What services does not require prior authorization?
No pre-authorization is required for outpatient emergency services as well as Post-stabilization Care Services (services that the treating physician views as medically necessary after the emergency medical condition has been stabilized to maintain the patient’s stabilized condition) provided in any Emergency Department …
What is the claims address for Blue Cross Blue Shield of Massachusetts?
Mailing Address (claims and correspondence): Blue Benefit Administrators of Massachusetts. PO BOX 55917. Boston, MA 02205-5917.
What is a standard authorization form?
The authorization form (sometimes called a patient HIPAA consent form), essentially serves as a handy dandy permission slip allowing a practice or business associate to use or disclose protected health information (PHI) in the ways a patient wants their data used.
Does PPO require prior authorization?
PPOs differ on which tests, procedures, services, and treatments they require pre-authorization for, but you should suspect you’ll need pre-authorization for anything expensive or anything that can be accomplished more cheaply in a different manner.
Who is eligible for FEP?
Your eligible family member can include either a spouse OR a child up to age 26. A child age 26 or over who is incapable of self-support because of a mental or physical disability that existed before age 26 is also an eligible family member.
What is an FEP member?
For 60 years, the Blue Cross and Blue Shield Service Benefit Plan, also known as the Federal Employee Program—or simply FEP—has provided health insurance to the federal employee workforce. It’s also because in everything we do, our members’ health and well-being always come first.
What is the payer ID for BCBS of MA?
Payer Name: Blue Cross Blue Shield of Massachusetts|Payer ID: BS059|Professional (CMS 1500)
What does Phi stand for Blue Cross Blue Shield?
HIPAA allows us to use and disclose identifiable health care and demographic information called Protected Health Information (PHI) for T reatment, P ayment and H ealth care operations (TPO) purposes.
What forms does Blue Cross and blue shield of Massachusetts provide?
A request form to inspect or obtain copies of your protected health information in the designated record set that Blue Cross and Blue Shield of Massachusetts maintains. A form to request coverage a psychologically or physically disabled dependent child.
How do I contact BCBSMA for medication request?
MASSACHUSETTS STANDARD FORM FOR MEDICATION PRIOR AUTHORIZATION REQUESTS *Some plans might not accept this form for Medicare or Medicaid requests. For professionally administered medications (including buy & bill), fax to 1-888-641-5355. For BCBSMA employees, fax to 1-617-246-4013. E. Compound and Off Label Use
How do I show my eligibility for Blue Cross and blue shield?
Use this form to show your eligibility. A request form to inspect or obtain copies of your protected health information in the designated record set that Blue Cross and Blue Shield of Massachusetts maintains. A form to request coverage a psychologically or physically disabled dependent child.
What does *Blue Cross stand for?
*Blue Cross refers to Blue Cross and Blue Shield of Massachusetts, Inc., Blue Cross and Blue Shield of Massachusetts HMO Blue ®, Inc., and/or Massachusetts Benefit Administrators LLC, based on Product participation. MPC_061319-2B-2 (11/19) Transition of Care A form for submitting a vision claim, with instructions for filing a claim.