If youre a medical biller or a provider and going to submit BCBS plan member claim to the insurance, make sure to submit member ID including prefix. American Health Group (AHG) Call 1-800-847-7605 . For 2021, there were no changes to overall care categories, but some of the codes within certain categories may have been updated. Now, with more than 15 years of experience as a medical biller and revenue cycle manager, I am on a mission to serve the medical billing industry with my vast knowledge and years of expertise. It means that BCBS members IDs prefixes will must have alphabets. So, to answer this query, we have mentioned below few important points to consider. If you have any questions or need help submitting a prior authorization, please call 816-395-3989 for assistance. These plans provide health insurance coverage for railroad employees, retirees, and their eligible dependents. Medical providers - Arkansas Blue Cross and Blue Shield To accommodate our increasing lines of business, Blue Cross and Blue Shield of Montana (BCBSMT) has adopted several new three character prefixes as part of the member identification numbers. So, to accomplish our goal, we have listed down the complete BCBS alpha prefix list so that you can easily identify correct BCBS plan. One option is Adobe Reader which has a built-in reader. How To Identify Blue Cross Blue Shield Member? On the other hand, the BCBS member ID number is a unique identifier assigned to each individual member covered under a BCBS health insurance policy. Do not create one or use the BCBS prefix from another member ID card. PDF 2021 Three Character Prefix BCBS Prefix should be included along with ID number, exactly as it appears on the member ID card when filing the claims to insurance company. %%EOF
The purpose of this list is to assist WA and AK providers to determine plan [PDF] CareFirst Third Party Administrator (TPA)/Network Lease Accounts Prefix. Prior Authorization List for Blue Shield Effective April 1, 2023 (This list is updated monthly) blueshieldca.com 601 12th Street | Oakland, CA 94607 Blue Shield of California is an independent member of the Blue Shield Association April 1, 2023 Page 1 of 8 Policy Name/Program Procedure Code (To search, press Ctrl + F) . Three-Character Prefixes. BCBS Alpha Prefix Its a three letter alpha prefix followed by id number. So, all BCBS plans, including Anthem prefix and Non-Anthem plans announced that member IDs will also be Alpha Numeric from 2018 onwards. PDF 2022 Commercial PA Code Lists December Updates - BCBSIL If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly. BCBS Alpha Prefix List from PAA to PZZ Updated 2023 Box 7930 Philadelphia, PA 19101-7930 $=0j]xkM#[f4YgI|in
Z(0zF1-9gk!D @WeUUn/R%$'c|J6:z}\}8ZNd+SL5-h"\wE$w{3\zO>,Vta$a`D7rHmr$bwZm7yYO)&^E<2@9#&UDOz Customer Service: 1-800-409-9462 HCSC-PORT. BCBS Prefix List - Alpha Lookup by State 2022 - Finder BCBS Alpha Numeric prefix are three characters at the start of each BCBS insurance member ID. Check any internal documents you may have and update any references of "alpha prefix" to "prefix". nKvo2>)*Y=}4i,+s[yL*2#kN@r115};|`R[5/iZ . PDF 2021 Commercial Prior Authorization Requirements Summary BCBS prefix List plays a vital role in filing the health care claims properly to the correct BCBS address and also to verify members eligibility, health insurance coverage information and to reach the correct BCBS department to check the claim status or disputes of the claim. Use this guide to see prior approval information for members with ID card prefixes: AEE, AXC, EXX, XCB, XCQ, XCR View guides [pdf] Medicare plans Learn more about providing care for Medicare members. Complete patient information, on the other hand, allows your claims to process without delays. Its important to remember that benefit plans differ in their benefits, and details such as prior authorization requirements are subject to change. T. he Summary of Benefits and Coverage (SBC) document will help you choose a health. We update BCBS prefix list data on daily basis to provide latest BCBS prefix home plan information. For more information, contact your Network Provider Consultant or call 406-437-6100. Most PDF readers are a free download. New BCBS Alpha Numeric Prefixes | My Payer Directory
