If not releasing the information would put your health in danger, we are allowed to release it to those who need to know it. Our representatives will respond within four business days. If you are currently in treatment with your PCP, we can make the change effective on the date of your request. The federal emergency required health insurers to provide certain COVID-related services at no cost to you. Please utilize the appropriate form and attach to ensure proper handling. (585) 339-7691 View member cards, benefits and claims, and more! All rights reserved. Beginning April 1, 2023, all Medicaid members enrolled in Blue Choice Option, HMO Blue Option, and Blue Option Plus will receive their prescription drugs through NYRx, the Medicaid Pharmacy Program. See our Privacy Policy for how we use information. We are working to resolve this issue and apologize for the inconvenience. Jefferson County, Lewis County, Onondaga County:Brittonfield Parkway,Cicero (13039), Clay (13041), St. Joseph's Medical PC and St. Joseph's Health PC, Syracuse (13210, 13211, 13212, 13217, 13220, 13244, 13290), HOSPITALS: How does the Surprise Bill dispute process work? This is when you or a family member requires medically necessary treatment in a facility that provides 24-hour care. Login for 24/7 Support View member cards, benefits and claims, and more! Frequently Asked Questions | Excellus BlueCross BlueShield This is also known as your protected health information (PHI). Contact Us | Providers | Excellus BlueCross BlueShield Call 1-800-278-1247 Access general information about NYRx, the Medicaid Pharmacy Program, along with additional information for Members and Providers. What. Register or create an account or request access today ! Register & Create Account. .p-3 { You will be going to a new website, operated on behalf of the Blue Cross and Blue Shield Service Benefit Plan by a third party. Eagan, MN 55121. Speak with one of our Medicare Customer Care Advocates toll-free. Your PCP is your partner in managing and coordinating your health care services. Geneva, Clifton Springs, Seneca Falls, Newark and Macedon, OB/GYN and Pediatric, regardless of ZIP code, HOSPITALS: Monday - Friday: 9 a.m. - 4:30 p.m. Friday: 9a.m. - 5p.m. Walk-ins welcome! Inpatient mental health is hospital-based treatment. Rushville, Farmington, Ontario, Geneseo, Lakeville, Livonia, Dansville, Avon, Canandaigua, Victor, Williamson, Sodus, Penn Yan, Nicole Trombley Submit a complaint about your Medicare plan at www.Medicare.gov or learn about filing a complaint by contacting the Medicare Ombudsman. Our representatives will respond within four business days. Excellus BlueCross BlueShield Friday: 9a.m. - 4:30p.m. Contact Us | BlueCross BlueShield of South Carolina This will allow your Mental Health or Chemical Dependency specialist to share information with your Primary Care Physician concerning your treatment plan and medical condition. You may or may not need a referral from your PCP in order to obtain services from a specialist or other provider. SSL encryption ensures that the information transmitted remains secure. In a managed care plan, most care is provided or arranged by a participating PCP. Whats changing: You will likely have to pay some costs for FDA-authorized COVID-19 lab tests and related visits after May 11, 2023, depending on the type of test and reason for the visit, as explained in your health plan benefits. ET Jason.Lutz@excellus.com, COVERAGE AREA: Alaura.Daniels@excellus.com, Children's Behavioral Health Services: Don't have your card? For our records, we may ask that you give a reason for changing your PCP. Brian.Fetterly@excellus.com, COVERAGE AREA - CNY: Chiropractic, Heather Ducot If you need an immediate response, please call by telephone. Angela.Bradley@excellus.com, COVERAGE AREA: Visit the Federal No Surprise Bill website for more information about submitting an IDR request. To make recommendations regarding the organization's members' rights and responsibilities. The 24/7 Nurse Call Line is a service provided to our members to support their relationship with their health care providers. Lets get you set up online today. If youre losing your employer-sponsored health insurance, there are affordable, high-quality options available to you. Explore our internship program Why Excellus BCBS Check your contract or benefit booklet, talk to your employer group representative or contact us if you are unsure whether or not you need to select a PCP. Our main address is: BlueCross BlueShield of South Carolina I-20 East at Alpine Rd. There is no cost to you if you have Silver&Fit included in your plan. Hospital or physicians: file claims with local BlueCross and/or BlueShield Plan. Or learn more online about coverage for: This number is used solely to receive calls and never to make calls to BCBS