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Regence Blue Cross Blue Shield of Oregon
Oregon state health insurance For Physicians, Other Health Care Professionals and Facilities
Contact Regence Provider Customer Service

What would you like assistance with today?

Patient coverage, benefits and eligibility

Access member information online

  • View member cards
  • Verify patient coverage, benefit types and eligibility effective dates
  • View estimates of patients' out-of-pocket expenses for select procedures and services
  • View patient benefit information, including office visit copayments and an overview of major medical coverage
  • Obtain real-time accumulation amounts for deductibles, out-of-pocket and coinsurance maximums for our members

Register or login »

Access member information over the phone

  • Access eligibility and claims-related information 24 hours a day, seven days a week by calling Customer Service and using the Interactive Voice Response (IVR) system.
  • For all other questions that cannot be resolved through Provider Center or IVR, contact a Provider Customer Service specialist.

Claims and payments

Access information online

  • View fee schedules
  • View claims status and payment information
  • Review the status of your organization's submitted claims and view payment information
  • Search for and print payment vouchers by provider name, voucher number or check number

Register or login »

Access member information over the phone

  • Access eligibility and claims-related information 24 hours a day, seven days a week by calling Customer Service and using the Interactive Voice Response (IVR) system.
  • For all other questions that cannot be resolved through Provider Center or IVR, contact a Provider Customer Service specialist.

Update your information

Help us keep critical information about your practice up-to-date by completing a Provider Information Update Form when:

  • A provider leaves or joins your clinic or practice
  • You have a change to your:
    • Organization's address
    • Phone number
    • Tax identification number
    • National Provider Identifier number

Note: Please do not use this form to update/maintain Provider Center Organization Access Identification (OAID) numbers. If the current Primary Account Manager (PAM) cannot perform the update, contact Provider Center Technical Support at 1 (888) 427-0470.

Addresses

Paper claims are only accepted when they are submitted by:

  • Members.
  • Providers who practice outside our service area and are not subject to state or other local paperless claim mandates.

Mail to:

Claims Address (except FEP):

  • Regence BlueCross BlueShield of Oregon
    P.O. Box 30805
    Salt Lake City, UT 84130-0805

Federal Employee Program (FEP) Claims Address:

  • Regence BlueCross BlueShield of Oregon - FEP
    P.O. Box 31105
    Salt Lake City, UT 84131-0105

Federal Employee Claims that require Medical Records

  • Regence BlueShield
    P.O. Box 2668
    Seattle, WA 98111-2668

Mail all other correspondence to the applicable address:

All correspondence (except Regence MedAdvantage) to:

  • Regence BlueCross BlueShield of Oregon
    P.O. Box 1271, MS C7A
    Portland, OR 97201-1271

Regence MedAdvantage correspondence to:

  • Regence BlueCross BlueShield of Oregon
    P.O. Box 12625
    Salem, OR 97309-0625

AIM order numbers for diagnostic imaging procedures

BlueCard® (out-of-area) members or claims

General questions:

Member benefits/eligibility (National):

  • 1 (800) 676-2583
  • 8:00 a.m. to 4:30 p.m.

View BlueCard Program information and resources >

Contracting or credentialing

We contract with physicians, dentists, other health care professionals and facilities to form provider networks essential for the delivery of health-care and dental services to our members.

All providers must be credentialed before they can participate in our provider networks. Once credentials have been verified, a provider agreement is offered. 

Credentialing and contracting steps:

  1. View a list of providers we contract with to make sure we contract with your specialty >
  2. Learn more about our provider networks >
  3. Register for the Provider Center >
  4. Learn about our credentialing policy and complete a credentialing application >
  5. Once credentials are verified, you will receive an email from our Credentialing department.
  6. Sign up for eContracting >
To check the status of a submitted credentialing application, contact our credentialing department.

Electronic transactions

Availity

1 (800) 282-4548

 

Medical providers, select option 1, then listen for the option you need assistance with

 
Dental providers, select option 4
support@availity.com
   

Office Ally:

National Electronic Attachment, Inc. (NEA) FastAttachTM - dental

Medical Electronic Attachment, Inc. (MEA) FastAttachTM - medical

Regence EDI Support Center

 

Learn more about electronic transactions >

Fee schedules

Fee schedules and other pricing documents are available on our Provider Center.