B}hJu`n+Z9>)2B~feo,TV [ZI^ylRr8DGo;ckrA;X2SjUlW]$4_vN(Tvh6#moc0!pbJ;oW)A'oR&bH=`1K}P(u3gD9:#1!m2saW1SD5/p2 'Su &x@`N.e#U(Fne]4;$"o*k;$~gn-Sd"mjdTY2R*I:w8w3;fpCfQH& BCBS Prefix List 2021 - Alpha Numeric State Lookup BCBS Company; Z2A-Prefix Unallocated/Not Assigned: Z2B: Indiana: Anthem Blue-Cross Blue-Shield of Indiana: Z2C-Prefix Unallocated/Not Assigned: Z2D-Prefix Unallocated/Not Assigned: Z2E-Prefix Unallocated/Not Assigned: Z2F: Minnesota: Individuals & Families We offer a wide choice of individual plans to fit your health needs and budget. Independence Blue Cross (BC) of Philadelphia (Phi) and the Southeastern Pennsylvania (PA) PAI. Here Letter R indicates BCBS FEP prefix. For Example: XYZ123456789. BCBS Alpha Prefix List Member ID cards with no prefix Some member ID cards may not have a prefix. a'm To identify correct blue cross blue shield department, they use three characters BCBS prefix in the start of each BCBS member plan ID. These prefixes may include alpha and numerical characters. These BCBS prefix may include alpha and numerical characters. You may see cards with four-character prefixes, e.g., HMSA Blue Cross Blue Shield of Hawaii uses four-character prefixes. No, the BCBS policy number is not typically the same as the BCBS member ID number. The prefix may also route claim status inquiries and remit searches. Policy number is a unique number, which is provided to their insured person by respective insurances in order for identification purposes and also for billing the healthcare claims. ", 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). BCBS Prefix List Z2A to Z9Z - Alpha Numeric Lookup 2022 Prior authorization requirements are specific to each patients policy type and the procedure(s) being rendered. Regence Prefix List Form - Fill Out and Sign Printable PDF Template Please look for instructions or a phone number on the back of the member ID card. Its critical to check member eligibility and benefits through the Availity Provider Portal or your preferred vendor portal prior to every scheduled appointment. Box 14115 Lexington, KY 40512 Mail Administrator P.O. Please DO NOT randomly select a three-character prefix. In addition, some sites may require you to agree to their terms of use and privacy policy. Final Remarks about BCBS Prefix Lookup Directory. Northwest Arizona Employee Benefit Trust (NAEBT) Group # 037461 . Yes, Policy number same as member ID number and also known as subscriber ID number. Does BCBS policy number same as BCBS member ID number? You may also be interested to read about denial code 27 reason and solutions. Make sure to make copies of the front and back of member ID card. BCBS Prefix List 2021 - Alpha State Lookup BCBS Company; AAA: Alabama: Blue-Cross Blue-Shield of Alabama: AAB: Michigan: Blue-Cross Blue-Shield of Michigan: AAC: Illinois: Blue-Cross Blue-Shield of Illinois: AAD: South Carolina: Blue-Cross Blue-Shield of South Carolina: AAE: Nevada: What is Medical Billing and Medical Billing process steps in USA? Additionally, the following services require Prior Authorization regardless of place of service or level of care: To submit a prior authorization request you may also fax or mail your request. First Care, Inc. are independent licensees of the Blue Cross and Blue Shield Association. Blue Shield (BS) of California. 15388 0 obj
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The main difference between BCBS alpha prefix and BCBS alpha numeric prefix is that BCBS alpha prefix only contains alphabets whereas BCBS alpha numeric prefix consists of alphabets as well as numbers ranging from 1 to 9. PDF CSS-E121 Blue Cross Select Silver 01012021 - bcbsal.org hbbd```b``"`r9LLN`DR,>6l30&U$60D2HO rH+H
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BCBS member ID card will have a suitcase logo at the bottom of card which will also help you to identify patient plan like HMO, PPO, POS etc. Also, pre-authorization information and medical policy for out of state plans may be found on the Blue Cross Blue Shield of Texas provider website section under Standards and Requirements, and then select "Medical Policy and Precertification/Preauthorization for Out of Area Members. Coverage Period: 01/01/2021 - 12/31/2021 . Note: Current three-character, alpha-only prefixes will not be affected by this change. BCBS Prefix will not only have numbers and the digits 0 and 1. Prior authorization to confirm medical necessity is required for certain services and benefit plans as part of our commitment to help ensure all Blue Cross and Blue Shield of Illinois (BCBSIL) members get the right care, at the right time, in the right setting. hbbd```b``@$Df/i #D2lE``vd@ "@,iZ R R2H{v# k
