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], Preauthorization. Our interactive voice response system is also available 24 hours a day, seven days a week when calling the Provider Contact Center. 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. The Plus plan networks are smaller, as each consists of regional providers spread throughout western Washington. 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. Regence Uniform Medical Plan (UMP) Insurance Connections Behavior Planning & Intervention is a preferred provider with Regence UMP. Providers call 1-888-849-3682. Learn more about the plans. Box 52890 Bellevue WA 98015 or fax at 1 … Provider claims. 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). PO Box 2998. The Uniform Medical Plan (UMP) Pre-authorization List includes services and supplies that require pre-authorization or notification for UMP members. 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. Learn more about our customized editing rules, including clinical edits, bundling edits, and outpatient code editor. Online access to medical claims. Where should I submit claims? We accept electronic claims through Availity using payer ID RGA01. 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. 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. Contact lenses are medical devices and require an exam to obtain or renew your prescription. 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 time limit for filing claims is one year from the date of service/purchase. Are you covered by Regence and another health insurance company? In Payer Spaces you can access our reimbursement schedules, pricing documents and more. Our Provider Contact Center is available for information that cannot be served by the Availity Portal. You can verify your address by calling PEBB Customer Service at 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. You can also submit claims via mail to our claims address P.O. Prescription Drug Claim Form . These are complex claims, Hensley said. You will be prompted to enter your tax identification number (TIN). Remember, if you cover eligible dependents, everyone must enroll in the same medical plan. Coordination of Benefits, Medicare crossover and other party liability or subrogation. For prescription, supplies or medical equipment requests, please complete a "Prescription & Durable Medical Equipment Claim Form" (PD001). Group - Fully-insured and administrative services only (ASO). To submit a claim online, go to the “Member Dashboard / Claims” section and select the yellow “Submit a Claim” button. 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 … Learn more about when, and how, to submit claim attachments. Box 202112 Florence, SC 29502-2112 www.tricare-west.com. Fax 1-877-663-7526. Regence Blue Shield in accordance with the terms of your provider contract with Regence. We can work with that company to reduce your costs. A claim denied as a duplicate when services were performed more than one time, and payment does not reflect multiple service payment. We provide Applied Behavioral Analysis (ABA) therapy benefit for Regence UMP members.Regence will cover ABA Therapy. Download and print helpful material for your office. Blue Shield of Idaho PO Box 30270 Salt Lake City, UT 84131-0207. Provider Contact Center staff will also verify that the TIN you entered corresponds to the member you are calling about. 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. 4. (medical services). For services abroad please utilize the International Claim Form located at www.bcbsglobalcore.com. As a member, you can register and sign in to view your claims and benefits information and get access to members-only tools. Frequently Asked Questions. 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. With the Uniform Medical Plan, you may choose from the plans listed below. Claims Department P.O. Box 7968 Madison, WI 53707-7968 www.tricare-overseas.com: Eurasia Africa (All Others) TRICARE Overseas Program P.O. Thank you for choosing Regence for your health care coverage. PART 1: *Indicates required information. Provider Contact Center: 1 (800) 253-0838. What is a Uniform Medical Plan (UMP)? What are my plan options? Regence BlueShield assumed administration functions for the state’s Uniform Medical Plan (UMP) in January 2011. Access Regence Group Administrators member forms for appeal submissions, care claims, and authorizations. You are about to leave regence.com and enter another website that is not affiliated with or … Note: The Puget Sound High Value Network (PSHVN) is a network comprised of the highest quality health care organizations. Phone: 800-732-1209. UMP is administered by Regence BlueShield and Washington State Rx Services. Preventive care list Check this list to see which preventive services are covered, for whom and how often they are recommended. Please complete a separate form for each family member. Blue Shield of Idaho PO Box 30270 Salt Lake City, UT 84131-0207. To browse each plan’s network or to find a … Learn about submitting BlueCard claims. The remainder goes to Regence, which on behalf of the state pays the rest, or however much the state Uniform Medical Plan allows. An authorization must be on file to ensure proper claims payment. A contact lens exam is not included in the annual eye exam and eye health exam. 4. 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. Use the electronic authorization tool to determine whether pre-authorization is required and submit requests online. Depending on your insurance plan, your out-of-network cost may be … Uniform Medical Plan CDHP 2017 Certificate of Coverage (COC) www.hca.wa.gov. Access most member eligibility, benefits and claims information online using the Availity Portal. 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 … Tacoma, WA 98401-2998. 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. Plus, have the peace of mind that comes from emergency coverage wherever you’re traveling. The Classic and CDHP plans share the same large network that includes providers both nationwide and worldwide. Fax 1-844-679-7763. (Medical services). You can verify your address by calling PEBB UMP Customer 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. Your account at www.regence.com. The mission of Sound Generations is to assist and educate people of all ages so they can make informed insurance decisions. Claims mailing address. Find forms to request pre-authorization, care management or appeals, or direct overpayment recovery. Claims and correspondence. Your evidence must support that you followed Regence policy. This section applies to requests for appeal when: NCCI or CCE coding rules apply to a claim or claim line. admission. Overseas (Active Duty) TRICARE Active Duty Claims P.O. 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 … Regence and another health insurance company voice response system is also available 24 hours a day, seven days week. 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