Fraud or abuse

  • General: 1 (888) 207-4211
  • Medicare Advantage (Part C): 1 (800) 548-4850
  • Medicare Part D: 1 (877) 479-8477
  • Online reporting form

Integrated Care Management referrals

Learn more about Case Management services >

Pharmacy-related questions

General inquiries for all products except Medicare Part D and FEP:

  • 1 (800) 643-5918
  • Fax: 1 (800) 884-4282

Medicare Part D:

  • 1 (888) 437-1508
  • Fax: 1 (888) 335-3016

Pharmacy Prior Authorization

  • Fax: 1 (800) 884-4282
  • Medicare Part D Fax: 1 (888) 335-3016

Pre-authorization

View our pre-authorization requirements and contact information for each service or supply for our various lines of business. Pre-authorization for dental procedures is not required.

Obtaining pre-authorization information for out-of-area (BlueCard®) members:
Use our online tool to be automatically routed to the home plan's pre-authorization / pre-certification requirements. Launch the tool

Medical Pre-authorization Forms
Form Description Instructions

Pre-authorization Request Form

Medical, surgical or DME services:

This form is used when a condition requires a pre-authorization. A limited number of services require a pre-authorization.

Expedited is defined as: when the Member or his/her physician believes that waiting for a decision under the standard time frame could place the Member’s life, health, or ability to regain maximum function in serious jeopardy.

Submit completed forms:

  • Securely online, or
  • By Fax to:
    • 1 (877) 663-7526 for Uniform Medical Plan (UMP) members
    • 1 (855) 232-0085 for all other members
    • 1 (855) 240-6498 for requests that meet the definition of expedited

Statement of Medical Necessity for Oncotype DX (PDF)

This form is used to facilitate medical necessity for Oncotype Dx® Breast Cancer Assay. Codes include S3854 and 84999.

Fax completed forms to 1 (855) 232-0085
Behavioral Health Pre-authorization Forms
Form Description Instructions
Behavioral Health Treatment Plan Request

This form is for members who require an authorization for behavioral health outpatient treatment, including chemical dependency.

Submit this form to Regence for authorization of continued services through June 30, 2014.

Please call Regence Behavioral Health Customer Service at 1 (800) 780-7881 for any authorization questions. 

  • Complete the Treatment plan request form securely online
  • Download and submit by fax to Regence Behavioral Health at 1 (888) 496-1540:

Provider Customer Service

Our web portals allow you to:

  • Verify patient coverage, benefit types and eligibility effective dates
  • View patient benefit information, including office visit copayments
  • View the status of your submitted claims and payment information
  • Search for and view payment vouchers by provider name, voucher number or check number

Login or register now >

For all other questions that cannot be resolved online, use the contact details below.

Administrative Services Only (ASO) 1 (866) 227-0913
7:00 a.m. to 5:00 p.m.

Federal Employee Program (FEP)

Please note new phone and email options effective September 25, 2013.

1 (877) 668-4654
Monday - Wednesday and Friday: 8:30 a.m. to 4:30 p.m.
Thursday: 9:00 a.m. to 4:30 p.m.

For basic information, please access our web portals as indicated above.

For other (more complex) questions, the following options are available:

  • Select option 1 to receive information about sending an email to our dedicated Provider Support Team.
  • Select option 2 to speak with a live agent.
Healthcare Management Administrators (HMA)

Obtaining pre-authorization, eligibility, claims status or answers to other inquires

Submit claims to HMA:

  • Electronically via Availity® using Payer Identification Code ID HMA01
  • Mail paper claims to:

    Healthcare Management Administrators, Inc.
    P.O. Box 85008
    Bellevue, WA 98015

Learn more about HMA >

Regence Group Administrators (RGA)

Obtaining pre-authorization, eligibility, claims status or answers to other inquires:

Submit claims to RGA:

  • Electronically via Availity® using Payer Identification Code ID HMA01
  • Mail paper claims to:

    Regence Group Administrators
    P.O. Box 52890
    Bellevue, WA 98015-2890

Learn more about RGA >

Specialty Programs
  • Bledsoe Trust: 1 (800) 245-9272
  • Teamsters: 1 (800) 452-8812
TriWest/TRICARE

Veterans Affairs Patient Centered Community Care (VAPCCC) program inquiries:

Contact TriWest  

TRICARE Inquiries
Contact UnitedHealthcare Military and Veterans Services for any of the following:

  • Credentialing or contracting questions
  • Claims inquiries for dates of services on or after April 1, 2013
  • TRICARE provider demographic changes (e.g., address, phone or fax number)
Uniform Medical Plan (UMP)

UMP customer service:

  • 1 (888) 849-3682
  • Monday through Friday 7:00 a.m. to 5:00 p.m. PST

Pre-authorization:

  • 1 (888) 849-3682
  • Fax: 1 (877) 663-7526

Learn more about UMP >

Regence Dental Products
Regence EncoreSM, ExpressionsSM and RadianceSM 1 (800) 452-6333
Monday - Wednesday and Friday: 6:00 a.m. to 6:00 p.m.
Thursday: 9:00 a.m. to 6:00 p.m.
Interactive Voice Response (IVR) available
Regence Medical Products

Group and Individual

  Regence EvolveSM Individual and Family (Core Individual) 1 (877) 395-4942
Monday - Wednesday and Friday: 6:00 a.m. to 6:00 p.m.
Thursday: 9:00 a.m. to 6:00 p.m.
Interactive Voice Response (IVR) available

  Regence HSA Healthplan 2.0SM and HSA 3.0SM 1 (888) 849-0422
Monday, Tuesday, Wednesday and Friday: 6:00 a.m. to 6:00 p.m.
Thursday: 9:00 a.m. to 6:00 p.m.
Interactive Voice Response (IVR) available

  Regence ClassicSM, Innova®, Engage® and BlueValue (Core Group) 1 (800) 452-6333
Monday - Wednesday and Friday: 6:00 a.m. to 6:00 p.m.
Thursday: 9:00 a.m. to 6:00 p.m.
Interactive Voice Response (IVR) available

Medicare

  Regence Bridge Medigap 1 (888) 323-6221
Monday - Wednesday and Friday: 6:00 a.m. to 6:00 p.m.
Thursday: 9:00 a.m. to 6:00 p.m.
Interactive Voice Response (IVR) available

  Regence MedAdvantage PPO

1 (877) 508-7362
Monday - Wednesday and Friday: 7 a.m. to 8:00 p.m.
Thursday: 9:00 a.m. to 8:00 p.m.


  Regence BlueAdvantage HMO 1 (855) 522-8898
Monday - Wednesday and Friday: 7 a.m. to 8:00 p.m.
Thursday: 9:00 a.m. to 8:00 p.m.
Other Regence products:
For patients on other Regence products, please call the Core Group or Core Individual phone numbers listed above.

Provider Relations

Provider Relations Representatives

Our representatives work with providers to resolve issues, acting as a liaison between your office and Regence. Reach out to our team for help with:

  • Contracting questions
  • Provider appeals and grievance process
  • Complex billing and coding information
  • Explanations of specific medical and reimbursement policies
  • Inquiries that cannot be resolved through our web portals or Customer Service

You can also provide anonymous feedback to Provider Relations using our secure feedback form.

Behavioral Health (including Clark County, Washington)
  Gina Freese
Phone: (503) 412-5720 or
1 (800) 643-4512 ext. 5720
Fax: 1 (800) 331-3505
Secure contact form
Cassady Lessig
Phone: (503) 412-5684 or
1 (800) 643-4512 ext. 5684
Fax: 1 (800) 331-3505
Secure contact form
Dentists and dental professionals (including Clark County, Washington)
  Jackie Neufeld
Phone: (503) 225-6995 or 1 (800 )547-0939 ext 6995
Fax: 1 (800) 331-3505
Secure contact form

Medical, rehabilitation, vision, complementary and alternative medicine providers

 
PROVIDER RELATIONS REPRESENTATIVE
TELEPHONE NUMBER
TERRITORY SERVED

  Sarah Zannotti (503) 587-3351
1 (800) 452-7278 ext. 3351
Fax: 1 (888) 309-8761
Counties:  Benton, Coos, Curry, Lane, Lincoln, Linn, Marion, Polk, and Yamhill

  Melanie Kelaidis 1 (801) 333-5842
1 (800) 452-7278 ext. 2016
Fax: 1 (888) 309-8761
Counties: Baker, Gilliam, Grant, Morrow, Sherman, Umatilla, Union, Wallowa and Wheeler

  Cindy Watters (801) 333-5710
1 (800) 452-7278 ext. 2015
Fax: 1 (888) 309-8761
Counties: Crook, Deschutes, Harney, Jefferson, Lake and Malheur

  Nancy O'Dell (503) 525-6587
1 (800) 452-7278 ext. 6587
Fax: 1 (888) 309-8761
Counties: N & NW Multnomah (N & NW Portland addresses);  SW Multnomah (SW Portland addresses) and Washington
      Please refer to the Portland Area Zip Code List for a specific listing of rep's Portland area zip codes.