To identify the plan that holds the members benefits, please call the Out-of-State Blues Plan Subscriber #: 1-800-676-BLUE (2583). eviCore healthcare (eviCore) is an independent specialty medical benefits management company that provides utilization management services for BCBSIL. Prior Authorization Services For Fully Insured and ASO, Prior Authorizations Lists for Blue Cross Medicare Advantage (PPO) and Blue Cross Medicare Advantage (HMO), Prior Authorizations Lists for Designated Groups, Prior Authorization Exemptions (Texas House Bill 3459), Medicare Advantage Private Fee-for-Service (PFFS), Eligibility and Benefits Inquiry (HIPAA 270/271), Behavioral Health Care Management Program, Quality Care Partner With Your Patients, Preventive Care Guidelines/Patient Wellness Guidelines, Health Equity and Social Determinants of Health (SDoH), Prescription Drug List and Prescribing Guidelines, Prior Authorization and Step Therapy Programs, Medical Policy and Pre-certification/Pre-authorization Information for Out-of-Area Members, Consolidated Appropriations Act and Transparency in Coverage Final Rule, Blue Cross Blue Shield of Texas provider website. Services that require precertification - IBX 1268 0 obj
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Benefits and eligibility should be verified for all members prior to rendering services. %%EOF
Prior-Authorization And Pre-Authorization | Anthem.com We have the right plan for you to keep you and your family covered. Title: Why does BCBSAZ update member accounts and . 1 of 7. Second Character G assigned to the BCBS Plan as well. For example: ABC12345678 Here " ABC" is BCBS alpha prefix. We recently received a query from a provider that how I can identify that patient is BCBS health insurance member. For Example: ABC, A2B, 2AB, 2A2 etc. A follow-up article with additional information on transition of member care was posted Dec. 4, 2020. Let's start with you. BCBS prefix are easy to identify using our BCBS prefix lookup because theyre part of every BCBS member ID and we included all of them here in the BCBS prefix list. Wheelchairs - Mobility Assistive Equipment (Manual & Power) & Scooters - Wheelchair Purchase only -Motorized) Wheelchair: E1050, E1060, E1070, E1083, E1084, E1085 . But dont worry because our BCBS prefix finder include alpha numeric prefix information as well. BCBS Railroad member IDs starts with a letter R. Narrow Network: Provider participation is by invitation. Carefirst BCBS of Maryland the (MD), District of Columbia (DC) and the Northern Virginia (VA) BCBS FEP Its indicated with letter R followed by the id number. AZBlue - Blue Cross Blue Shield of Arizona - Health Insurance Plans A healthier Arizona is what we're all about. BCBS prefix lookup directory is a valuable resource for anyone who is looking for right Blue Cross Blue Shield home plan. Decide on what kind of signature to create. We offer a wide choice of individual plans to fit your health needs and budget. Final Instructions about BCBS Prefix Lookup, United Healthcare Claims Address Information. We offers a wide range of RCM solutions to improve your healthcare services financial health and allows you to focus on patients care rather than collecting payments from insurances and patients for services performed. Always make sure to submit claims to insurance company on time to avoid timely filing denial. PDF Network Prefix List - CareFirst Provider 1254 0 obj
