| Transition Instructions |
| Eligibility and Pre-certification |
| To check eligibility and benefits after 1/1/2010, call 800-676-BLUE (2583) and provide the alpha prefix (WMW), or send an electronic eligibility inquiry (HIPAA transaction 270 online, Availity, etc.). |
| If a service requires pre-certification, please use the designated telephone number on the back of the patient's ID card.
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| Claims |
| Services provided to Walmart associates on or after 1/1/2010 for members previously administered by BCBS of Texas must be filed under the new BlueAdvantage ID number (WMW) to prevent delays of claim processing. |
| Claims filed for 2009 services should be billed using the prefix of MRT for BCBS of Texas. |
| Claims should be filed through your local plan. |
Claim status may be obtained online (Availity, etc.) or by contacting your local Blues Plan.
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| ID Cards |
| Insurance ID cards for all Walmart associates should be photocopied during every visit during 2010 to ensure that claims are filed appropriately. |
| New ID cards will be issued to all Walmart associates who previously had claims administered by BCBS of Texas. Effective dates will be 1/1/2010. New ID cards will have the WMW prefix. |
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| Behavioral Health and Mental Health Parity |
| BlueAdvantage administrators and Walmart have contracted with New Directions Behavioral Health to perform utilization management services. |
| Eligibility and Pre-certification |
| To contact New Directions for pre-certification of behavioral health services, call 877-709-6822, or utilize the New Directions WebPass. |
WebPass - allows providers and office staff to:
- Submit pre-certification requests
- Contact Provider Relations
- Update online profile
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To use New Directions WebPass, obtain a user name and password by downloading the Access Request Form
- Fax completed form to 913-982-8227, or
- Mail to Network Operations, P.O. Box 6729, Leawood, KS 66206-0729
- Login information will be e-mailed within two business days
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To access New Directions WebPass
- Go to www.ndbh.com
- Click Provider Section
- Click Provider WebPass
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| Outpatient Behavioral Health Services |
| Eight visits for associate or family members may be provided without pre-certification or review. |
| Psychiatric medication management does not require authorization. |
Pre-certification is required beginning with the 9th visit. New Directions will respond within 72 hours with authorization or a request for more information.
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| Inpatient, Partial Hospital and Intensive Outpatient Services |
Contact New Directions for authorization of all Inpatient, Partial Hospital and Intensive Outpatient services.
- Call 877-709-6822, or
- Use New Directions WebPass
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