  Dawn Hughes (503) 226-8715
1 (800) 452-7278 ext.  8715
Fax: 1 (888) 309-8761
Counties: Douglas, Josephine, Jackson, Klamath, NE Multnomah County (NE Portland addresses), including Gresham, Troutdale and Fairview
      Please refer to the Portland Area Zip Code List for a specific listing of rep's Portland area zip codes.

  Lisa Battrick (503) 225-4827
1 (800) 452-7278 ext.  4827
Fax: 1 (888) 309-8761
Counties: Clackamas, Clatsop, Columbia, Hood River, Tillamook, SE Multnomah (SE Portland addresses), Wasco and Clark (WA)
    Please refer to the Portland Area Zip Code List for a specific listing of rep's Portland area zip codes.

Additional territory information:

Contact information for bordering states is available on the Provider Web sites:

Provider Consultants

Provider consultants are the primary external contact, building relationships with clinics, physician offices and facilities. Consultants support providers by addressing issues and implementing solutions to decrease administrative burden. Consultants can assist with:

  • Electronic tools
  • Strategic initiatives
  • New office orientations
  • Educational workshops
  • Office manager forum participation
  • Office visits requested for problem solving
  • Resolution of global issues (e.g., policies, medical review)

You can also provide anonymous feedback to Provider Relations using our secure feedback form.


  Counties: Benton, Lincoln, Linn, Marion, Polk, Lane and Yamhill

Angie Gibson
(503) 375-4312
Fax: (888) 309-8761
Secure contact form


 

Counties: N, NW and SE Multnomah (including Gresham and Troutdale), Hood River and Wasco

Hospitals and clinics: Legacy Health System, Adventist Medical Center and Oregon Health & Sciences University (OHSU)

Twila Baker
(503) 226-8740
Fax: (888) 309-8761
Secure contact form


 

Oregon Counties: SW & NE Multnomah (excludes Gresham and Troutdale), Washington County zip 97225 only

Washington state counties: Clark

Hospitals and clinics: Providence Health Systems, The Portland Clinic and The Oregon Clinic

Kassie Fisk
(503) 525-6520
Fax: (888) 309-8761
Secure contact form


  Counties: Baker, Crook, Deschutes, Gilliam, Grant, Harney, Jefferson, Lake, Malheur, Morrow, Sherman, Umatilla, Union, Wallowa and Wheeler

Vivian Taunton
(541) 318-2923
Fax: (888) 309-8761
Secure contact form


  Counties: Coos, Curry, Douglas, Jackson, Josephine and Klamath

Karen Thompson
(541) 734-8962
Fax: (888) 309-8761
Secure contact form


 

Counties: Clackamas, Clatsop, Columbia, Tillamook and Washington except for zip 97225

Hospitals and clinics: Department of Veteran's Affairs (VA), Shriner's Hospital, Tuality hospitals and clinics University Medical Group

Vivian Taunton
(541) 318-2923
Fax: (888) 309-8761
Secure contact form


Additional territory information:

Contact information for bordering states:

Receiving secure emails

Emails from Regence staff that contain personal health information are sent securely through Securemailbox. Please view our secure email (Securemailbox) troubleshooting guide (PDF) to create an account in order to receive secure emails and, if needed, reset your password.

Regence Medical Policy

Comments from physicians and other health care professionals regarding Regence Medical Policies are welcome. Please complete our secure online contact form.

Regence closure schedule

Our offices will be closed for the following holidays:

2013
Christmas Tuesday and Wednesday

December 24-25 

2014
New Year's Day Wednesday

January 1

President's Day Monday   

February 17

Memorial Day Monday 

May 26

Independence Day Friday July 4
Labor Day Monday   September 1
Thanksgiving Thursday and Friday  November 27-28
Christmas Thursday and Friday 

December 25-26