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01/01/2021 . The policy number is a unique identifier which may cover multiple members under the same policy, such as a family or a group. To get information about such member IDs, you can contact BCBS prefix directory phone number i.e. claims_and_billing/edi/ibc_ professional_payer_id.pdf 54704 -SX083 837I -12X26 Claims Address Claims Receipt Center Box 211184 Eagan, MN 55121 Adjustment Claims Inquiries P.O. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. The following summaries and related prior authorization lists were posted on the Support Materials (Government Programs) page as of Jan. 1, 2021: Important Reminder: Check Eligibility and Benefits First Does policy number same as member ID number? Summaries and code lists are posted as a reference to help you determine when prior authorization may be required for non-HMO government programs members. The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. BCBSIL makes no endorsement, representations or warranties regarding any products or services provided by third party vendors such as eviCore, AIM or Availity. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. %%EOF
BCBS National accounts are employer groups that have outlets/offices in multiple states but they offer limited coverage to their employees. What If BCBS Member ID doesnt have Prefix mentioned on Card? By using this directory, you can ensure that you have the most up-to-date information about BCBS home plans and make more informed decisions about choosing right insurance plan. There are three variants; a typed, drawn or uploaded signature. First Character Z assigned to the BCBS Plan. by calling 1-844-377-1278 (BCN) or 1-800-728-8008 (Blue Cross) or by logging oncology and in to the AIM ProviderPortal. In the District of Columbia and . Third, it can help you make more informed decisions to choose right insurance plan and benefits. Although we regularly update the BCBS Prefix information but in case youre unable to get information about correct BCBS plan from our BCBS Prefix lookup, feel free to contact us OR call BCBS directory phone number at 800-676-2583. Enter a location and search by doctor or hospital name, health condition, or specialty. First Character P is symbolizing that member plan/product type is BCBS PPO. Our Health Choice plans are available to Arizonans who qualify for Medicaid. Amerihealth Caritas Directory Healthcare, Health Insurance in United States of America, Place of Service Codes List Medical Billing, Empire Blue-Cross Blue-Shield of New York, Anthem Blue-Cross Blue-Shield of Kentucky, Maryland/District of Columbia/Northern Virginia, Highmark Blue-Cross Blue-Shield of Pennsylvania, Anthem Blue-Cross Blue-Shield of Connecticut, Anthem Blue-Cross Blue-Shield of Colorado, Anthem Blue-Cross Blue-Shield of New Hampshire, Anthem Blue-Cross Blue-Shield of Missouri, Blue-Cross Blue-Shield of Western New York, Independence Blue-Cross of Philadelphia and Southeastern Pennsylvania, Anthem Blue-Cross Blue-Shield of Virginia, Excellus Blue-Cross Blue-Shield of New York, Anthem Blue-Cross Blue-Shield of Wisconsin, Highmark Blue-Cross Blue-Shield of West Virginia, Horizon Blue-Cross Blue-Shield of New Jersey, Highmark Blue-Cross Blue-Shield of Delaware. Lo-+J52(h' hb```I! In case, you need any additional information related to BCBS prefix then feel free to reach out to us. Infusion Site of Care Prior Authorization Drug List: New Codes Will Be Added, Effective Jan. 1, 2021 This notice was posted Dec. 28, 2020, to advise you of 14 new codes being added to our specialty pharmacy prior authorization drug list. Curious to know what are national Accounts? For example: A2A12345678 Here " A2A" is BCBS alpha numeric prefix. Few times, BCBS plan members doesnt have prefix mentioned on their BCBS Insurance card. PDF Updated November 2021 - BCBSIL For accurate and quick claims processing, it is necessary to get complete patient insurance information. For Example: ABC, AQT, TXX, TEA, A2B, 2AB, 2A2, PAS, ZGP, XXU etc. Most Blue Cross Blue Shield (BCBS) member IDs begin with a three-character prefix. The three-character prefix identifies the Blue Cross and Blue Shield Plan to which the member belongs. What is Medical Billing and Medical Billing process steps in USA? You can also contact us for specialty medical billing services. And to manage such a big network, they divided it into different departments state wise or employer specific. In some case provider or billing company may file the claim to an incorrect address without checking the correct BCBS address. BCBS Alpha Prefix Lookup 2023 This new site may be offered by a vendor or an independent third party. endstream
