral Health Toolkit, contact us: Blue Shield offers maternity clinical support and coaching for pregnant members and their spouse/partner through the Maven Maternity care management program. The notice must include the required information for submitting a dispute as well as a clear statement indicating why the provider believes that the claim is not overpaid. Find phone and fax numbers for compliance and ethics, disease management, wellness prevention, and more. 6300 Canoga Ave. We use cookies on this website to give you the best experience and measure website usage. P.O. MHSA Contacts. Call the Provider Services Line at 1-800-788-4005, Monday - Friday, 6 a.m. to 3:30 p.m. (Pacific). We've designed the documents in this section to support you in your quality care of Magellan members. Learn about our tools and how to use them in our upcoming webinars. Free Account Setup - we input your data at signup. 100 North Sepulveda Blvd. All rights reserved. Demographics |Electronic Data Interchange (EDI) | Recoveries, Need help with Provider Connection: Blue Shield Provider Connection Guide Provider Connection training. State law does not require health plans to offer two levels. ), Make an appointment for Teladoc mental health services. You can now file disputes, attach supporting documents, and retrieve letters for submitted disputes online! Ask to speak to a mental health clinician, or follow the prompts to get help with a mental health or substance use issue 24 hours a day, seven days a week. P.O. You want to know you can call your billing admin, a real person you've already spoken with, and get immediate answers about your claims. All rights reserved. For more information, refer to the California provider handbook supplement, section 3(PDF). Available for commercial, Shared Advantage, and BlueCard. P.O. Visit the California webpage for the California handbook supplement and other important resources, such as a California provider orientation and quick reference guide. View Claims - Blue Cross and Blue Shield's Federal Employee Program Blue Shield of California Prior Authorization | Blue Cross and Blue Shield of Illinois Access a wealth of healthcare resources and tools with MyBlue. Blue Cross & Blue Shield of Mississippi disclaims any liability that may arise through the use and acceptance hereof by its said associate trading partners. and The Dental Network, Inc. are independent licensees of the Blue Cross and Blue Shield Association. Address Blue Shield of CA (BSC)/ MHSA 1-877-263-9952 1-800-424-6064 1-800-424-5999, option 3 Claims Mailing Address Blue Shield of California Mental Health Service Administrator (MHSA) P O Box 710400 San Diego, CA 92171 Appeals and all other Correspondence Office Ally > Pages > Resource Center > Landing > BlueShieldCA. What if I submit a dispute with incomplete information? The information provided herein is HAIs proprietary information, which is provided to you pursuant to HAIs Confidentiality Agreement with Blue Shield of California (BSC). Magellan is the mental health carve out of Blue Shield of California. Learn how to offload your mental health insurance billing to professionals, so you can do what you do best. Mental health - Blue Shield of California Blue Cross and Blue Shield of Illinois P.O. By continuing to use this website, you consent to these cookies. These are Mental Health Services Administrator (MHSA)services and phone numbers. Forms - Magellan Provider Intake / Evaluation (90791) Billing Guide, Evaluation with Medical Assessment (90792). Contact Medical Care Solutions for questions about authorization requests, preauthorization, medical policy, and more. Find resources and information here regarding provider disputes, including an overview of the dispute process, instructions, and our online dispute form. P.O. Free Account Setup - we input your data at signup. Therefore they call it Blue Shield MHSA but in reality it is owned by Magellan. Access preventive health guidelines for healthy children, adolescents and adults. Call MHSA instead of Blue Shield first to inquire about the clients mental health benefits. When an out-of-area Blue plan member seeks medical care from your office, use our tools to simplify claims submission to Blue Shield of California. View your Personal Health Record and your Financial Dashboard. Call Blue Shield of CA at800 541 6652 and inquire about the members eligibility and benefits. Want to Reach Us? Behavioral health resources | Blue Shield of CA Provider Overpayments from Blue Shield are to be directly refunded to Blue Shield. Email Us Prior authorization requests for our Blue Cross Medicare Advantage (PPO) SM (MA PPO), Blue Cross Community Health Plans SM (BCCHP SM) and Blue Cross Community MMAI (Medicare-Medicaid Plan) SM members can be submitted to eviCore in two ways. 1:1 non-emergent telephonic consultations with a Magellan psychiatrist including, but not limited to: Read an overview of payment processing policies and rules. Box 272540 Enter your location details, and select provider type, specialty, gender, ages treated, and any other criteria that are important to you. 1999-2023 Magellan Health, Inc. All Rights Reserved. When the name of a medical foundation appears on a subscriber's identification card, the benefits for that subscriber are administered by that foundation. 110 S Euclid Ave. San Diego, CA 92114 (877) 534-2524 The County of San Diego MHSA Issue Resolution Process has a detailed look at the process. California Physicians Service DBA Blue Shield of California 1999-2023. If the overpayment involves a Coordination of Benefits (COB) issue, and Blue Shield processed the claim as the primary payer in error, please send a copy of the Explanation of Benefits (EOB) from the primary payer to the appropriate service center. Want to view claims, statements, costs and benefits? Disputes that are returned due to missing information are resolved within 45 working days of receiving an amended dispute with missing information. 