RGA is a wholly owned subsidiary of Regence BlueShield (in Washington) 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 of Idaho Participating and Preferred Provider Organization (PPO) networks.
Identifying members
The front of the member cards include the:
- RGA logo or
- National Account BlueCross BlueShield logo
Obtaining pre-authorization, eligibility, claims status or answers to other inquires
Obtain this information by:
Note: 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
Effective through March 31, 2012
Submit claims to Regence through the BlueCard Program.
Beginning April 1, 2012
Submit claims to RGA electronically or via paper. (Note: Claims will be accepted and processed when submitted to Regence. However, the preferred method will be to submit claims directly to RGA.)
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 together with claims for Regence members.
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.
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 of Idaho Participating, PPO and Dental networks, please contact your provider consultant.
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