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BCBS is one of the biggest insurance companies in USA and serving more than 106 million people. Box 805107, Chicago, Illinois 60680-4112. This step will help you determine if prior authorization may be required for a specific member and service. 1229 0 obj
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Box 14114 Lexington, KY 40512 Federal Employee Program (FEP) R prefix DC/Metropolitan Area 2024884900 MD 8008545256 DC/Metropolitan Area Mail Administrator P.O . BCBS Prefix will not only have numbers and the digits 0 and 1. In addition, some sites may require you to agree to their terms of use and privacy policy. The notice also refers to a medical policy for more information to help clarify when and how prior authorization requirements may apply. Health Equity and Social Determinants of Health (SDoH), Over the Counter Equivalent Exclusion Program, Prior Authorization and Step Therapy Programs, Consolidated Appropriations Act & Transparency in Coverage, Medical Policy/Pre-certification: Out-of-area Members, 2021 Commercial Prior Authorization Requirements Summary, 2021 Commercial Outpatient Medical Surgical Prior Authorization Code List, 2021 Commercial Specialty Pharmacy Prior Authorization Drug List, 2021 Commercial Outpatient Behavioral Health Prior Authorization Code List, New Prior Authorization Requirements for Some Custom Account Members Will Take Effect Jan. 1, 2021, 2021 Medicaid Prior Authorization Requirements Summary, 2021 Medicaid Prior Authorization Code List, 2021 MA PPO Prior Authorization Requirements Summary, 2021 MA PPO Prior Authorization Code List, BCBSIL Provider Network Consultant (PNC) team, Update: Utilization Management Change for Advocate Aurora Health Members, Effective Jan. 1, 2021 This News and Updates was posted Dec.15, 2020, and updated Dec. 31, 2020 to reflect a corrected phone number. %PDF-1.6
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For Example: ABC, AQT, TXX, TEA, A2B, 2AB, 2A2, PAS, ZGP, XXU etc. BCBS Prefix can be classified as follows: BCBS Alpha Prefix - It's a three letter alpha prefix followed by id number. First, it saves you time and hassle by allowing you to quickly identify correct BCBS insurance home plan without having to call customer service. Amerihealth Caritas Directory Healthcare, Health Insurance in United States of America, Place of Service Codes List Medical Billing. The BCBS prefix lookup directory is regularly updated with the latest BCBS insurance plan information, so you can be sure that the information youre viewing is 100% accurate. BCBS Alpha Numeric Prefix Its a three letter Alpha numeric prefix followed by id number. BCBS Alpha Prefix list is useful for both providers and BCBS enrolled members/patients. PDF Blue Cross and BCN utilization management medical drug list - BCBSM DIGNITY HEALTH YAVAPAI REGIONAL MEDICAL CENTER AND BLUE CROSS BLUE SHIELD OF ARIZONA REACH AGREEMENT, FIESTA BOWL AND BLUE CROSS BLUE SHIELD OF ARIZONA OPEN APPLICATIONS FOR FOURTH ANNUAL EMPOWERING DIVERSITY SCHOLARSHIP, PCMH PROGRAM DELIVERS HEALTHIER PATIENTS AND HAPPIER PROVIDERS. Baltimore, MD 21237 . %PDF-1.5
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We make it easy for you to offer the healthcare coverage that delivers for your business. By knowing the details of BCBS home plan, including BCBS insurance plan benefits, coverage options, and costs, you can make better decisions about your healthcare needs. endstream
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We have a track record of providing quality medical billing services to multiple healthcare organizations and specialty providers across USA. TPA Name & Address. The SBC shows you how you and the plan would share t. he cost for covered health care services. This can be especially helpful if youre in a rush or need to access your BCBS prefix home plan information quickly. Prefix UTS assigned to University of Texas. This includes our Medicaid Blue Cross Community Health PlansSM (BCCHPSM) and Blue Cross Community MMAI (Medicare-Medicaid Plan)SM and Blue Cross Medicare Advantage (PPO)SM(MA PPO) members. BCBS alpha numeric prefix contains alphabets as well as digits ranging from 1 to 9. Benefits will be determined once a claim is received and will be based upon, among other things, the members eligibility and the terms of the members certificate of coverage applicable on the date services were rendered. Stand-alone dental products, vision and pharmacy when delivered through an intermediary model. For Federal Employee Program (FEP) precertification requirements, please see the separate FEP precertification list. endstream