members. Deidra.Powell@excellus.com, COVERAGE AREA: Chiropractic, HOSPITALS: What do I do if my benefits are exhausted for mental health or alcohol/substance use services? Search job postings by category Internship Opportunities Our paid internship opportunities attract the best and brightest students in the area and are focused on personal and professional development. Yes. Binghamton, NY 13902-5266, In the Central New York and Southern Tier Regions: Chemical Dependency benefits are for the treatment of drug and/or alcohol problems. right to confirm if a service requires prior authorization. Visit Silver&Fit (requires login) Check Out Our Process for Enrollment Inquiry & SupportOpen a PDF. You will be prompted to log in. Copyright 2023 Excellus BlueCross BlueShield, a nonprofit independent licensee of the Blue Cross Blue Shield Association. Syracuse, NY 13214-1803 Terms of Use | Web Privacy Policy | Accessibility Statement. Monroe County (14020, 14423, 14428, 14464, 14468, 14470, 14514, 14546, 14559, 14605, 14606, 14612, 14613, 14615, 14616, 14617, 14621, 14622, 14624, 14626), PHYSICAN PRACTICES: If you are unable to submit your documentation electronically, you may continue to submit your documentation via mail to the address on the back of your member card. 333 Butternut Drive Links marked with an (external site) icon indicate you're leaving ExcellusBCBS.com. Some health programs provide a limited number of inpatient chemical dependency rehabilitation days. All rights reserved. Welcome | Excellus BlueCross BlueShield Community Memorial, Oneida Healthcare, Rome Hospital, Contact Customer Care for eligibility/benefits and claims inquiries, Contact By: Excellus BlueCross BlueShield is an HMO plan and PPO plan with a Medicare contract. Register for an Online Account View your member card View benefits and coverage, including copays and coinsurance costs Estimate medical costs and check drug prices View claims and track your spending (deductible and out-of-pocket costs) Choose to go paperless for available documents Credentialing Policies | Providers | Excellus BlueCross BlueShield Once the federal government runs out of its supply of treatments, however, what you pay will be based on the terms of your health insurance plan. Customer Service, Claims & Operations at Excellus BCBS Apply for Business Automation Engineer I/II/III- 015306 job with Excellus BCBS in Binghamton, NY. To submit a claim electronically, please login and go to Submit Claims page. The New York Consumer Guide to Health Insurers is available from the New York State Insurance Department. Select Blue Cross Blue Shield Globalor GeoBlue if you have international coverage and need to find care outside the United States. Follow these links to send a private, secure message to us. Health Insurance Plans for Excellus BCBS Employers, Add or Remove Group Numbers for Online Enroll & Update. Managed care and point of service (POS) plans require you to select a PCP to provide, manage, arrange or authorize almost all the medical care you receive. You'll find phone numbers and email links on our Contact Us page. Whether you need help enrolling in a health plan, have questions about your bill, or dont know where to start when it comes to coverage, our local team is here to help. }. You can still order free over-the-counter tests through. Prior Authorization Lookup | Providers | Excellus BlueCross BlueShield How can I add or remove a dependent from my policy or change my type of coverage? The information you're accessing may not be provided by Excellus BCBS. What should I do if I receive additional bills from my provider? Box 5266 Whats changing: You will likely have to pay some costs for FDA-authorized COVID-19 lab tests and related visits after May 11, 2023, depending on the type of test and reason for the visit, as explained in your health plan benefits. Excellus BlueCross BlueShield Employee Reviews for Customer Service Representative Review this company Job Title Customer Service Representative19 reviews Location United States19 reviews Ratings by category 3.7 Work-Life Balance 3.7 Pay & Benefits 3.2 Job Security & Advancement 3.3 Management 3.4 Culture Sort by Helpfulness Rating Date Language See our Privacy Policy for how we use information. What happens if my doctor is leaving my insurance plan? Call 1-800-348-9786 (TTY 1-800-662-1220). We use cookies and other technologies to optimize site functionality, analyze website traffic, and share information with social media, advertising, and analytics partners. Clinton, Essex, Franklin, Hamilton, Warren, Washington, Vermont, all Planned Parenthood locations regardless of ZIP code, HOSPITALS: Submit an inquiry online, For medication prior authorization, benefit questions, or to reach a pharmacist, Contact By: The OASAS HOPEline offers help 24 hours/7 days/365 days a