Get all the coverage of Original Medicare plus prescription drugs and extra benefits, with plan premiums as low as $0/month. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. Curious to know what are national Accounts? The prefixes include filling up the claims of the insurance details.It also checks out the incorrect members of gaining the claim setting up the correct number about the IDs. Health Equity and Social Determinants of Health (SDoH), Over the Counter Equivalent Exclusion Program, Prior Authorization and Step Therapy Programs, Consolidated Appropriations Act & Transparency in Coverage, Medical Policy/Pre-certification: Out-of-area Members, HMO Medical Service Agreement Highlight and Process Summary, 3rd Trimester Pregnancy IPA Transfer Policy, 3rd Trimester Pregnancy IPA Transfer Procedure, Ancillary Hospital Institution Care Transition Exceptions Policy, Ancillary Hospital Institution Care Transition Exceptions Procedure, Contract Management Firms Confidentiality Agreement Policy, Contract Management Firms Confidentiality Agreement Procedure, Corrective Action for Failed Utilization Management Audit of Participating IPAs Policy, Corrective Action for Failed Utilization Management Audit of Participating IPAs Procedure, Collaborative Improvement Coaching for HMO Quality Improvement Projects Policy, Collaborative Improvement Coaching for HMO Quality Improvement Projects Procedure, IPA Availability andAccessibility Requirements forImmediate Care Services Policy, IPA Availability andAccessibility Requirements forImmediate Care Services Procedure, IPA Guidelines for Member Complaints, Inquiries, Appeals and Grievances Policy, IPA Guidelines for Member Complaints, Inquiries, Appeals and Grievances Procedure, IPA Process for Establishing Out of Area for Emergency Services Policy, IPA Process for Establishing Out of Area for Emergency Services Procedure, IPAs Request for Member Transfer Procedure, Member Access to Behavioral Health Services Policy, Member Access to Behavioral Health Services Procedure, Member Notification Process when a Provider Leaves the IPA Policy, Member Notification Process when a Provider Leaves the IPA Procedure, Oversight of Contracted Infertility Vendor Policy, Oversight of Contracted Infertility Vendor Procedure, Primary Care Physician (PCP) Affiliation with Multiple IPAs Policy, Primary Care Physician (PCP) Affiliation with Multiple IPAs Procedure, Utilization Management and Case ManagementAdherence Audit of Participating IPAs Policy, Utilization Management and Case ManagementAdherence Audit of Participating IPAs Procedure, Accountable Care Organization (ACO) Dual Claimed Physician Policy and Procedure, BCBSIL Marketing Communications HLA Policy Procedure, Blue Cross Blue Shield of Illinois Quality of Complaints & Occurrences Process Policy, Blue Cross Blue Shield of Illinois Quality of Complaints & Occurrences Process Procedure, Provider Handling of Member Inquiries Complaints and Appeals, Provider Urgent/Expedited Clinical Appeal Process, Recovery of Provider Overpayments due BCBSIL, MA HMO Detailed Explanation ofNon-coverage, MA HMO Notice of Dismissal of Organization Determination Request, MA HMO UM Approval In Network ProviderLetter, MA HMO UM Approval Out of Network ProviderLetter, MA HMO Sample Provider Appeal Language for Explanation ofPayment, MA HMO Sample Waiver of LiabilityStatement, MA HMO Transition to Transplant ManagementForm, HMO Provider Credentialing Pre-application. Commercial Communications Health Equity and Social Determinants of Health (SDoH), Over the Counter Equivalent Exclusion Program, Prior Authorization and Step Therapy Programs, Consolidated Appropriations Act & Transparency in Coverage, Medical Policy/Pre-certification: Out-of-area Members, Behavioral Health IP PA - IVR Caller Guide, Behavioral Health OP PA - IVR Caller Guide, Inpatient Preauthorization - IVR Caller Guide, Outpatient Preauthorization - IVR Caller Guide, Preauthorization: Check Request Status - IVR Caller Guide, Utilization Management Process Overview (Commercial), Patients medical or behavioral health condition, Date of service, estimated length of stay (if the patient is being admitted), Provider name, address and National Provider Identifier (NPI), Government Programs 877-774-8592 (MA PPO); 877-860-2837 (BCCHP); 877-723-7702 (MMAI). Blue Cross Blue Shield insurance Companies - Statewise. For Example: XYZ123456789. BCBS Blue Care Network Michigan (MI) UAB. Anthem Blue-Cross Blue-Shield of Ohio. 11 0 obj
