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BlueCross BlueShield of Texas
   
         
     
 
What's New
1st Quarter 2010 - Formulary Updates
New Exclusive HMO and Preferred Statewide PPO/POS Clinical Reference Lab Provider Effective June 1, 2010
Change to claims run-out period for U.S. Virgin Islands
Easier Access to Pre-Certification/Pre-Authorization Information for Out-of-Area Blue Members
Availity Participating Provider Training Webinars - March 2010
Duplicate 1099 Request
Secondary Claims - Electronic Filing Guidelines
Change to HMO Blue Texas Outpatient Clinical Reference Lab Services Effective June 1, 2010
Electronic Refund Management (eRM) - March Webinars
New Be Smart. Be Well.® Topic Launches with Redesigned Site
2010 BlueCard® Program - Seeking Your Feedback
Physician Assistant and Advanced Practice Nurse Copayments
Blue Cross Member ID Cards Include Behavioral Health Pre-Cert Contact Information
Resolved: Missing Information on 835 Transaction - January 2010
Walmart 2010 Changes & Instructions
Electronic Transactions - 2010 Holiday Schedule Reminder
Pharmacy Compounding
Eligibility and Benefits Fax Back
Extended release Niacin vs. Ezetimibe: Results of the ARBITER 6-HALTS Trial
New Wellness Initiatives for Federal Employees eff January 1, 2010
Newly Designed Public Web Site Launches
System Upgrade For Medicare Crossover Claims
Untimed Billing Procedure CPT Codes - Update


Alpha Prefix Importance

Most members with coverage through a Blue Cross Blue Shield Plan are assigned a three letter alpha prefix as a part of their unique identification number. The alpha prefix can easily be identified as it is the first three characters.

The alpha prefix is very important to the identification number. The prefix acts as a key element in confirming the members’ eligibility and coverage information. Prefixes are also used to identify and correctly route claims to the appropriate Blue Cross Blue Shield Plan for processing.

There are two types of alpha prefixes: plan-specific and account-specific.

Plan-Specific alpha prefixes are assigned to each plan. The first two characters of the prefix identifies each plan and the third character identifies the type of product the member is enrolled in.

Example: Prefix "ZGP" (Blue Cross Blue Shield of Texas - PPO Product)

1st Character "Z" Plan Specific (letter assigned to the BCBS Plan)

2nd Character "G" Plan Specific (letter assigned to the BCBS Plan)

3rd Character "P" PPO Product (letter assigned by the BCBS Plan to identify product type elected by the member)

Account-Specific alpha prefixes are assigned to national accounts. National accounts are employer groups that have offices across multiple states but offer standardized coverage to their employees. Normally, the alpha prefix assigned to national accounts will associate to the employer group name.

Example: Prefix "UTS" (University of Texas - National Account)

Identification Cards without an Alpha prefix:

Some identification cards may not include an alpha prefix, which may indicate that the claim filing instructions for these type policies are different. We suggest that you verify claim filing instructions during the time eligibility information is obtained. If not, please follow the instructions on the back of the member's ID card or contact the plan directly. Member eligibility can be obtained at 1 (800) 676-BLUE (2583). Once connected, you will then simply provide the alpha prefix and the operator will then route you to the member's plan.

Helpful Tips Related to the Alpha Prefix:

  • Do not omit or randomly select an alpha prefix.
  • Do not substitute another Blue Cross Blue Shield Member’s prefix.
  • Include the alpha prefix and all alpha numeric characters preceding the alpha prefix on all correspondence and claims submitted to Blue Cross Blue Shield of Texas.
  • The alpha prefix is always three letters followed by the member's ID number which can be from 6 up to 14 characters total.
  • If possible, make copies of the member's ID card (front and back) for your records.
  • We recommend that you obtain a copy of the ID card any time there has been a coverage or policy change. If there are no changes, we suggest that you obtain card copies annually.

6/2007


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a Mutual Legal Reserve Company, an Independent Licensee of the
Blue Cross and Blue Shield Association.
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