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Regence Group Administrators

RGA is a wholly owned subsidiary of Regence BlueShield that provides third-party administrative services to self-funded employer groups primarily located in Oregon and Washington. RGA’s self-funded employer group members may utilize our Participating and Preferred and Dental networks.

Members may live in or travel to our service area and seek services from you. The RGA medical product uses BlueCard® nationwide and the Regence BlueShield Participating and Preferred Provider Plan (PPP) networks.

Identifying members
The front of the member cards include the:

  • RGA logo or
  • National Account BlueCross BlueShield logo

HMA Member Card Front
HMA Member Card Back

Obtaining pre-authorization, eligibility, claims status or answers to other inquires
Obtain this information by:

Notes:

  • RGA member information is not available in the Regence Provider Center
  • Please contact RGA to obtain pre-authorization information for RGA members. RGA employer group’s pre-authorization requirements differ from Regence's. Self-funded plans typically have more stringent authorization requirements than those for fully-insured health plans

Submitting claims to RGA
Submit claims to RGA electronically or via paper.

Electronic claims

  • Submit claims directly to Availity® with Payer Identfication Code ID HMA01.
  • The claim should include the three-digit alpha prefix and the subscriber number listed on the member's card.
  • Do not submit RGA claims to Regence. RGA claims that are submitted incorrectly to Regence will be returned with instructions to resubmit to the correct payer.

Paper claims

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

Receiving vouchers and payment
Vouchers and reimbursement checks will be sent by RGA. Claims information and vouchers for your RGA patients are not available in the Regence Provider Center.

Provider vouchers and member Explanation of Benefits (EOBs) will include a message code and description. As indicated in your provider agreement with Regence, you will need to hold the member harmless (write-off) the amount indicated on the voucher when these message codes appear.

Document type Message Code Description
Provider voucher DR RGA dental provider discount. The patient is not responsible for this amount.
Provider voucher PD Preferred provider discount. The patient is not responsible for this amount.

Member Explanation of Benefits (EOB)

PD

Preferred provider discount. The patient is not responsible for this amount.

To have payments deposited directly into your bank account through electronic funds transfer (EFT), contact RGA's Customer Service department at 1 (866) 738-3924.

Questions
If you have any questions regarding RGA access to the Regence BlueShield Participating, Preferred Provider Plan and Dental networks, please contact your provider consultant.

 

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