Blue Cross and Blue Shield of Illinois is proud to be the state's only statewide, customer-owned health insurer. Denials with solutions in Medical Billing, Denials Management Causes of denials and solution in medical billing, CO 4 Denial Code The procedure code is inconsistent with the modifier used or a required modifier is missing, CO 5 Denial Code The Procedure code/Bill Type is inconsistent with the Place of Service, CO 6 Denial Code The Procedure/revenue code is inconsistent with the patients age, CO 7 Denial Code The Procedure/revenue code is inconsistent with the patients gender, CO 15 Denial Code The authorization number is missing, invalid, or does not apply to the billed services or provider, CO 17 Denial Code Requested information was not provided or was insufficient/incomplete, CO 19 Denial Code This is a work-related injury/illness and thus the liability of the Workers Compensation Carrier, CO 23 Denial Code The impact of prior payer(s) adjudication including payments and/or adjustments, CO 31 Denial Code- Patient cannot be identified as our insured, CO 119 Denial Code Benefit maximum for this time period or occurrence has been reached or exhausted, Molina Healthcare Phone Number claims address of Medicare and Medicaid, Healthfirst Customer Service-Health First Provider Phone Number-Address and Timely Filing Limit, Kaiser Permanente Phone Number Claims address and Timely Filing Limit, Amerihealth Caritas Phone Number, Payer ID and Claim address, ICD 10 Code for Sepsis Severe Sepsis and Septic shock with examples, Anthem Blue Cross Blue Shield Timely filing limit BCBS TFL List, Workers Compensation Insurances List of United States, Workers Compensation time limit for filing Claim and reporting in United States. BCBS Insurance goes on dealing with the oldest and largest health insurance system. BCBS prefix is a three character prefixes followed by the id number except for the following products and programs. '/&s0k?Nb~$;,KAz1J X#!&H&K8
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( Note: See Medicaid page for BCCHP and MMAI Provider Finder links.) Benefits will be determined once a claim is received and will be based upon, among other things, the members eligibility and the terms of the members certificate of coverage, including, but not limited to, exclusions and limitations applicable on the date services were rendered. The coverage that the organization holds on travel, medical and other conditions. Z2A to Z9A. Blue Cross Blue Shield insurance Companies - Statewise. Prior authorization requests for our Blue Cross Medicare Advantage (PPO)SM(MA PPO), Blue Cross Community Health PlansSM(BCCHPSM) and Blue Cross Community MMAI (Medicare-Medicaid Plan)SMmembers can be submitted to eviCore in two ways. Prefixes are also used to identify and correctly route claims to the appropriate Blue Cross Blue Shield [] The address and its verification of the members eligibility cover the areas of all the departments and claim the perfect status. Stand-alone dental products, vision and pharmacy when delivered through an intermediary model. Any individuals who impact HCSC's Medicare or Medicaid contract(s) are expected to abide by the Medicare and Government Contracts Compliance Program, the Code of Business Ethics and Conduct and the Medicare Compliance Policies. We always make sure to keep BCBS prefix list and BCBS provider phone numbers directory up to date. 1 0 obj
What is Medical Billing and Medical Billing process steps in USA? Denials with solutions in Medical Billing, Denials Management Causes of denials and solution in medical billing, CO 4 Denial Code The procedure code is inconsistent with the modifier used or a required modifier is missing, CO 5 Denial Code The Procedure code/Bill Type is inconsistent with the Place of Service, CO 6 Denial Code The Procedure/revenue code is inconsistent with the patients age, CO 7 Denial Code The Procedure/revenue code is inconsistent with the patients gender, CO 15 Denial Code The authorization number is missing, invalid, or does not apply to the billed services or provider, CO 17 Denial Code Requested information was not provided or was insufficient/incomplete, CO 19 Denial Code This is a work-related injury/illness and thus the liability of the Workers Compensation Carrier, CO 23 Denial Code The impact of prior payer(s) adjudication including payments and/or adjustments, CO 31 Denial Code- Patient cannot be identified as our insured, CO 119 Denial Code Benefit maximum for this time period