Diabetes. Regence BlueCross BlueShield of Oregon | OneHealthPort Waiting too long on the phone, waiting room, in the exam room or when getting a prescription, The length of time required to fill a prescription or the accuracy of filling a prescription, Access to health care benefits, including a pre-authorization request denial, Claims payment, handling or reimbursement for health care services, A person who has bought insurance for themselves (also called a contract holder) and any dependents they choose to enroll. If an initial phone call does not resolve your complaint, you may submit your complaint over the phone or by email, fax, or mail. Regency Blue Cross Blue Shield Of Oregon (541) 772-8906 Visit Website Map & Directions 2057 Commerce Dr Medford, OR 97504 Write a Review. Visit the Regence provider website, regence.com to learn more about: Contact Us View information about who to contact for questions and issues. Call customer service and web support at 800-607-0546 between 8 a.m. and 6 p.m., Monday through Friday, Pacific Time. For more information about dual coverage, read the If you have other medical coverage (or UMP High Deductible "If you have other HDHP coverage") section in your plans certificate of coverage. Why choose Regence Individual & family plans You can submit your appeal online, by email, by fax, by mail, or you can call using the number on the back of your member ID card. (Note: Claims received with an ICD-9 code will be rejected with a notice to re-bill using ICD-10.) Complete the Prescription Drug Claim Form and send it with your pharmacy receipts to: Pharmacy Manual ClaimsP.O. For member appeals that qualify for a faster decision, there is an expedited appeal process. Tagalog | Regence BlueCross BlueShield of Oregon hiring Trainer I in Medford Premera Blue Cross Blue Shield of Alaska FEP PO Box 33932 Seattle, WA 98133-0932, Phone:800-562-1011 Claims edits If you do not submit your claims through Availity Essentials, follow this process to submit your claims to us electronically. Your provider should supply clinically relevant information, such as medical records for services denied based on medical necessity or for other clinical reasons. 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. Completion of the credentialing process takes 30-60 days. Coverage decisionsA coverage decision is a decision we make about what well cover or the amount well pay for your medical services or prescription drugs. Box 1106 Lewiston, ID 83501-1106 Fax: 1 (877) 357-3418 . <> 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. Overpayment Recovery Process - Regence See Complaints about quality of care in your certificate of coverage to learn more. You should wait until the primary plan has paid to submit a secondary claim to UMP, unless the primary plan's processing of the claim is delayed. Grievances must be filed within 60 days of the event or incident. Regence BlueCross BlueShield of Oregon. PO Box 52080 Rev 3/2007 We're ready. Premera Blue Cross See what were doing in your community to keep people safe and healthy. Get 5 free searches. 2 0 obj You must submit prescription drug claims within 12 months of purchase. Join us! If the decision was after the 60-day timeframe, please include the reason you delayed filing the appeal. Learn more about our payment and dispute (appeals) processes. Locate a network pharmacy by using the Pharmacy Locator Tool. Regence BlueCross BlueShield of Oregon, headquartered in Portland, has been serving Oregonians since 1941 and now provides more than 974,000 people with comprehensive health insurance solutions. Portugus | The ambulance claim will be processed by Blue Cross Blue Shield of Oregon. TTY users should call, 1-800-325-0778; or your Medicaid Office. Open 24 hours a day, 7 days a week. Regence Provider Appeal Form Special Message: Coming soon, you will be able to dispute (appeal) a claim on Availity from the claim status result page. You or your authorized representative (including a relative, friend, advocate, attorney, or provider) may submit an appeal by using the methods described in the Where to send complaints or appeals section below or by calling UMP Customer Service (medical appeals) or WSRxS Customer Service (prescription drug appeals). Regence BlueShield serves select counties in the state of Washington and is an independent licensee of the Blue Cross and Blue Shield Association. A complaint or grievance is an oral statement or written document submitted by or on behalf of a member regarding: Note: If your issue is regarding a denial, reduction, or termination of payment or non-provision of medical services, it is an appeal. Make sure you contact the right company (see below). In every state and every community, BCBS companies are making a difference not just for our members, but For the Health of America. treatment center. You have the right to appeal, or request an independent review of, any action we take or decision we make about your coverage, benefits or services. 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. If you buy your prescription drugs at a network pharmacy, your claim will be submitted for you.
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