Tuesday, June 29, 2010

BCBS alpha prefix list and claim submission address - Begins with A and B

Blue Cross Blue Shield Prefix Assignments

Prefix begin with A & B

 Prefix    Product    Area    Billing Address    Phone #    Employer  
 AAX    CA    BC CA, POB 60007  ,  Los Angeles  ,  CA  ,  90060    800-765-2588    PC 800-275-7767  
 ABW    VA    BC VA, Trigon POB 27401  ,  Richmond  ,  VA  ,  23279    800-445-7490  
 ACM    MA  
 ACN    PA    BC PA, Highmark BC PO Box 1210  ,  Pittsburgh  ,  PA  ,  15230    800-682-3386    800-544-9335 (PC)  
 ACT    NY    BCBS Empire, POB 11800  ,  Albany  ,  NY  ,  12211-0800    800-992-2583  
 AEO    MI    BC MI, POB 1618  ,  Detroit  ,  MI  ,  48231    800-462-7237    AerpQuip INOAC Co (Medicare Comp)  
 AFM    PA    BC PA, 5th Ave Pl Ste 2012L  ,  Pittsburgh  ,  PA  ,  15222    800-489-4484    800-452-8507(PC)  
 AFV    PPO    Excel  
 American Food & Vending (eff 9/1/02  
 AGB    PPO    CNY  
 TL Cannon Mgmt Corp  
 AGC    MO    BCBS MO, POB 419169  ,  Kansas City  ,  MO  ,  64141-6169    888-989-8842    816-395-2222  
 AHP    Empire    Empire BC, POB 5020  ,  Middletown  ,  NY  ,  10940    800-772-2875  
 AHU    PPO    MD    BC MD, 10455 Mill Run Circle  ,  Owings Mills  ,  MD  ,  21117    877-228-7268    PC 877-546-2568  
 AHW    PA    BCBS NE PA, 70 N Main St  ,  Wilkes-Barre  ,  PA  ,  18711    717-829-8500  
 AIU    PA    Independence BC, 1901 Market St  ,  Philadelphia  ,  PA  ,  19103    215-564-2100    215-241-2400  
 AKM    MI    BC MI, POB 1618  ,  Detroit  ,  MI  ,  48231    800-462-7237    Collins and Aikman  
 ALC    Roch  
 800-942-4254    716-325-3630  
 ALF    TRAD    Roch  
 AgriLink (8/98)  
 ALN    PA    BC PA, Highmark, POB 1210  ,  Pittsburgh  ,  PA  ,  15230    800-433-9906    Alcoa Retirees  
 ALO    PPO    Roch  
 Alstom Transportation (1/99)  
 ALR    AR    BC AR, PO Box 2181  ,  Little Rock  ,  AR  ,  72203-2180    888-847-1400  
 AMF    POS    Utica  
 Choice Plus Amphenol Corp (5/00)  
 AMK    PPO    Excel  
 AML    HMO    Utica  
 Choice Amphenol Corp (5/00)  
 AMS    PPO    Excel  
 AMS Companies (eff 9/1/02)  
 AMU    RI    BCRI, 444 Westminister St  ,  Providence  ,  RI  ,  02903-3279    401-831-7300  
 AMZ    KY    BC KY, POB 37690  ,  Louisville  ,  KY  ,  40233    800-925-0135  
 AON    IL    BC IL, POB 1364  ,  Chicago  ,  IL  ,  60690    800-972-8088  
 APJ    PPO    Excel  
 APM    TRAD    CNY  
 APT    DE    BC DE, POB 8830  ,  Wilmington  ,  DE  ,  19899-8830    800-342-2221    PC 800-572-2872 Psy 800-421-4577  
 AQI    KY    BC KY Anthem, PO Box 37690  ,  Louisville  ,  KY  ,  40233    800-332-2540    800-568-0075(PC) McQuay Int'l  
 ARH    IN    BCBS of Indiana, POB 68416, Accordia NW  ,  Indianapolis  ,  IN  ,  46268    317-488-6000  
 ARR    OH    BC OH Anthem, 4361 Irwin Simpson Rd  ,  Mason  ,  OH  ,  45040    513-872-8100    Armco (Medicare Supplemental)  
