independent licensees of the Blue Cross and Blue Shield Association Look for announcements about revised payer ID grids in Partners in Health UpdateSM
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[PDF] Update Minnesota Health Care Programs Payer ID - Blue Cross MN
23 jan 2019 · Claims for Blue Cross and Blue Shield of Minnesota and Blue Plus Minnesota Health Care Programs (MHCP) subscribers, including Families
[PDF] Payer ID provider number reference - Independence Blue Cross
independent licensees of the Blue Cross and Blue Shield Association Look for announcements about revised payer ID grids in Partners in Health UpdateSM
[PDF] BCBSMN Eligibility and Benefits Tips - Availity
Review the payer's website Blue Cross and Blue Shield of Minnesota: type displays in the list above the top five for that payer All benefit/service types are
[PDF] Claims and Remits Payer List - Experian
12 mar 2021 · Aetna Better Health of Nebraska (for claims with DOS prior to 1/1/17) 42130 837 ✓ ✓ Anthem Blue Cross Blue Shield of California (Claims and Encounters) 47198 837 ✓ ✓ Delta Dental Minnesota 07000 837 ✓
[PDF] AUC payer contact information for faxing claims attachments and
Disclaimer: The following information has been provided by AUC Payer Members in efforts to provide further assistance with electronic connectivity Blue Cross Blue Shield Minnesota and Blue Plus mailing address on the patient's ID card
[PDF] List of Automatic Crossover Trading Partner (Insurers) In - CMS
Do Not Include Number Shown Below on Incoming Claims Coordination of Supplemental Payers and Insurers (Trading Partners) Updated: 09/30/ BCBS OF MINNESOTA 00088 Of ID Card EMPIRE BLUE CROSS BLUE SHIELD II
[PDF] PROGRAM COMPARISON UPlan/SEGIP UPlan MTM Network
The MTM Network currently provides MTM services for two programs: UPlan MTM Benefit Program and State of Minnesota SEGIP (State Employee of the agreement Payer ID Medica 94265 Blue Cross/Blue Shield: 00720 Health Partners:
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BlueCross BlueShield BluePlus of Minnesota Featured below is an example of the new ID card for Covered Persons of BlueCross BlueShield BluePlus of
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Payer ID provider number reference Professional 1 Use this guide as a reference tool when submitting professional claims. The information was current at the time of publication. We will announce changes on the
Provider News Center and the Provider Engagement, Analytics & Reporting (PEAR) portal.Product namePayer information
for electronic claimsPaper claim mailing addressBilling providerISA-08GS-03
Keystone Health Plan EastIndependence
QCGKeystone Health Plan East POS
5470495056Claims Receipt Center
P.O. Box 211184
Eagan, MN 55121Valid and registered
NPI is
required.Electronic (837P)
Loop 2010AA
NM108 = XX
NM109 = NPI #
Paper (CMS-1500)
NPI # - Box 33AQCHKeystone Health Plan East HMO
QCIKeystone 65 HMO
Keystone 65 Focus Rx HMO
QCJKeystone Health Plan East ERISA POS
QCKKeystone 65 POS
QCLKeystone Health Plan East ERISA HMO
QHXႇ
QSPIBC HMO Proactive Small Group
QXJIBC HMO Proactive Individual - On Exchange
YXQKeystone HMO Platinum - On Exchange*
Keystone HMO Gold - On Exchange
Keystone HMO Silver Classic - On Exchange
Keystone HMO Silver Basic - On Exchange
Keystone HMO Bronze - On Exchange
Keystone HMO Gold Classic - On Exchange
YXRSmall Group POS - On Exchange*
YXW ႇPersonal ChoiceIndependence
WYXPersonal Choice EPO - HSA
5470454704Claims Receipt Center
P.O. Box 211184
Eagan, MN 55121YXFPersonal Choice PPO
YXKPersonal Choice 65
SM PPOPersonal Choice 65 Prime Rx PPO
Payer ID provider number reference ProfessionalRev. April 2023
2Product namePayer information
for electronic claimsPaper claim mailing addressBilling providerISA-08GS-03
Personal Choice
(continued)IndependenceValid and registered
NPI is
required.Electronic (837P)
Loop 2010AA
NM108 = XX
NM109 = NPI #
Paper (CMS-1500)
NPI # - Box 33AYXO
5470454704Claims Receipt Center
P.O. Box 211184
Eagan, MN 55121ႇ
YXPPersonal Choice PPO Platinum - On Exchange*
Personal Choice PPO Gold - On Exchange
Personal Choice PPO Gold Classic - On Exchange
Personal Choice PPO Silver - On Exchange
Personal Choice PPO Bronze - On Exchange
Personal Choice PPO Bronze Reserve - On Exchange*
YXUSmall Group PPO - On Exchange*
YXX Personal Choice EPO Catastrophic, Bronze Basic, Gold*, Bronze Reserve, Platinum*, and Silver Reserve* - On Exchange YXY Personal Choice EPO Catastrophic, Bronze Basic, Gold*,Bronze Reserve, Platinum*, Silver Reserve*,
BlueCard
Independence
PPO Professional Blue Cross or Blue Shield member ID card with Medicare Advantage PPO Blue Cross or Blue Shield member ID card5470454704Claims Receipt Center
P.O. Box 211184
Eagan, MN 55121
Payer ID provider number reference ProfessionalRev. April 2023
3Product namePayer information
for electronic claimsPaper claim mailing addressBilling providerISA-08GS-03
BlueHPN
Independence
All BlueHPN Prefixes
the Blue High Performance Network name and the "BlueHPN in a suitcase" logo ID Card Back: A disclaimer indicates that the member has5470454704Claims Receipt Center
P.O. Box 211184
Eagan, MN 55121
Valid and registered
NPI is
required.Electronic (837P)
Loop 2010AA
NM108 = XX
NM109 = NPI #
Paper (CMS-1500)
NPIBox 33A
Blue Cross
Independence
QMOMedigapFreedom5470454704Claims Receipt Center
P.O. Box 211184
Eagan, MN 55121
Blue Shield
Highmark
QCAQCCTraditional Blue Cross
Blue Shield
Concurrent Major Medical
5477154771Highmark Blue Shield
P.O. Box 890062
Camp Hill, PA 17089-0062QCESecurity 65
, 65 Special, and MedigapSecurity QCNQCO Comprehensive Major Medical (CMM)
Blue Cross Indemnity
QCRMedigap, Blue Cross only
Federal Blue CrossHighmark
R followed by 8 numeric charactersFederal Employee Program (FEP) member ID starts with an "R"5477154771Highmark Blue ShieldP.O. Box 890062
Camp Hill, PA 17089-0062
Payer ID provider number reference ProfessionalRev. April 2023
4 When treating non-Independence members, professional claims for Highmark Blue Shield, Highmark Blue Cross Blue Shield of Delaware, Highmark BCBS of Western New York, Highmark BS Northeastern New York, and HighmarkProduct namePayer information
for electronic claimsPaper claim mailing addressBilling providerISA-08GS-03
Third-party administratorsIndependence
Administrators
Valid and registered
NPI is
required.Electronic (837I)
Loop 2010AA
NM108 = XX
NM109 = NPI #
Paper (UB-04)
NPI # - Box 56Independence Administrators
I ndependence Administrators logo on the ID card withIndependence Administrators
For additional claims information, visit
54704TA720 or