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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

If claims are not submitted electronically, the preferred method, paper claims must be submitted on the appropriate claims form and mailed to:

Claims Address (except FEP):

  • Regence BlueShield
    P.O. Box 30271
    Salt Lake City, UT 84130-0271

Federal Employee Program (FEP) Claims Address:

  • Federal Employee Program (FEP)
    P.O. Box 31207
    Salt Lake City, UT 84131-0207

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:

Group and Individual:

  • Regence BlueShield
    P.O. Box 1271, MS C7A
    Portland, OR 97207-1271

FEP:

  • Federal Employee Program (FEP)
    P.O. Box 21709
    Seattle, WA 98111

Regence MedAdvantage:

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

AIM order numbers for diagnostic imaging procedures

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

General questions:

  • 1 (800) 206-1244

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 our web portals >
  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

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

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

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

Integrated Care Management referrals

Regence provides a wide range of care management programs and resources designed to support our members at any stage of health. Care management programs are either targeted to specific conditions or designed to improve or maintain overall health. All care management programs are intended to supplement and reinforce the care and guidance you provide to our members.

Learn more about Integrated Care Management services >

Member Customer Service

Boeing  
  • Boeing Medical Plans
Contact BlueCross BlueShield of Illinois at
1 (888) 802-8776
  • ValueOptions
1 (800) 892-1411

Dental 1 (888) 367-2112

Federal Employee Plan 1 (800) 552-0733


Regence BlueShield Employee Claims

1 (800) 245-2268


For all other lines of business

1 (800) 343-8915 or 1 (800) 458-3523

Local offices

Burlington
333 Gilkey Road
Burlington, WA 98233
(877) 276-5906
Seattle
1800 Ninth Avenue
Seattle, WA 98101-1322
(206) 464-3600
Everett
12728 19th Avenue S, Suite 101
Everett, WA 98208
(425) 225-8100
Tacoma
1501 Market Street
Tacoma, WA 98402
(253) 597-6500

Pharmacy-related questions

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

  • 1 (800) 732-9157
  • Fax: 1 (800) 884-1053

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 >

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.
Boeing

These phone numbers may be used for member customer service, provider customer service, general information, referrals, pharmacy pre-authorizations and exceptions.

Contact BlueCross BlueShield of Illinois at 1 (888) 802-8776

ValueOptions: 1 (800) 892-1411

Federal Employee Program (FEP)

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

1 (877) 668-4651
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 >

KingCare 1 (800) 334-2583
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 >

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 and ExpressionsSM

1 (800) 253-0838
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) 395-4943
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) 849-0299
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 ClassicSM, Innova® and Engage® (Core Group)

1 (800) 253-0838
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) 323-5802
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:

  • Core Group: 1 (800) 253-0838
  • Core Individual: 1 (877) 395-4943

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
  • Complex billing and coding information
  • Provider appeals and grievance process
  • 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

Syed Yusuf Ali
1 (206) 470-4285

 

Dentists and dental professionals

Please review our dental consultant list (PDF)

 

Medical, vision, complementary and alternative medicine providers
 

Counties: Adams, Chelan, Douglas, Ferry, Garfield, Grant, Kittitas, Lincoln, Okanogan, Pend O’reille, Spokane, Stevens and Whitman

Karen Nichols
1 (800) 452-7278 ext. 2909
1 541-318-2909


 

Counties: Island, San Juan, Skagit, Snohomish and Whatcom

Chris Ayala
1 (800) 452-7278 ext. 6582
1 (503) 525-6582

  Counties: Cowlitz, Kitsap, Lewis, Pierce, Thurston, Skamania

Lynette Welland
1 (253) 382-7770


  Counties: King

Crystal Woods
1 (253) 382-7276


  Counties: Benton, Clallam, Columbia, Franklin, Grays Harbor, Jefferson, Klickitat, Mason, Pacific, Wahkiakum, Walla Walla and Yakima

Anneli Robino
1 (800) 452-7278 ext. 8735
1 (503) 226-8735


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)
  • Explanations of specific medical and reimbursement policies

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

Specialty

Ancillary providers

Joan Bargelt
1 (253) 382-7192

  • Ambulance
  • Home Health Agencies
  • Hospice
  • Infusion Therapy
  • Kidney Centers
  • Laboratories
  • Medical Equipment (DME/HME)
  • Prosthetics & Orthotics

Joan De La Paz
1 (253) 382-7743

  • Free-standing Ambulatory Surgery Centers
  • Skilled Nursing Facilities
  • Independent Sleep Labs

Anesthesia providers

Statewide

Joan Bargelt
1 (253) 382-7192

Behavioral health

  • Fairfax Hospital and Navos
  • All chemical dependency treatment facilities and all mental health provider types
Syed Yusuf Ali
1 (206) 470-4285

Dental professionals

Please review our dental consultant list (PDF)


Emergency room providers

Statewide

Joan De La Paz
1 (253) 382-7743

Hospitals Please review our hospital list (PDF)

Physical Therapy

Statewide

Alex Cheng
1 (253) 382-7325

Radiology professionals

Statewide

Joan Bargelt
1 (253) 382-7192

Clinics and specialties not listed above

  • Large clinics or groups may locate their provider consultant using our clinic list (PDF).
  • Small groups/practices or other specialties not listed above should use our county listing (PDF).

 

Receiving secure emails

Emails from Regence staff that contain personal health information are sent securely through Tumbleweed Communications. Please view our secure email (Tumbleweed) 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