BCBS Prefixes to Pull Patient - Medicaid managed care plan

• When a claim is billed to Medicaid insurance and received a denial as a patient enrolled under managed care plan then we can perform an eligibility check on the Medicaid website to find out the correct managed care plan and bill to managed care insurance.

• If Medicaid website access is not available then need to call the insurance to obtain managed care insurance information.

• Sometimes correct policy ID is found for managed care insurance on the website or call, if not found then we can bill the managed care insurance by using Medicaid policy ID except for BCBS insurance.

• BCBS policy ID contains 3 character alpha prefix in the first three positions.

• Below is the common prefix that can be used before Medicaid policy ID on the Availity website to pull the patient. Once the patient shows active on the Availity website, it will also show the correct policy ID.

• Medicaid LA - Prefix for Healthy Blue of LA is "HBR".
• Medicaid NM - Prefix for BCBS of NM is "YIF".
• Medicaid VA - Prefix for Anthem BCBS of VA is "YTD" OR "VAQ".
• Medicaid IN - Prefix for Anthem BCBS of IN is "YBH".
• Medicaid TX - Prefix for BCBS of TX is "ZGP".