year for alcoholism, drug use and problem gambling. Prior Authorization Lookup. Some programs do not have coverage for outpatient mental health treatment. Create an Account. For Claims, Membership Enrollment forms, and related Correspondence: Excellus BlueCross BlueShield Health Insurance Plans for Excellus BCBS Medicare Member, For billing questions or to pay by phone, please call us at. The Substance Use and Mental Health Services Administration (SAMHSA) is the agency within the U.S. Department of Health and Human Services that leads public health efforts to advance the behavioral health of the nation. Check out the changes and updates to our plan in 2023. (585) 530-6752 Enrollment in Excellus BlueCross BlueShield depends on contract renewal. If you disagree with a decision made by us to deny a requested service, you may contact Customer Service and a representative will be glad to assist you. The federal emergency required health insurers to provide certain COVID-related services at no cost to you. 165 Court Street All Rights Reserved. Contact Us | Employers | Excellus BlueCross BlueShield At a Resource Center, you can: Meet 1-on-1 with a licensed advisor to discuss your health insurance options Website - www.samhsa.gov. Login | Members | Excellus BlueCross BlueShield Our specially trained registered nurses can answer your questions and provide support. Your Provider Relations representative is your liaison with our health plan, bringing your needs, suggestions and concerns to the attention of our medical directors, policy makers and communications staff. Visit Us in Person | Excellus BlueCross BlueShield Submit a complaint about your Medicare plan at www.Medicare.gov or learn about filing a complaint by contacting the Medicare Ombudsman. Utica, NY 13502 The information provided is intended to help educate members, not to replace the advice of a medical professional. At a Resource Center, you can: Need to pay a bill? Please note that if your doctor was terminated by us due to fraud, imminent harm to patients or final disciplinary action by a state board or agency that impairs the doctors ability to practice, continued treatment with that doctor is not available. Aleisa.Bevilacqua@excellus.com, COVERAGE AREA: We use cookies and other technologies to optimize site functionality, analyze website traffic, and share information with social media, advertising, and analytics partners. Whats changing: After May 11, 2023, the health plan will resume reviewing requests for early prescription refills. Chenango County physicians, SOUTHERN TIER SPECIALTY PROVIDERS: *Members of a select number of grandfathered employer groups may need to pay a cost share for the administration of the vaccine. If we are unable to agree on a payment, we will pay what we deem to be a reasonable amount. Phone - 1-877-846-7369 Chiropractic, Jason Lutz See our Privacy Policy for how we use information. Discover all the ways members can earn wellness incentives and rewards for taking an active role in their health. 14 Durkee Street Strong Memorial, Highland, FF Thompson, Noyes, Aleisa Bevilacqua Stop by our walk-in customer service units if you'd like to visit us in-person. The information you're accessing may not be provided by Excellus BCBS. Visit our Find an Urgent Care Center page to find an Urgent Care Center near you. The best way to stay informed and have access to your coverage is online. Copyright 2023 Excellus BlueCross BlueShield, a nonprofit independent licensee of the Blue Cross Blue Shield Association. In the majority of cases, your health care providers will file claims to us on your behalf. Contact Us | Excellus BlueCross BlueShield Customer Care Advocate IA De Witt, Town of, NY Customer Service, Claims & Operations The Customer Care (CC) Advocate resolves customer inquiries via telephone, walk in, mail, fax, web chat, off-phone work, and email concerning, but not limited to, contract benefits, claim payments, and. BCBS recognizes doctors and hospitals for their expertise and exceptional quality in delivering care. Prior to your care, you or your provider should contact Customer Service to see what the benefits and prior authorization requirements are for your coverage. Enrollment Inquiry & Support Tool If you are experiencing severe symptoms such as sharp pains, fever, loss of bodily function control, vomiting or any other immediate medical concern, dial 911 or contact a physician directly. BY APPOINTMENT ONLY Our Find A Doctor online tool is designed to help you connect with any doctor participating in our network, including Primary Care Physicians. The information you're accessing may not be Medicare-specific and/or provided by Excellus BCBS. Back to Help Center BlueCross BlueShield of Western New York General Inquiries 1-716-887-6900 BlueCross BlueShield of Western New York 257 