or occurrence has been reached or exhausted, Molina Healthcare Phone Number claims address of Medicare and Medicaid, Healthfirst Customer Service-Health First Provider Phone Number-Address and Timely Filing Limit, Kaiser Permanente Phone Number Claims address and Timely Filing Limit, Amerihealth Caritas Phone Number, Payer ID and Claim address, ICD 10 Code for Sepsis Severe Sepsis and Septic shock with examples, Anthem Blue Cross Blue Shield Timely filing limit BCBS TFL List, Workers Compensation Insurances List of United States, Workers Compensation time limit for filing Claim and reporting in United States. We make sure to share latest data but in case you find some misinformation, please let us know so that we can help you to provide most accurate BCBS Alpha Prefix List. Do not create one or use the BCBS prefix from another member ID card. How To Identify Blue Cross Blue Shield Member? . Below is a list of the old and new alpha prefix codes. Save my name, email, and website in this browser for the next time I comment. Certain employer groups may require prior authorization or pre-notification through other vendors. Ans. In general, there arethreestepsprovidersshould follow. endobj
BCBS Alpha prefix and BCBS Alpha numeric prefix are very important to submit claims to BCBS insurance. For . The BCBSIL Commercial Provider Manual is organized into the following sections for providers participating in PPO, Blue Choice PPOSM, HMO and the Blue High Performance NetworkSM(Blue HPNSM)EPO. The benefits that BCBS Insurance provides are. BCBS Insurance mainly focuses on medical treatments and providing maximum support for the financial condition. But dont worry because our BCBS prefix finder include alpha numeric prefix information as well. BCBS Company. Learn more about timely filing limits and CO 29 Denial Code. HOME; . 7 0 obj
Have a look at our BCBS alpha prefix and BCBS alpha numeric prefix directory below. To request a hard copy of Blue Advantage's provider directory, please call our Member Service Department at 1-888-234-8266, 8 a.m. to 8 p.m., seven (7) days a week. There is a total of 732 alpha prefixes in the BCBS EAA-EZZ list and 39 are Not Assigned prefixes out of 732. The employees suggest to the customers select the packages and illustrate more about the service. BCBS member ID prefix help medical billers, health care providers and patients to identify BCBS healthcare plan. You may also be interested to read about denial code 27 reason and solutions. LAA. Insurance Identifier Lookup; Plan Phone Numbers; Medicare Contractors; State Medicaid Plans; Home; Medicare Advantage List; . Create an account. Also, these BCBS prefixes helps providers and medical billers to reach the correct claims department for claims and benefits inquiry. <>
Complete Guideline and Strategy, Tips to Create the Perfect Medical Provider Resume, Benefits and Eligibility Verification Services. The cross also goes through the analysis of gaining health insurance and forms a series of packages. Sign up for theLifeTimes newsletterto get health and benefits articles delivered to your inbox every month. <>
Save my name, email, and website in this browser for the next time I comment. Earn Money by doing small online tasks and surveys, McKesson Corporation: Company Overview & History (2023), AAPC: What it is and why it matters in the Healthcare (2023). We cant decide Blue cross Blue shield members state just by looking first alpha prefix. For prior authorization requests handled by BCBSIL: There are two ways to initiate your request. Blue Shield has negotiated with the local hospitals and pays off the steep fees for encountering charges on the specific benefits. Prior authorization (sometimes called preauthorization or pre-certification) is apre-service utilization management review. Admin 22A. By using this directory, you can ensure that you have the most up-to-date information about BCBS home plans and make more informed decisions about choosing right insurance plan. BCBS National accounts are employer groups that have outlets/offices in multiple states but they offer limited coverage to their employees. BCBS of Kansas City. The calculation begins from the date of service, discharge date or last date of treatment up to 365days, including weekends. The prefix acts as a key element in confirming the members' eligibility and coverage information. When does health insurance expire after leaving job? Prefix ZGP identifies Blue Cross Blue Shield of Texas PPO Product. CPT is registered trademark of American Medical Association. <>
