Transcription of 2021 Provider Reference Guide
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2021 Provider Reference Guide
PR_RefGuide-20212021 Provider Reference Guide2021 Provider Reference Guide HELPFUL PLAN INFORMATION Commercial & MedicareMedicaidWebsite ResourcesProvider Home Provider and Search #/searchProvider Home and Search #/searchClaims/Eligibility VerificationProvider PortalPlease visit our website at the following to determine the appropriate portal for claims and eligibility verification: Verification Line (IVR Line): or Provider Portal Customer Service855-TX-RIGHT ( ) Claims FilingElectronic Clearinghouse AvailityPayor ID: 94999 Initial Filing Deadline 95/365 (Commercial/Medicare) days from date of service Corrected Filing Deadline 90 (Commercial) days from the date of deter-mination on the initially filed clean claim 365 (Medicare) days from the date of servicePaper Claims Filing AddressScott and White Health PlanATTN: Claims Review Box 21800 Eagan, MN 55121-0800 BSWHP is transitioning commercial business to a new claims system in a phased approach.
202 Provider Referece Guide GROUP PRODUCTS No referrals are required in any of our networks . HMO and EPO plans offer in-net-work benefits only, except in cases of emergency or urgent care. HMO-POS and PPO plans offer both in- and out-of-network benefits (members pay a higher cost share for out-of-network services).
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