962 26 45 71International: +34 962 26 45 71. Montesa, Valencia, Valencia, Spain - City, Town and Village of the world Mental Health Services Act (Amended in 2020) County Performance Contract Provider Information & Enrollment Health plans are offered by Blue Shield of California. To find a provider in the MHSA Network: Select the link below. Please review directory information to ensure its accuracy before attesting. How to Submit a Claim - Blue Cross and Blue Shield's Federal Employee The MHSA network provides in-network services for the majority of Blue Shield of California plans* For behavioral health providers in the MHSA network, search by provider or location: Provider: Enter a name, license, or NPI (National Provider ID) Location: Enter a specific ZIP code and refine the search with gender or other search filters. Phone:(800) 541-6652. 3335 South Fairway El Dorado Hills, CA 95762-9010, Blue Shield Final Appeal Resolution Office Contact Provider Services If you have questions about a specific claim, contact Blue Shield of California Provider Services. It's our goal to ensure you simply don't have to spend unncessary time on your billing. Find detailed instructions for activities like checking eligibility, making a referral, determining if prior authorization is necessary, prescreening claims, checking claims status, and other tools and information you need to serve our members. Included are immunizations, health screenings and more. Guadassuar Postal address: Mayor, 43 46610 GUADASSUAR Espaa: Guadassuar Phone number: 962 57 00 00 International: +34 962 57 00 00: Guadassuar #COM# fax number: 962 57 12 85 International: +34 962 57 12 85: Guadassuar Email address [email protected] Guadassuar Website //www.guadassuar.es : Other information: Ayuntamiento Espaa : Guadassuar Contact the phone number on the member ID card for more information. Blue Shield of California and Magellan: A Deceptive Arrangement You will find clinical and referral information, screening tools and patient education resources to help you manage or refer your patient to meet their behavioral health care needs. To quickly and easily find out if you, the provider, or a provider referral, participate in the member's plan network*, either log in or register for Provider Connection. Go paperless by submitting claims and managing payments online for free. Download and complete the appropriate form below, then submit it by December 31 of the year following the year that you received service. Save time and money when you submit your claims electronically using Electronic Data Interchange (EDI). California Physicians Service DBA Blue Shield of California is an independent member of the Blue Shield Association. Pregnancy - Blue Cross and Blue Shield's Federal Employee Program An EOB is sent each time Blue Shield processes a claim submitted by a provider. Blue Shield will research the claim and advise you of the amount of overpayment. You can now file disputes, attach supporting documents, and retrieve letters for submitted disputes online! Phone - Call eviCore toll-free at 855-252-1117 . Find paper dispute resolution forms, filing instructions, and mailing addresses. Also, a group of substantially similar contractual disputes that are individually numbered using the section of the contract and sequential numbers that are cross-referenced to a document or spreadsheet. Read Blue Shield Promise provider dispute resolution policies. Phone:(866) 510-8778, Blue Shield Medicare Advantage Plan Chico, CA 95927-2540 Phone:(310) 744-2580, Blue Shield of California List of claims mailing addresses BlueCard out-of-area program: Check subscriber ID for three-letter prefix before sending. Chico, CA 95927-2630 Box 272620 P.O. If you're in crisis or have suicidal thoughts . Blue Shield will return the dispute and notify the provider or capitated entity of the missing information necessary to resolve the dispute. MyBlue Customer eService is your source to access your claims, view your Explanations of Benefits (EOBs) and review a summary of your healthcare finances in your Financial Dashboard. Call(877) 263-9952. Learn more about professional fee schedule. The email address for submission will depend on your patients type of benefit plan. Attention: Provider Contracting EAP. Go. Enroll in EDI and submit claims for free using Office Ally. Blue Shield of California - Magellan Provider Contact Medical Care Solutions for questions about authorization requests, preauthorization, medical policy, and more. Claims for non-capitated services provided to a Blue Shield HMO member that are erroneously submitted to the capitated IPA or Medical Group for processing are required to be forwarded by the capitated IPA or Medical Group to Blue Shield within 10 working days. A group of substantially similar claims that are individually numbered using the Blue Shield assigned Internal Control Number (ICN) to identify each claim contained in the bundled dispute. Simply speak your request and our voice-activated system will direct your call to the appropriate representative. Monterey Park, CA 91755. Try again later. Have your member ID card ready and then follow the prompts to register and create your username and password. During this call you will also collect where to send the claims (Blue Shield of CA vs MHSA). We can help you sort out these sorts of things without your input whatsoever. Weve suppressed the directory info in Find a Doctor associated with one or more TINs. Appeals and Grievances Claims for capitated services provided to a Blue Shield HMO member that are erroneously sent to Blue Shield for processing/payment will be forwarded to the appropriate capitated provider within 10 working days of the receipt. To participate, you must also enroll with Medi-Cal through the California DHCS. Final disputes can be submitted online or by mail with the same required information as initial disputes. * Services include: *In accordance with State Bill 1207 (Health care coverage: maternal