In recent years medical treatment and its cost has increased, which has become unbearable to manage. In case, you need any additional information related to BCBS prefix then feel free to reach out to us. The following prefix list comes with filling up the health care claims and analyses the correct address of the BSCs sections. Blue Cross Blue Shield of Illinois: Y2M: Blue Cross Blue Shield of Nebraska: YAA: Anthem BCBS of Connecticut: YAB: Regence Blue . Continue with Recommended Cookies. And to manage such a big network, they divided it into different departments state wise or employer specific. Not assigned prefix: GAX: BCBS Illinois: GAY: Anthem Central Region (OH, IN, KY) GAZ: Not assigned prefix: GBA: BCBS Montana: GBB: Anthem Blue Cross California: GBC: Wellmark BCBS: GBD: For government programs prior authorization requests handled by eviCore healthcare (eviCore): It also states the important papers for identification that would help safeguard the situation and also save the expenses. Health Exchange. <>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S>>
This includes strict observance of and compliance with the laws and regulations governing the business operations of HCSC, and in particular, the services that it performs or has delegated to others to perform pursuant to its Medicare and Medicaid contract(s). Health Care DeliveryPolicy and Procedures, Blue Cross Community Health Plans ProviderManual, Medicaid Provider Orientation(Professional), Medicaid Prior Authorization RequestForm, Medicaid Provider Orientation (Professional), Blue Cross Community OptionsSMBehavioral Health Benefit Grid. To view this file, you may need to install a PDF reader program. knowledge of BCBS alpha prefix is compulsory if you are handling denials and AR follow up. Health insurance is nowadays the most wanted series of getting rid of the expenses from the high medical costs. Do not delay the billing of a claim for any reason. Check Claims Claim Explanation Codes Request a Claim Adjustment View Fee Schedules . Xceed Billing Solutions motive is to create ease for providers, medical billers, patients and everyone who is involved in revenue cycle process. V2A to V9Z. To view this file, you may need to install a PDF reader program. One option is Adobe Reader which has a built-in reader. BCBS Alpha Prefix List of "U"-series. To run such a large number of people, they divided Blue Cross Blue Shield Insurance Association into different departments which is employer specific or state wise. <>
Blue Cross and Blue Shield of Illinois is proud to be the states only statewide, customer-owned health insurer. If you are using electronic submission then prefix is important to submit claims successfully and received by insurance correctly. We are also the largest provider of health benefits in Illinois, serving more than 8.1 million members in all 102 counties across the state. External link You are leaving this website/app (site). I have completed my Bachelor of Business Administration in Healthcare Management from University of Texas. CAA. Coupon "NSingh10" for 10% Off onFind-A-CodePlans. endobj
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*!uB9^AwjF(v,o Search articles and watch videos; ask questions and get answers. The organization is famous just for this particular service apart from the other policies. All claims must be submitted to Blue Cross Blue Shield. So, to answer this query, we have mentioned below few important points to consider. What kind of cases do personal injury lawyers handle? For Example: ABC, A2B, 2AB, 2A2 etc. Preferred PPOSM Alpha Prefix Codes December 15, 2015 As a reminder, the alpha prefix codes on Blue Cross and Blue Shield of Illinois (BCBSIL) members' ID cards in the BlueCare Direct and Blue Choice Preferred PPO plans have been updated. eviCore healthcare (eviCore) is an independent company that has contracted with BCBSIL to provide prior authorization for expanded outpatient and specialty utilization management for members with coverage through BCBSIL. <>
If youre a medical biller or a provider and going to submit BCBS plan member claim to the insurance, make sure to submit member ID including prefix. UAA. &UMDU}%h UX[_kRGyzte,.-pD?^]Yt%i7=$Foy*ja(5}31$9w}eLvdA