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0t9~pE_ >if}~t~iM 'yn8Pgi |hxQD_Y. Independence Blue Cross* Quick Reference Guide . Blue Cross and Blue Shield of Illinois, P.O. Plan Type: PPO . The three-character prefixes listed do not represent an exhaustive listing of prefixes. Please look for claim filing instructions on the back of the ID card. Also, these BCBS prefixes helps providers and medical billers to reach the correct claims department for claims and benefits inquiry. A2Z, G2A, J4K etc. See the Medical oncology prior authorization list for Blue Cross and BCN commercial members for a supportive care drugs (other than CAR -T comprehensivelist of managed by AIM, and groupsincluded in the program. It allows you to quickly and easily identify your insurance home plan, saving you time and hassle. Note for Front Desk and Providers: When Blue Cross Blue Shield members comes to your facility or office, make sure to ask them for their active BCBS plan member ID card. K8Z : Page 2 . Right after completing my degree in 2011, I started my job career as an Accounts Receivable in a medical billing company. 800-676-2583. for medical policies and prior authorization requests. Services that require precertification As of January 1, 2022, this list applies to all Independence Blue Cross HMO, PPO, and POS products, including Flex products. bcbs prefix list PDF,Doc ,Images - pdfprof.com PAJ.
The prior authorization information in this notice does not apply to requests for HMO members. endstream
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Blue Cross Select Silver. Commercial Prior Authorization Summary and Code Lists BCBS Alpha prefix are the three characters at the start of each BCBS insurance member ID. O}BAXv:OP)Qt9>PN,RG4uZu~?raYW+Q`|w[OD klW1Kg|'6'8=rRW00+,oD~`Ox(4DLMm,$Uy69r!$w0.<5>gJd'0?wf\2t| :\xQ cwh)}Ycb8I5vg~TQNnx^Y$M'JL+0?\:3Y(+Sb1:_%^uur(h>mS
The three-character prefix at the beginning of the members identification number is the key element used to identify and correctly route out-of-state claims to the appropriate BCBS Plan. BlueCard. In order to get rid of this denial or sometimes delay in processing, Provider or Billing companies has to find out the correct address by BCBS prefix from the above list before filing the claim.
PPO 837P Prefixes are also applicable, . PDF Provider Quick Reference Guide - CareFirst We update BCBS prefix list data on daily basis to provide latest BCBS prefix home plan information. It means that BCBS members IDs prefix will must have alphabets and they may or may not have numbers. hbbd``b`f3$ bE FM Dmb"@
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Save my name, email, and website in this browser for the next time I comment. The following summary and related prior authorization lists were posted on the Support Materials (Commercial) page the Utilization Management section of our Provider website as of Jan. 1, 2021: Commercial Communications BCBS prefix is a three character prefixes followed by the id number except for the following products and programs. ;MTK PAH. b(f{YH^tn}u62\}TgT>ENWJB=J #=a$oXIq(n,tU+D'j}L(t#,w?!^oZUQR, 7a. bcbs prefix list PDF,Doc ,Images [PDF] Common Prefix Portal List PBC Premera Blue Cross Three Character Prefixes. 15456 0 obj
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The policy number is usually provided to the policyholder, who is the individual or entity that holds the insurance policy. e@'SZD/KCbv*pKq~ Some members ID cards may not have an alpha prefix. BCBS alpha prefix only contains alphabets and each alpha prefix represents different BCBS home plan. BCBS is one of the largest medical insurance company by total members of more than 45 million. Unraveling the Truth, United Healthcare Claims Address, Payer ID, Fax and Phone Number, BCBS Prefix List 2023 Alpha Prefix and Alpha Number Prefix Lookup, BCBS Alpha Numeric Prefix from L2A to L9Z (Updated 2023), BCBS Provider Phone Number for Claims and Eligibility Verification, Benefits and Eligibility Verification Services.
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