An authorization must be on file to ensure proper claims payment. Regence Blue Shield in accordance with the terms of your provider contract with Regence. No enrollment needed, submitters will receive this transaction automatically, Web portal only: Referral request, referral inquiry and pre-authorization request, Implementation Acknowledgement for Health Care Insurance. Learn more about the plans. 4. Regence Uniform Medical Plan (UMP) Insurance Connections Behavior Planning & Intervention is a preferred provider with Regence UMP. What are my plan options? A plan’s network consists of doctors, clinics, hospitals, specialists, and other health care providers. To submit a claim online, go to the “Member Dashboard / Claims” section and select the yellow “Submit a Claim” button. Download and print helpful material for your office. Box 52890 Bellevue WA 98015 or fax at 1 … National BlueCard member benefits and eligibility: Phone 1 (800) 676-2583, Monday through Friday, 7:30 a.m. to 10 p.m. (PT). Learn more about when, and how, to submit claim attachments. Provider Contact Center staff will also verify that the TIN you entered corresponds to the member you are calling about. Sound Generations helps individuals understand the basics of Medicare, long-term care and related insurance, plan for retirement, process medical billings, claims and appeals and understand health care reform. Blue Shield of Idaho PO Box 30270 Salt Lake City, UT 84131-0207. Where should I submit claims? Uniform Medical Plan ublic Employees Benefits Board (PEBB) – 10008217 . UMP is administered by Regence BlueShield and Washington State Rx Services. For information that cannot be served by the Availity Portal, our Provider Contact Center is available Monday through Friday, 6 a.m. to 5 p.m. (PT). The Puget Sound High Value Network (PSHVN) is a network comprised of the highest quality health care organizations. Coordination of Benefits, Medicare crossover and other party liability or subrogation. We provide Applied Behavioral Analysis (ABA) therapy benefit for Regence UMP members.Regence will cover ABA Therapy. You are about to leave regence.com and enter another website that is not affiliated with or licensed by the Blue Cross Blue Shield Association. Preauthorization. Even though I am "out-of-network" with all Regence, Health Management Administrators (HMA), and Uniform Medical Plans, I am happy to submit claims on your behalf for your out-of-network benefits. You can verify your address by calling PEBB Customer Service at What is a Uniform Medical Plan (UMP)? Our Provider Contact Center is available for information that cannot be served by the Availity Portal. PO Box 2998. For prescription, supplies or medical equipment requests, please complete a "Prescription & Durable Medical Equipment Claim Form" (PD001). We provide flexible, affordable health care for members of the School Employees Benefits Board (SEBB) and Public Employees Benefits Board (PEBB) programs.. PSHVN has a large geographic footprint with over 6,500 providers and 1,100 locations. Phone: 800-732-1209. By using providers within your network, your health care costs will be significantly lower than if you use providers outside your network. A claim denied as a duplicate when services were performed more than one time, and payment does not reflect multiple service payment. Host Plan phone: Monday through Friday, 6 a.m. to 5 p.m. (PT). If you do not submit your claims through the Availity Provider Portal, follow this process to submit your claims to us electronically. Depending on your insurance plan, your out-of-network cost may be … You are about to leave regence.com and enter another website that is not affiliated with or licensed by the Blue Cross Blue Shield Association. Box 7968 Madison, WI 53707-7968 www.tricare-overseas.com: Eurasia Africa (All Others) TRICARE Overseas Program P.O. Use the electronic authorization tool to determine whether pre-authorization is required and submit requests online. To help you decide on a plan, it can be helpful to know the network—or the group of doctors, hospitals and pharmacies that are part of the plan. Blue Shield of Idaho PO Box 30270 Salt Lake City, UT 84131-0207. an informed decision. Fax: 800‐207‐8235, ATTN: Rx Claims Department . Plus, have the peace of mind that comes from emergency coverage wherever you’re traveling. Use this claim form for any reimbursement requests you may have or if you prefer, send a copy of your bill with your Group and ID Numbers written at the top and mail to the address below. This includes all applicable professional and facility claims: • Effective April 1, 2019, for professional services • Effective May 1, 2019, for facility services These requirements apply to all Regence plans (group, Individual, Uniform Medical Plan [UMP], Access most member eligibility, benefits and claims information online using the Availity Portal. We accept electronic claims through Availity using payer ID RGA01. Preventive care list Check this list to see which preventive services are covered, for whom and how often they are recommended. The time limit for filing claims is one year from the date of service/purchase. The Classic and CDHP plans share the same large network that includes providers both nationwide and worldwide. 