oV;_$myuVLW5v^{=GW;ig)aYff,WW(/-"*{Wf;x5qS:@-q$QJLgvCd2>OXe|lqc;Kv.&Pkuz?&jm*1qm1UqmeETH}6Iq?} Dl]mh*MNgUh9dzQ!hTk H:Azif+ ]V"U23 Third, it can help you make more informed decisions to choose right insurance plan and benefits. Policy number is a unique number, which is provided to their insured person by respective insurances in order for identification purposes and also for billing the healthcare claims. Log In to the Shopping Cart, Need to Make a Payment? Access Your Payment Options. If you are using electronic submission then prefix is important to submit claims successfully and received by insurance correctly. BCBS Prefix List 2021 - Alpha State Lookup BCBS Company; AAA: Alabama: Blue-Cross Blue-Shield of Alabama: AAB: Michigan: Blue-Cross Blue-Shield of Michigan: AAC: Illinois: Blue-Cross Blue-Shield of Illinois: AAD: South Carolina: Blue-Cross Blue-Shield of South Carolina: AAE: Nevada: Anthem Blue-Cross Blue-Shield of Nevada: AAF: BCBS Prefix should be included along with ID number, exactly as it appears on the member ID card when filing the claims to insurance company. BCBS prefix are easy to identify using our BCBS prefix lookup because theyre part of every BCBS member ID and we included all of them here in the BCBS prefix list. A Google Certified Publishing Partner. Carefirst BCBS of Maryland the (MD), District of Columbia (DC), and the Northern Virginia (VA) CAB. For example, baggage and other items will get lost if you fall sick before or during the trip. So, all BCBS plans, including Anthem and Non-Anthem plans announced that member IDs will also be Alpha Numeric from 2018 onwards. 17 0 obj
The alpha prefix is always three letters followed by the member's ID number which can be from 6 up to 14 characters total. The alpha prefix is very important to the identification number. Lets dig into it! BCBSIL, as well as several independent Blue Cross and Blue Shield Plans, has an ownership interest in Prime. This new site may be offered by a vendor or an independent third party. The alpha prefix is very important to the identification number. The following travel insurance helps to deal with all the medical costs and also covers the family expenses. BAB. MedicalBillingRCM.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com. endobj
855-854-1438. Note for Front Desk and Providers: When Blue Cross Blue Shield members comes to your facility or office, make sure to ask them for their active BCBS plan member ID card. stream
T2A to T9Z. Admin 83A. BSBS insurance involves unique prefixes and follows up a unique ID number. 5 0 obj
What is Medical Billing and Medical Billing process steps in USA? Ohio. Blue Cross Blue Shield of Illinois: IBU: Blue Cross Blue Shield of Alabama: IBV: Blue Cross Blue Shield of Massachusetts: IBW: Blue Cross . 7aM- I|x,# Sample BCBS prefix list. To view this file, you may need to install a PDF reader program. In addition, some sites may require you to agree to their terms of use and privacy policy. BCBS Alpha Numeric Prefix from F2A to F9Z (Updated 2023) January 7, 2023 by Kim Keck. Here you can find the BCBS prefix finder along with BCBS home plan name and website for BCBS member IDs ranging from F2A to F9Z. BCBS prefix lookup directory is a valuable resource for anyone who is looking for right Blue Cross Blue Shield home plan. In addition, some sites may require you to agree to their terms of use and privacy policy. Step 1 Confirm if Prior Authorization is Required. In that case claim may be denied as Submit the claim to the correct address / Member ID not found. JFIF x x C
The BCBS prefix lookup directory is regularly updated with the latest BCBS insurance plan information, so you can be sure that the information youre viewing is 100% accurate. The Home and Host plan is also working in the Blue Cross Blue Shield plan. Returning Shopper? Correct BCBS home plan can easily be identified using our BCBS prefix lookup directory. BCBS prefix are easy to identify using our BCBS prefix lookup because they're part of every BCBS member ID and we included all of them here in the BCBS prefix list. The site may also contain non-Medicare related information. Now, with more than 15 years of experience as a medical biller and revenue cycle manager, I am on a mission to serve the medical billing industry with my vast knowledge and years of expertise. Check out our Corporate Social Responsibility Report and learn about the ways we are serving our community. Topics include everything from improving your well-being to explaining health coverage. 3 0 obj