West Genesee Street Buffalo, NY 14202-2657 www.bcbswny.com Customer Service 1-800-234-6008 1-716-884-5082 Precertification 1-800-677-3086 Mental Health/Substance Use Disorder Precertification 1-877-837-0814 Monday - Friday: 9 a.m. - 4:30 p.m. You will need to attach an itemized bill from the provider who rendered services to you. Select "Submit A Claim" to complete a claim form and "Send to Us Electronically". While our Resource Centers are not able to process bill payments, you can always pay your bill online, by phone, or by mail. Most managed care plan members must have a referral from their PCP prior to seeking emergency room care if the condition does not appear to be for an emergency medical condition. This is a dedicated line staffed by individuals to handle all your questions, including prescription-related questions. This is the customer service number for questions about your health insurance coverage, benefits or treatment. If you are experiencing severe symptoms such as sharp pains, fever, loss of bodily function control, vomiting or any other immediate medical concern, dial 911 or contact a physician directly. Reminder: Personal Protective Equipment ("PPE") Used by Providers, Commercial Group, Medicare, and Qualified Health Plan members, call 1-800-499-1275, Medicaid and Child Health Plus members, call 1-800-650-4359, Essential Plan members, call 1-877-626-9298. This information is optional and can be used to track patient access, quality of care and other provider trends. (518) 561-2243 (option 5, then option 3) Medicaid Managed Care, Essential Plan, Health and Recovery Plans (HARP) and Child Health Plus will cover certain brands of over-the-counter tests at no cost until further notice. The Health Plan will review your inquiry to ensure that the bill in question meets the New York State definition of a surprise bill and will work with your provider regarding the payment. A PCP is a physician whose principal medical specialty is in family practice, internal medicine, OB/GYN, general practice or pediatrics. Optometry, Ophthalmology, Optical, SOUTHERN TIER SPECIALTY PROVIDERS: What is your mailing address? Onondaga County: Baldwinsville (13027), Liverpool (13090, 13088), Crouse physicians (regardless of ZIP code);Oswego County, St. Lawrence County, HOSPITALS: By continuing to use this website, you consent to these cookies. Exercise at Home Exercise at home with a wide range of Home Fitness Kits such as yoga, strength, and more. Submit an inquiry online Terms of Use | Web Privacy Policy | Accessibility Statement. Optometry, Ophthalmology, Optical, Carrie Clifford Watertown, NY 13601, Modal for Improving Enrollment & Billing Support. We use cookies and other technologies to optimize site functionality, analyze website traffic, and share information with social media, advertising, and analytics partners. Cayuga, Cortland, Jefferson, Lewis, Onondaga, Oswego, St. Lawrence, Tompkins, COVERAGE AREA - Southern Tier: Go Paperless! he 24/7 Nurse Call Line is a service provided to our members to support their relationship with their health care providers. The guide provides important consumer information on the performance of health maintenance organizations (HMOs) and other insurers. New York - Blue Cross and Blue Shield's Federal Employee Program You may also submit your grievance or request for appeal in writing. Commercial Large Group (50 or more eligible subscribers) Benefits, Setup, Updates, Cancellations, Billing, Member Enrollment or Member Cancellations, Call your dedicated Broker and/or Account Service Consultant, Commercial Small Group (Less than 50 eligible subscribers) Benefits, Setup, Updates, Cancellations, Billing, Member Enrollment or Member Cancellations, Call our Web Help Desk at 1-800-278-1247 Excellus BlueCross BlueShield Reviews - Glassdoor Excellus BlueCross BlueShield is an HMO plan and PPO plan with a Medicare contract. Our online Find a Doctor feature includes participating health care professionals names, addresses and driving directions, specialties, office hours, and much more. Contact Customer Care for eligibility/benefits and claims inquiries Contact By: Call 1-800-920-8889 Submit an inquiry online Monday - Thursday: 8 a.m. - 5 p.m. Y0028_8830_C. 165 Court Street CR-01 - PCP and Specialty Care Physician Initial Credentialing. Copyright 2023, Excellus BlueCross BlueShield, a nonprofit independent licensee of the Blue Cross Blue Shield Association. All rights reserved. If you receive treatment for an emergency medical condition at the emergency room, be sure to notify your PCP within 24 hours to arrange for follow-up visits and continuing care. If you are experiencing severe symptoms such as sharp pains, fever, loss of bodily function control, vomiting or any other immediate medical concern, dial 911 or contact a physician directly.