and pandemic-related mental health conditions), Obtaining In-Office Injectable Medications(PDF), How toAccess In-Office Injectable Policies on BSC Provider Portal(PDF), Prescription Drug Prior Authorization or Step Therapy Exception Request Form(PDF). September 2, 2022 by Sandra Hearth Spread the love Blue Shield's mental health service administrator (MHSA) Table of Contents show What is CBS mental health? Phone:(800) 622-0632, Blue Shield of California, CalPERS Get out of network benefits quoted if you are out of network and obtain authorization if required. Box 710400 San Diego, CA 92171-0400 Appeals Magellan supports the rights of members and their providers acting on the member's behalf to appeal adverse determinations. Visiting the MHSA network. Note: Disputes for Medicare Advantage, Blue Shield of California Promise Health Plan, Federal Employee Program (FEP), and dental plan claims must be filed by mail. TheraThink.com 2023. Payer ID:01260 Claims Address:P.O. Log in to Provider Connection to start the process. Explanation of Benefits (EOB) inform providers of the availability of Blue Shield's Provider Dispute Resolution Process and provide instructions for filing a dispute. A notice contesting a refund request will be identified as a dispute and follow Blue Shield's Provider Dispute Resolution Process. If you find an overpayment, notify Blue Shield by contacting the appropriate service center. On the provider search page, under "Choose your Benefit Plan," select, Enter your location details, and select provider type, specialty, gender, ages treated, and any other criteria that are important to you. We are here to help, whether you're already a network participant or just want to know more about us. Verify eligibility of Blue Shield of California, Blue Shield of California Promise Health Plan, other Blue plan and Federal Employee Program members, and access associated benefits information. 962 29 90 02. International: +34 962 29 90 02. Box 272510 Find completed dispute forms, supporting documents, and acknowledgement and determination letters to view and download on Provider Connection. If a dispute involves a lack of a decision, it must be submitted within 365 days, or the time specified in the provider's contract, whichever is greater, after the time for contesting or denying a claim has expired. How to bill Blue Shield MHSA becomes a problem when the clients coverage is not handled directly by the parent company, Blue Shield of CA. Upon request, the IPA/Medical Group will make available to Blue Shield, or the California Department of Managed Health Care (DMHC), all records, notes, and documents regarding their provider dispute resolution mechanism and the resolution of provider disputes. Phone:(510) 607-2000, Blue Shield of California An EOB is an outline of what services you received from a provider and how your benefits were applied to cover those services. Learn about the range of information and tools available to Blue Shield of California providers on this website. Bcbs Mental Health Claims - Your Health Improve Hours: 8 a.m.-5 p.m. Monday-Friday (voice mail messages will be returned within 1 business day). Save. Please review the terms of use and privacy policies of the new site you will be visiting. Examples of circumstances beyond the control of the provider, include, but are not limited to: Examples of circumstances that dont constitute "good cause": A request for information regarding claim status, member eligibility, payment methodology rules (ClaimCheck logic, bundling/unbundling logic, multiple surgery rules), Medical Policy, coordination of benefits or third-party liability/workers compensation issues. 6300 Canoga Avenue Under "Choose a Provider List," select Non-Medicare provider . Find phone numbers and addresses for claims, the EDI help desk, and member appeals and grievances. Available for commercial, Shared Advantage, and BlueCard. Claims contacts | Blue Shield of CA Provider BSC offers support to moms-to-be and their partners during and after pregnancy through the Maven Maternity Program. This change to a carve out policy was put in place on January 1st of 2012. Login to Provider Connection to start a chat, Blue Shield of California Find phone and fax numbers for Blue Shield eligibility and benefits contacts. Forms. MHSA addresses a broad continuum of prevention, early intervention, and service needs and the necessary infrastructure, technology, and training elements that effectively support the public behavioral health system. Provider Connection Reference Guide (PDF, 4.4 MB). information for instate claims, Accessing member eligibility and benefits, claims information, or Clear Claim Connection (C3) claims prescreening simulation tool, Provider network inquiries and applications, Address, phone, fax, and practice changes, EDI set-up inquiries (270/271, 276/277, 278, 837, 835), Member benefit enrollment setup inquiries (820/834). When requested, send refund checks to the following address: Blue Shield of California Heres everything you need to know about it. Each individual dispute in a bundled dispute is reported separately. Find phone and fax numbers for Blue Shield eligibility and benefits contacts. Disputes that lack the required information will be returned to the provider or capitated entity. Monterey Park, CA 91755 The date Blue Shield's determination in response to a dispute is electronically submitted or deposited in the U.S. mail. MyBlue gives you access to a variety of health and wellness resources. Learn more about the BlueCard Program. MHSA Contacts - PCP BH Toolkit Chico, Ca 95927-2640 The fast pace of life today, combined with 24/7 news, anxiety and a historical increase in negative feelings*, has many of us near the breaking point. Contact Us Phone: 619-584-5063 Toll Free: 888-977-6763 Email: MHSProp63.HHSA@sdcounty.ca.gov For administrative information or to provide feedback about this page, send us an email.
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