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BCBS FEP Its indicated with letter R followed by the id number. Independence Blue Cross (BC) of Philadelphia (Phi) and the Southeastern Pennsylvania (PA) ZAB. ZAA. Blue Cross Blue Shield Federal Phone Number. The consent submitted will only be used for data processing originating from this website. endobj
X2A to X9Z. Hi, Im Kim Keck! Compliance, Fraud, Waste and Abuse Program and Reporting: HCSC and its subsidiaries are founded on the basic principles of good business behavior. Join us as we build the next generation of health insurance. An example of data being processed may be a unique identifier stored in a cookie. Livestock Protection. External link You are leaving this website/app (site). Always use the BCBS prefix on the members current ID card followed by the member id number. Account Specific Prefix are assigned by BCBS to national accounts. Most PDF readers are a free download. Blue Access for MembersSM is a powerful tool for managing all your health plan benefits. The blue cross blue shield coverage deals with the best services for its customers and involves a better statement of the medical treatments. N9=*io1*sLxfLf9`El/Ou:!fUKc3'I"UIcL 0 d.|XbY!&e|&1'b[7N!B!axHgY&K8Ugxl
]j.,pj,$&GHox Does policy number same as member ID number? An Independent Licensee of the Blue Cross Blue Shield Association 020469 (03-01-2023) Prefix BCBS Plan Prefix BCBS Plan Prefix BCBS Plan A2T Premera Blue Cross A9P Premera Blue Cross ACF Premera Blue Cross AGL Premera Blue Cross/Shared Admin GUJ AHC Premera Blue Cross AJX Premera Blue Cross GVY ALK Premera Blue Cross BCBS Alpha Prefix List from UAA to UZZ Updated 2023. BCBS Prefix will not only have numbers and the digits 0 and 1. Anthem BCBS of Connecticut. It is one of the giant sectors that provide more than 106 million health facilities. Click on a section title to view the content. BCBSIL contracts with Prime to provide pharmacy benefit management and other related services. In case, you need any additional information related to BCBS prefix then feel free to reach out to us. The Blue cross blue shield company mainly provides proper health insurance coverages. LAB. State Lookup. Unassigned Prefix. In addition, some sites may require you to agree to their terms of use and privacy policy. BCBS Alpha Prefix Lookup. In plan-specific alpha prefixes, the first two characters denote a given plan, while the third character identifies the product type chosen by the member, explains the BCBS of Texas. We recently received a query from a provider that how I can identify that patient is BCBS health insurance member. Today you will find The BCBS Alpha Prefix List from SAA to SZZ. Blue cross coverage goes through the idea of calling out the blue cross blue shield company, which helps to provide the programs benefits. Here Letter R indicates BCBS FEP prefix. Always make sure to submit claims to insurance company on time to avoid timely filing denial. Calls will be returned the next . Step-by-Step Guide for Provider Finder . <>
BCBS Prefix BCBS Plan Name E2A Blue Cross Blue Shield Texas E2B Blue Cross Blue Shield Texas E2C Anthem BCBS Indiana E2E Regence Blue Cross . 4 0 obj
Provider Finder . First, it saves you time and hassle by allowing you to quickly identify correct BCBS insurance home plan without having to call customer service. Prior authorization requests for our Blue Cross Medicare Advantage (PPO) SM (MA PPO), Blue Cross Community Health Plans SM (BCCHP SM) and Blue Cross Community MMAI (Medicare-Medicaid Plan) SM members can be submitted to eviCore in two ways. J7Wr}pY+Gqpgx
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et BCBS Alpha Prefix List of "E"-series: Blue Cross Blue Shield insurance Companies - Statewise: EAA: Not assigned prefix: EAB: BCBS of Kansas City: EAC: Anthem BCBS of Virginia (VA) EAD: BCBS of Illinois (IL) EAE: Regence BCBS: EAF: BCBS of Massachusetts (MA) EAG: Capital Blue Cross of Pennsylvania (PA) EAH: BCBS of Alabama (AL) EAI: Not . BCBS Alpha Numeric Prefix - It's a three letter Alpha numeric prefix followed by id number. Prior authorization isrequiredfor some members/services/drugsbefore services are rendered to confirm medical necessity as defined by the members health benefit plan. This new site may be offered by a vendor or an independent third party. BCBS Alpha Numeric Prefix Its a three letter Alpha numeric prefix followed by id number. Here " ABC" is BCBS alpha prefix. Remember, member benefits and review requirements will vary based on service/drug being rendered and individual/group policy elections. Business health insurance plans designed to fit any size small business and budget.