 ASA    Indemnity    CNY    PO Box 4809  ,  Syracuse  ,  NY  ,  13221    315-448-3735    Dairylea Agrichoice  
 ASB    PPO    CNY  
 ASD    POS    CNY  
 ASG    PPO    Excel  
 ASH    WNY    BCBS WNY, Auto Nat'l Accts, POB 757  ,  Buffalo  ,  NY  ,  14240-0757    800-462-7237    PC 800-568-0075  
 AST    TN    BCBS Of Tennessee, 801 Pine St  ,  Chattanooga  ,  TN  ,  37402    423-755-5600  
 ATT    Empire    Empire BC, POB 5020  ,  Middletown  ,  NY  ,  10940    800-772-2875  
 AWR    PA    PA BS Highmark, POB 535045  ,  Pittsburgh  ,  PA  ,  15253-5045    800-294-2217    Armstr World  
 AWY    PPO    Roch  
 Agway Inc (1/02)  
 AXI    PPO    CNY/Excel    See AXT  
 AXT    PPO    CNY/Excel    Axiohm Transactions Solutions  
 AZN    PPO    Excel  
 Azon Corporation (4/02)  
 AZO    IL    BC IL, POB 1364  ,  Chicago  ,  IL  ,  60690-1364    800-637-6917    PC 877-493-3447  
 BAN    WV    BC Washington DC/Carefirst, 550 12th St SW  ,  Washington  ,  DC  ,  20065    800-642-2411    PC 866-773-2884  
 BBH    PPO    GA    BCBS GA, POB 9907  ,  Columbus  ,  GA  ,  31908    800-628-3988  
 BDC    MI    BC MI, POB 1618  ,  Detroit  ,  MI  ,  48231    800-462-7237    Budd (Medicare Comp)  
 BES    PPO    Roch  
 Benchmark Sales (effective 7/02)  
 BET    PA    BC PA, 120 Fifth Ave  ,  Pittsburgh  ,  PA  ,  15222-3099    412-544-7000    Bethlehem Steel  
 BFM    PA    BC PA Highmark, POB 176  ,  Pittsburgh  ,  PA  ,  15230-0176    866-316-6339    Bombardier Transport  
 BGH    AL    BCBS of Alabama, POB 995  ,  Birmingham  ,  AL  ,  35298    205-988-2213    205-988-2200  
 BGN    PPO    Excel  
 BGP    MI    BC MI, POB 1618  ,  Detroit  ,  MI  ,  48231    800-462-7237    Barnes Group  
 BHP    PA    BC PA, POB 778988  ,  Harrisburg  ,  PA  ,  17177-8988    800-222-3341    800-958-5558  
 BIM    MI    BC MI, POB 1618  ,  Detroit  ,  MI  ,  48231    800-462-7237    Bissel (Medicare Comp)  
 BLC    BC WNY  
 800-888-0130    800-752-2583(PC)  
 BLD    PPO    Excel  
 BLE    MA  
 BMI    IN    BCBS of Indiana, 120 Monument Circle  ,  Indianapolis  ,  IN  ,  46204    317-488-6000  
 BMK    TRAD    Roch  
 Beam Mack Sales & Service (2/99)  
 BOG    MI    BC MI, POB 1618  ,  Detroit  ,  MI  ,  48231    800-462-7237    Back One Corp (Medicare Comp)  
 BPM    PPO    Excel  
 Barrett Paving Materials (eff 10/1/02)  
 BRH    TX    BCBS of TX, POB 655730  ,  Dallas  ,  TX  ,  75265-5730    800-451-0287    972-669-3900  
 BRI    MA    BC MA, PO Box 9198  ,  N Quincy  ,  MA  ,  02171-9198    800-451-8123    800-287-8757  
 BRV    MI    BC MI, PO Box 166  ,  Detroit  ,  MI  ,  48231-0166    800-249-5103    PC 800-245-2513  
 BTR    MA  
 BUP    PPO    Excel  
 BUR    Indemnity    CNY    PO Box 4809  ,  Syracuse  ,  NY  ,  13221    315-448-3735    Burrows Paper Corp  


