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Walmart 2010 Changes and Instructions


Effective January 1, 2010, there are changes that alter the way you file claims for Walmart associates. BlueAdvantage® Administrators of Arkansas will be the third-party administrator for all Walmart associates nationwide, including those previously administered by Blue Cross and Blue Shield of Oklahoma.

Transition Instructions


Eligibility and Pre-certification
  • To check eligibility and benefits after 01/01/2010, call 800-676-BLUE (2583) and provide the alpha prefix (WMW), or send an electronic eligibility inquiry (HIPAA transaction 270 online, Availity, etc.).
  • If a service requires pre-certification, please use the designated telephone number on the back of the patient’s ID card.
Claims
  • Services provided to Walmart associates on or after 01/01/2010 for members previously administered by BCBS of Oklahoma must be filed under the new BlueAdvantage ID number (WMW) to prevent delays of claim processing.
  • Claims filed for 2009 services should be billed using the prefix of MRT for BCBS of Oklahoma.
  • Claims should be filed through your local plan.
  • Claim status may be obtained online (Availity, etc.) or by contacting your local Blues Plan.
ID Cards
  • Insurance ID cards for all Walmart associates should be photocopied during every visit during 2010 to ensure that claims are filed appropriately.
  • New ID cards will be issued to all Walmart associates who previously had claims administered by BCBS of Oklahoma. Effective dates will be 01/01/2010. New ID cards will have the WMW prefix.


Behavioral Health and Mental Health Parity

BlueAdvantage administrators and Walmart have contracted with New Directions Behavioral Health to perform utilization management services.


Eligibility and Pre-certification
  • To contact New Directions for pre-certification of behavioral health services, call 877-709-6822 or utilize the New Directions WebPass.
  • WebPass allows providers and office staff to:
    • Submit pre-certification requests
    • Contact Provider Relations
    • Update online profile
  • To use New Directions WebPass, obtain a user name and password by downloading the Access Request Form:
    • Fax completed form to 913-982-8227, or
    • Mail to Network Operations, P.O. Box 6729, Leawood, KS 66206-0729
    • Login information will be e-mailed within two business days
  • To access New Directions WebPass:
    • Go to www.ndbh.com ,
    • Click Provider Section
    • Click Provider WebPass.
Outpatient Behavioral Health Services
  • Eight visits for associate or family members may be provided without pre-certification or review.
  • Psychiatric medication management does not require authorization.
  • Pre-certification is required beginning with the 9th visit. New Directions will respond within 72 hours with authorization or a request for more information.
Inpatient, Partial Hospital and Intensive Outpatient Services
  • Contact New Directions for authorization of all Inpatient, Partial Hospital and Intensive Outpatient services.
    • Call 877-709-6822 or
    • Use New Directions WebPass


View 2010 Provider News and Updates