All claims must be submitted to UMP within 12 months of the date of service or purchase to prevent denial of the claim. Consult theFEP local plan directory to find addresses and telephone numbers for other plans.Note: If the laboratory work was sent to Washington for testing or analysis, refer to theWashington claims submission map to determine where to send your claim for processing. If the decision was after the 60-day timeframe, please include the reason you delayed filing the appeal. Click on it. **If you, or your prescribing physician, believe that waiting for a standard decision (which will be provided within 72 hours) could seriously harm your life, health or ability to regain maximum function, you can ask for an expedited decision. 2023 Regence health plans are Independent Licensees of the Blue Cross and Blue Shield Association serving members in Idaho, Oregon, Utah and select counties of Washington. 0. . *If you are asking for a formulary or tiering exception, your prescribing physician must provide a statement to support your request. Youll receive notice of the action on your complaint within 30 calendar days of our receiving it. Call the phone number on the back of your member ID card. You must submit the claim to Regence as a medical claim. The following information must appear on the provider's itemized bill for the plan to consider the claim for payment: a. Your life. Deutsch |
In every state and every community, BCBS companies are making a difference not just for our members, but For the Health of America. You can submit your appeal online, by email, by fax, by mail, or you can call using the number on the back of your member ID card. When the plan is the primary payer (pays first), UMP pays its normal benefit as described in the certificate of coverage. Learn more about our customized editing rules, including clinical edits, bundling edits, and outpatient code editor. PO Box 52057
About Regence BlueCross BlueShield of Oregon. A decision to deny, modify, reduce, or terminate payment, coverage, certification, or provision of health care services or benefits, including the admission to, or continued stay in, a health care facility. You may need to submit your own claim if you buy drugs at a non-network pharmacy, dont show your ID card, or have other prescription coverage that pays first and UMP is secondary. Open 24 hours a day, 7 days a week. Coverage decisionsA coverage decision is a decision we make about what well cover or the amount well pay for your medical services or prescription drugs. ** We respond to medical coverage requests within 14 days for standard requests and 72 hours for expedited requests. Dissatisfaction with service provided by the health plan. Join us! Your provider should supply clinically relevant information, such as medical records for services denied based on medical necessity or for other clinical reasons. PDF State Mail to Mailing Address City, State Zip