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. Fill in this form (sign-in required) to give us information about your other coverage. Group - Fully-insured and administrative services only (ASO) Individual; Medicare Advantage plans; Uniform Medical Plan: 1 (888) 849-3682 . Provider Contact Center: 1 (800) 253-0838. 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. 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. Access most member eligibility, benefits and claims information online using the Availity Portal. 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 A claim denied as a duplicate when services were performed more than one time, and payment does not reflect multiple service payment. Access Regence Group Administrators member forms for appeal submissions, care claims, and authorizations. 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). Claims mailing address. These are complex claims, Hensley said. admission. Learn more about when, and how, to submit claim attachments. PART 1: *Indicates required information. Group - Fully-insured and administrative services only (ASO). You can verify your address by calling PEBB UMP Customer In Payer Spaces you can access our reimbursement schedules, pricing documents and more. To submit a claim online, go to the “Member Dashboard / Claims” section and select the yellow “Submit a Claim” button. 4. Claims Department P.O. Fax 1-877-663-7526. A contact lens exam is not included in the annual eye exam and eye health exam. Host Plan phone: Monday through Friday, 6 a.m. to 5 p.m. (PT). Find forms to request pre-authorization, care management or appeals, or direct overpayment recovery. Find hearing information and important documents from the Washington state Office of the Insurance Commissioner regarding Regence BlueShield. Plus, have the peace of mind that comes from emergency coverage wherever you’re traveling. 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. The Plus plan networks are smaller, as each consists of regional providers spread throughout western Washington. With the Uniform Medical Plan, you may choose from the plans listed below. Choose a plan that opens doors to top doctors and coordinated, cost-saving networks close to home. Provider Contact Center staff will also verify that the TIN you entered corresponds to the member you are calling about. Fax: 800‐207‐8235, ATTN: Rx Claims Department . Remember, if you cover eligible dependents, everyone must enroll in the same medical plan. What are my plan options? Phone: 800-732-1209. Provider Contact Center: 1 (800) 253-0838. Your evidence must support that you followed Regence policy. You can also submit claims via mail to our claims address P.O. Primary member/subscriber ID number* Group/employer name: Uniform Medical Plan . This section applies to requests for appeal when: NCCI or CCE coding rules apply to a claim or claim line. Claims and correspondence. 4. View our guidelines for claims submission and helpful coding resources. Box 7968 Madison, WI 53707-7968 www.tricare-overseas.com: Eurasia Africa (All Others) TRICARE Overseas Program P.O. 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 … Pre-authorization: Use our online tool to be routed to the home plan's requirements. We can work with that company to reduce your costs. Learn more about informational, preventive services and functional modifiers. Thank you for choosing Regence for your health care coverage. Learn more about our customized editing rules, including clinical edits, bundling edits, and outpatient code editor. Tacoma, WA 98401-2998. The Classic and CDHP plans share the same large network that includes providers both nationwide and worldwide. 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. Sign up for EFT and quickly receive payment. 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. The remainder goes to Regence, which on behalf of the state pays the rest, or however much the state Uniform Medical Plan allows. 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 … Frequently Asked Questions. Regence BlueShield assumed administration functions for the state’s Uniform Medical Plan (UMP) in January 2011. Fax 1-844-679-7763. The Uniform Medical Plan (UMP) Pre-authorization List includes services and supplies that require pre-authorization or notification for UMP members. Prescription Drug Claim Form . Uniform Medical Plan CDHP 2017 Certificate of Coverage (COC) www.hca.wa.gov. 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). 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. 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. Preauthorization. (medical services). Member claims. Are you covered by Regence and another health insurance company? For services abroad please utilize the International Claim Form located at www.bcbsglobalcore.com. 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. Please complete a separate form for each family member. Depending on your insurance plan, your out-of-network cost may be … PO Box 2998. 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 … Online access to medical claims. Regence Blue Shield in accordance with the terms of your provider contract with Regence. Blue Shield of Idaho PO Box 30270 Salt Lake City, UT 84131-0207. 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. 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. An authorization must be on file to ensure proper claims payment. You can verify your address by calling PEBB Customer Service at Download and print helpful material for your office. If you do not submit your claims through the Availity Provider Portal, follow this process to submit your claims to us electronically. For prescription, supplies or medical equipment requests, please complete a "Prescription & Durable Medical Equipment Claim Form" (PD001). We accept electronic claims through Availity using payer ID RGA01. 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 are about to leave regence.com and enter another website that is not affiliated with or licensed by the Blue Cross Blue Shield Association. The time limit for filing claims is one year from the date of service/purchase. Our interactive voice response system is also available 24 hours a day, seven days a week when calling the Provider Contact Center. As a member, you can register and sign in to view your claims and benefits information and get access to members-only tools. The mission of Sound Generations is to assist and educate people of all ages so they can make informed insurance decisions. A plan’s network consists of doctors, clinics, hospitals, specialists, and other health care providers. You will be prompted to enter your tax identification number (TIN). Overseas (Active Duty) TRICARE Active Duty Claims P.O. Blue Shield of Idaho PO Box 30270 Salt Lake City, UT 84131-0207. Your account at www.regence.com. Contact lenses are medical devices and require an exam to obtain or renew your prescription. 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. Providers call 1-888-849-3682. Where should I submit claims? Regence Uniform Medical Plan (UMP) Insurance Connections Behavior Planning & Intervention is a preferred provider with Regence UMP. Uniform Medical Plan ublic Employees Benefits Board (PEBB) – 10008217 . 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. (Medical services). To browse each plan’s network or to find a … Note: Box 52890 Bellevue WA 98015 or fax at 1 … The Puget Sound High Value Network (PSHVN) is a network comprised of the highest quality health care organizations. By using providers within your network, your health care costs will be significantly lower than if you use providers outside your network. 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], 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. Our Provider Contact Center is available for information that cannot be served by the Availity Portal. Box 202112 Florence, SC 29502-2112 www.tricare-west.com. Learn more about the plans. Learn about submitting BlueCard claims. What is a Uniform Medical Plan (UMP)? National BlueCard member benefits and eligibility: Phone 1 (800) 676-2583, Monday through Friday, 7:30 a.m. to 10 p.m. (PT). Use the electronic authorization tool to determine whether pre-authorization is required and submit requests online. an informed decision. You are about to leave regence.com and enter another website that is not affiliated with or … 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 We provide Applied Behavioral Analysis (ABA) therapy benefit for Regence UMP members.Regence will cover ABA Therapy. Coordination of Benefits, Medicare crossover and other party liability or subrogation. 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