30% of costs until the plan has paid $500 (for PPO, out of state, and non-PPO providers); then any amount over $500 in the member's lifetime (maximum lifetime benefit) This is a summary of UDP plan … Fax 1-844-679-7763. For services abroad please utilize the International Claim Form located at www.bcbsglobalcore.com. Learn more about informational, preventive services and functional modifiers. This exam includes computerized topography and mapping of the cornea as well as an evaluation of which lenses will fit and provide optimal comfort, vision, and eye health. Regence BlueShield assumed administration functions for the state’s Uniform Medical Plan (UMP) in January 2011. Find hearing information and important documents from the Washington state Office of the Insurance Commissioner regarding Regence BlueShield. About Uniform Medical Plan (UMP), administered by Regence BlueShield. Fax 1-877-663-7526. Provider claims. Video en español About Uniform Medical Plan Uniform Medical Plan (UMP) is a collection of high-quality, self-insured preferred provider organization (PPO) health plans and accountable care plans offered through Washington State’s Public Employees Benefits Board (PEBB) Program. Our interactive voice response system is also available 24 hours a day, seven days a week when calling the Provider Contact Center. The Plus plan networks are smaller, as each consists of regional providers spread throughout western Washington. Uniform Medical Plan (UMP) is a collection of high-quality, self-insured preferred provider organization (PPO) health plans and accountable care plans offered through Washington State’s School … Learn more about our customized editing rules, including clinical edits, bundling edits, and outpatient code editor. With the Uniform Medical Plan, you may choose from the plans listed below. Uniform Medical Plan (UMP) is a self-insured health plan offered through the Washington State Health Care Authority’s (HCA) Public Employees Benefits Board (PEBB) Program and the School Employees Benefits Board (SEBB) Program.UMP is administered by Regence … (Medical services). Pre-authorization: Use our online tool to be routed to the home plan's requirements. The mission of Sound Generations is to assist and educate people of all ages so they can make informed insurance decisions. Please complete a separate form for each family member. Provider Contact Center: 1 (800) 253-0838. You can verify your address by calling PEBB UMP Customer Note: Group - Fully-insured and administrative services only (ASO). Group - Fully-insured and administrative services only (ASO) Individual; Medicare Advantage plans; Uniform Medical Plan: 1 (888) 849-3682 . You can also submit claims via mail to our claims address P.O. For information that cannot be served by the Availity Portal, our Provider Contact Center is available Monday through Friday, 6 a.m. to 5 p.m. (PT). Providers call 1-888-849-3682. Claims and correspondence. PART 1: *Indicates required information. Access Regence Group Administrators member forms for appeal submissions, care claims, and authorizations. In Payer Spaces you can access our reimbursement schedules, pricing documents and more. These are complex claims, Hensley said. Thank you for choosing Regence for your health care coverage. Your account at www.regence.com. In August, the Health Care Authority (HCA, which administers the PEBB Program) called for a recovery plan after Regence had amassed more than 300,000 backlogged claims-most of them Medicare claims by retired state workers. Contact lenses are medical devices and require an exam to obtain or renew your prescription. Regence 1800 Ninth Avenue PO BOX 91015 Seattle, WA 98111-9115 h ttE c' Uniform Medical Plan MEDICAL CLAIM FORM Use this form to submit reimbursement requests for services received from a non-network provider. Your evidence must support that you followed Regence policy. Tacoma, WA 98401-2998. We can work with that company to reduce your costs. Uniform Medical Plan CDHP 2017 Certificate of Coverage (COC) www.hca.wa.gov. View our guidelines for claims submission and helpful coding resources. Box 202112 Florence, SC 29502-2112 www.tricare-west.com. The Uniform Medical Plan (UMP) Pre-authorization List includes services and supplies that require pre-authorization or notification for UMP members. Overseas (Active Duty) TRICARE Active Duty Claims P.O. A contact lens exam is not included in the annual eye exam and eye health exam. UMP Achieve 1 UMP Achieve 2 UMP High Deductible UMP Plus—Puget Sound High Value Network UMP Plus—UW Medicine Accountable Care Network UMP Plus— Puget Sound Learn about submitting BlueCard claims. 4. Member claims. (medical services). The remainder goes to Regence, which on behalf of the state pays the rest, or however much the state Uniform Medical Plan allows. The Uniform Medical Plan (UMP) was built to provide top-quality, affordable healthcare to eligible Washington state public employees (active and retired), Leave Without Pay members, non-Medicare retirees or COBRA members. Sign the completed form where indicated at the bottom of this page and submit the completed claim form to: Regence BlueShield Attn: UMP Claims PO Box 1106 Lewiston, ID 83501-1106 or by fax to: 1 (877) 357-3418 Payments will be mailed to the address on file for the subscriber. To browse each plan’s network or to find a … Sign the completed form where indicated at the bottom of this page and submit the completed claim form to: Regence BlueShield Attn: UMP Claims PO Box 1106 Lewiston, ID 83501-1106 Or by fax to: 1-877-357-3418 Payments will be mailed to the address on file for the subscriber. Regence BlueShield Regence BlueShield serves select counties in the state of 1800 Ninth Avenue | Seattle, WA 98101 Washington and is an Independent Licensee of the Blue Cross and Blue Shield Association © 2020 Regence BlueShield What’s new at UMP (PEBB) for 2021 Find forms to request pre-authorization, care management or appeals, or direct overpayment recovery. Claims Department P.O. Choose a plan that opens doors to top doctors and coordinated, cost-saving networks close to home. Primary member/subscriber ID number* Group/employer name: Uniform Medical Plan . Sign up for EFT and quickly receive payment. 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