First, What is the Blue Cross Blue Shield Association (BCBSA), Exactly?
Blue Cross Blue Shield Association is actually not a singular entity in the way many insurance giants are. BCSCA is actually composed of over 34 independent, “community-based” BCBSA companies, which their website claims are “locally operated.” BCBSA is essentially a franchise that grants licenses to “independent companies” who then use the logos, trademarks and other proprietary assets in their marketing and general operations.
Some BCBSA companies are non-profits, others are for-profits. Some, like Health Care Service Corporation (HCSC), have had their non-profit status contested in court unsuccessfully.
In the healthcare industry, BCBSA is often simply referred to as “the association.”
The most important thing to know when you’re billing for BCBSA is to make sure that you’re working with the correct licensee and the correct contact information for that licensee. Because each of the 35 local companies are managed by completely different teams, you can’t send claims to one BCBSA entity and expect them to communicate the claim to the correct company. Double-check that your billing contact information is correct before you begin.
What’s Blue Cross Blue Shield Association’s Track Record With Addiction Treatment Billing?
In general, BCBSA is considered to be one of the highest-reimbursing and “easiest” - or, shall we say, least difficult - insurance providers to work with in the behavioral health field. Sadly, this makes patients with BCBSA memberships more highly sought after than other patients subject to plans with lower reimbursement rates and more complex billing processes, such as Medicaid patients.
However, this “easy to work with” generalization does not apply to all BCBSA licensees. For example, Anthem, a BCSCA member, is notorious for high claims denial rates in the behavioral health space. In fact, seven different BCBSA companies were named on a “highest denial rates of 2019” Health Payer Intelligence report. These local idiosyncrasies further underscore the importance of researching and understanding which of the 35 BCBSA companies you’re dealing with when you’re handling addiction treatment billing, as the structure of BCBSA makes it difficult to generalize about the experience your addiction treatment billing department will have with any one BCBSA company.
Where to Find Billing Contact Information for BCBS for Your Addiction Treatment Center
Every state has a different BCBSA company with different addiction treatment billing contact information. To make matters even more confusing, some states have more than one BCBSA company operating within their borders!
To start, you’ll want to identify what BCBSA entity you’re working with, whether it’s Regence Blue Cross Blue Shield in Oregon or Wellmark Blue Cross Blue Shield in South Dakota.
From there, you’ll want to find the appropriate BCBSA company on this list of BCBS companies and licensees, organized by state.
Once you’ve found the correct BCBSA company, you’ll follow the link to their website to find the appropriate addiction treatment or behavioral health billing contact information.
Many BCBSA companies, like Blue Cross Blue Shield of Alabama, only accept eClaims entered through a particular online portal, usually found under the “Provider” section of the BCBSA companies’ websites.
Other companies, like Blue Cross Blue Shield of Texas, contract eClaims with a third party service called Availity, while still retaining the ability to submit paper claims. For BCBSTX, you can find the addiction treatment billing contact information - and a physical claims address for behavioral health claims - on their “Contact Us” page.
Following this example, for BCBSTX, the claims address for addiction treatment providers is:
Blue Cross and Blue Shield of Texas
P O Box 660044
Dallas, TX 75266-0044
Tired of Searching for Addiction Treatment Billing Contact Information? We Can Help.
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Verification of Benefits
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