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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.
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| 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.
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| 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.
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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.
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| 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.
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| 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
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View 2010 Provider News and Updates