Nikki said...

Nice to know, this should be useful as a reference...

Medicare Missouri

Medical Billing

What is the overall Billing process?

The physician doesn’t get paid for his services immediately after they are rendered. Majority of the patients have insurance coverage and details of such coverage are provided to the physician before treatment. It is the responsibility of the physician to submit claims to the insurance company and get paid for his services. Submitting Claims and getting paid is a lengthy process and involves a lot of rules and regulatory systems and is very complicated. The physician needs to adhere to all these rules before submitting claims. This is the concept of Medical Billing. Sometimes the physician cannot provide his entire attention to this activity. He entrusts this activity to Billing Companies. This is a process of the physician providing rights to Billing Companies to bill Medical Insurance claims in order to save his time energy, and money.

After the provider renders services to the patient, the billing company will submit bills to the insurance company/ payer, using the insurance information that was last provided, as well as information about the reason for the examination, and the exact type of procedure performed.

Medical coding is the process of converting Medical terms to numeric code and it required Medical knowledge skills.

Medical billing is the process of submitting the claims and get paid behalf of provider.

I have listed the important process in Medical Billing. Each process is very important.

1. Insurance verification.

2. Demo and Charge entry process.

3. Claim submission.

4. Payment posting.

5. Action on denials or Denial management or Account receivables.

Insurance verification

Process started from here and usually front desk people are doing this process. Its a process of verifying the patients insurance details by calling insurance or through online verification. If this department works well, we could resolve more problem. We have to do this even before patient appointment.

Demo and Charge entry process

Demographic entry is nothing but capturing all the information of patients. It should be error free.

Charge-entry is one of the key departments in Medical Billing. Key department?? Yes, that's true. It is the keying-in department in Medical Billing. After receiving the super bills from the Doctor's office, it gets passed through the coding department, and then comes to the charge-entry department.

A Charge-entry person also has one other vital role to perform. That is, to look-up the codes entered in the claim, and to assign the relevant charges for those codes.

Claim submission Process

The next step after demographics and charge entry is claim generation. Claims may be paper claims or electronic claims. There are various types of forms for paper claims. The most widely used form is Health Care Finance Admin-1500 designed by the Health Care Financing Administration.

Electronic transmission of claims is the modern way of sending claims with less paper work. The most common means of transmission are through internet . The claim information is directly loaded into the insurance company's computer system or to the clearing house.

Payment Posting Process

Once the claims reach the carriers and they complete processing, they issue a check and prepare an Explanation of Benefits . The checks and the Explanation of Benefits would be sent to the pay-to address with the carrier or in the Health Care Finance Administrators.

In this processing we have accounted the money into the account as per the Explanation of Benefits. Now a days we are using Electronic payment posting also.

Action on denials or Denial management or Account Receivables

This is a most important function in the process flow of data. Unless this is taken care of, insurance balance will only be on an upward trend.

Problem in Medical Billing

•Inaccurate or lack of coding

• Incomplete claims

• Lack of supporting documentation

• Poor communication with the payer

• Not billing for services rendered

* Not being follow up AR balance claims

The person who is doing this process will be called Medical billing specialist.

Who is Medical Billing Specialist.

Medical billing Specialist is the one who is handling the below process and having well knowledge in each and every process.

* Insurance verification process

* Patient demographic and charge entry process.

* Submitting the claims by electronic as well as paper method. Tracking various claim submission report.

* Payments posting process for insurance as well as patient.

* Denial management.

* Insurance followup management.

* Insurance appeal process.

* Handling patient billing inquiries.

* Patient statement process.

* Preparing monthly reports such as revenue report and account receivable report and as per the provider requirement.

Medical Billing Specialists are in charge of reviewing patient charts and documents. They prepare and review all medical insurance claims based on the rules and regulations of insurance companies. Medical Billing Specialists also review insurance communications, payment and rejection notices to properly track all claims and payments.

Medical Billing specialist Professional

If a person is computer literate he is a fit enough candidate to take up the profession of medical billing and medical coding. However he will need to be trained and be aware of a lot of new information before he can start working effectively. He has to learn about the medical billing software and must be familiar with and master the various commands used while working with it.

Who are medical coders and how is it related to medical billing? Medical billing is a sub specialty of medical coding. Medical coding is the first step in the billing process. All patient records are maintained using the ICD-9 index system so that it is compliant with the federal rules.

A medical Biller’s most important skill includes filling up of the various medical forms correctly without any mistakes what so ever. All information required should be complete without any mistake at all. And the work will be include the following

Patient demographic entry

Insurance enrollment

Charge entry

Insurance verification

Billing and reconciling of accounts

Payment posting

Insurance authorization

Medical coding

Scheduling and rescheduling

Account receivable follow-ups and collections

Is it worth taking a medical billing program?

Usually don't spend too much cost on Medical billing program because the program will not do anything with real experience. What you learn from these kind of program will not be going to match with when you are working in the real environment. Hence just use as the start kind of program and get the real time experience even in small salary and later you can come up with more demanding one.

Problem of In House Processing of Medical Claims

Medical claims are generally very complex and have long extended details. While processing medical claims, one has to be highly critical and do efficient follow-up in order to get results. The process requires a lot of time and effort. And even after all this, there can be cases where files get lost or a small error can ruin the entire lot and everything has to be re-submitted again. Usually practice staff can be held up with lot of current work rather than submitting the claim and resubmitting the corrected claim hence it will lead to time delay on payment flow and it will affect all the relationship with in the practice. Even cost wise is also not effective when compare to outsourcing.

Advantage of Medical Billing Outsource

Medical Billing Company helps you in managing all your billing requirements proficiently. By choosing right medical billing company, you can get benefit such as improved financial strength.

