#Bcbs timely filing limit how to#

We will notify you of our decision within 30 days after we receive your post-service claim.

#Bcbs timely filing limit how to#

(See pages 100- 102 for information on how to obtain benefits from the Retail Pharmacy Program and the Specialty Drug Pharmacy Program.) We may request updated treatment plans as your treatment progresses.Ĭlaims for prescription drugs and supplies that are not received from the Retail Pharmacy Program must include receipts that show the prescription number, name of drug or supply, prescribing physician’s name, date, and charge. Claims for dental care to repair accidental injury to sound natural teeth should include documentation of the condition of your teeth before the accidental injury, documentation of the injury from your provider(s), and a treatment plan for your dental care.If your claim is for the rental or purchase of durable medical equipment, home nursing care, or physical, occupational, speech, or cognitive rehabilitation therapy, you must provide a written statement from the physician specifying the medical necessity for the service or supply and the length of time needed.Bills for home nursing care must show that the nurse is a registered or licensed practical nurse.If another health plan is your primary payor, you must send a copy of the explanation of benefits (EOB) form you received from your primary payor (such as the Medicare Summary Notice (MSN)) with your claim.Note: Canceled checks, cash register receipts, balance due statements, or bills you prepare yourself are not acceptable substitutes for itemized bills. Dates that services or supplies were furnished.

Name and address of person or company providing the service or supply.Patient’s name, date of birth, address, telephone number, and relationship to enrollee.Bills and receipts should be itemized and show: For long or continuing inpatient stays, or other long-term care, you should submit claims at least every 30 days. Use a separate claim form for each family member. When you must file a claim – such as when another group health plan is primary – submit it on the CMS-1500 or a claim form that includes the information shown below.

Your facility will file on the UB-04 form. Your physician must file on the CMS-1500, Health Insurance Claim Form. Just present your FEP Blue Focus ID card when you receive services. To obtain claim forms or other claims filing advice, or answers to your questions about our benefits, contact us at the customer service telephone number on the back of your FEP Blue Focus ID card, or at our website at In most cases, physicians and facilities file claims for you. See Section 3 for information on pre-service claims procedures (services, drugs, or supplies requiring precertification or prior approval), including urgent care claims procedures. This section primarily deals with post-service claims (claims for services, drugs, or supplies you have already received).