Medical Billing task is very tedious and time consuming. However, billing must require more accuracy and special attention to strengthen the financial condition of clinical or hospital. You can do this task at own or assign to clinical staff but you have to be pleased with low patients satisfaction. Medical billing company can help you in supportive task. By efficient medical service, you will get highly satisfied patients.

A Medical Billing service can improve the efficiency of your billing system, reduce denials, cut down operating costs, boost reimbursements and save valuable time that can be devoted to patient care. These services are better equipped to adapt to continuously changing billing codes and industry requirements.

* Prince is low compare to doing it in house

* Dedicated Highly Skilled Professionals

* No need to maintain the hardware . Ability to perform Medical Billing remotely, using the software of your choice

* Usually Maximum reimbursements and fewer denials

* Accuracy is high when compare

* Faster transaction

Question need to ask when Medical Billing Outsourcing

1. Check with their referral and how long they are doing this business.

2. Are they HIPAA compliance

3. Where they are doing their work. If possible just visit there.

4. Data security.

5. Compare the price with others.

6. what are the reports they will provide

7. Your specialty wise question

8. Their software skills.

Services and process involved in Medical Billing

* Coding ( CPT, ICD-9, and HCPCS)

* Patient Demographics Entry

* Charge Entry – All specialties

* Payment Posting (Manual and Electronic)

* Payment Reconciliation

* Denials/rejections analysis, re-billing

* Accounts Receivable Follow-up

* Systemic A/R projects, re-billing

* Collection Agency Reporting

* Refunds

Medical Billing Salary Range

Depending on the education qualification, the hourly rate varies from $12-$15. Another most important factor that affects billing pay is how long someone has worked in the field. Medical specialist with experience of 1 year earns around $12 per hour. Those who have more experience in billing earn up to $16 per hour. However, the geographic location also plays a role in pay scale. For instance, areas where cost of living is high, the pay will be more. Billers who work in New York City, Houston, Chicago and California are able to pull a good amount of salary. Work locations such as hospital, billing company or private practice will also affect the salary. Since there are lots of factors which affect the salary of billing, it is really not easy to predict the pay scale. Studies have shown that 50% of people earned around $35,000-$45,000 annually.

Most of the medical Billers are paid hourly, rather than annually. While Biller who is experienced can earn around $40,000 a year as an independent contractor working from home, a billing and coding specialist who runs his own firm can earn $100,000 a year. However, people who are searching for home based job should be very careful. There is lots of fraud going on in this field. These spammers charge hundred to thousand dollars and in exchange they claim they will help to get a placement in billing. They also promise that medical billing job can earn a substantial amount of money and no experience required. But in reality, those who paid to get a job end up with no job, no money. Billing is a very competitive field, so without experience or training in medical billing field, it is almost impossible to get a job.

Selecting Medical Billing Software - 10 things to consider

1. The first step is to evaluate your needs. And when evaluating different systems look for a package that goes one step ahead of billing. Choose a medical practice management system MPP. This will handle considerably more that just medical billing.

2. Determine whether the system handles electronic transmission of claims, direct billing for patients, co-pays, co-insurance, and expenses not covered by insurance.

3. Weigh the pros and cons of different medical billing systems and ask to see a system in operations. Always check out the references yourself.

4. Look for a medical billing management system that is user friendly. When a vendor demonstrates get your office staff to be present. This way you will be able to check how the software functions. Any software must be easy to use to be productive. The system should be fool proof.

5. Ask whether the medical billing software is a traditional system, one that will work on your office computers or an application service provider system (ASP), one that will process data at the software company’s data center.

6. Always get quotes from at least three medical billing software providers.

7. Ask whether they are offering an evaluation period or trial. This will enable you to know in actuality whether the system works or not.

8. Find out about training your office people, up-gradation of system, and whether the software is compatible with your office computer systems

.9. Find out whether the system will handle appointment scheduling, maintenance of records and so on apart from electronic medical records, SOAP notes, and billing. Choose a system that is comprehensive.

10. An ideal Medical Billing software system must include aspects like payment posting, reconciliation; follow up, secondary submission, and patient billing.Choose a transparent billing system that enhances your office efficiency. Install a system that you can use not one that will lead to frustration and problems.Medical billing systems must free your time and that of your office staff not make you run in circles. Choose a system with care.


All the contents and articles are based on our experience and our knowledge in Medical billing. All the information are educational purpose and we are not guarantee of accuracy of information. Before implement anything do your own research. All our contents are protected by copyright laws and guidelines.
If you feel some of our contents are misused please mail me at medicalbilling4u@gmail.com. We will response ASAP.