OPX

BCBS Prefix OPX

Anthem Blue Cross and Blue Shield of Wisconsin

Wisconsin • Traditional Indemnity, Medicare Advantage, HMO

Billing essentials

Provider phone
(855) 558-1443
Electronic payer ID
00246
Claims mailing address
P.O. Box 105557, Atlanta, GA 30348-5557
Timely filing limit
90 daysCompare all plans
Prior authorization phone
(855) 558-1443

Coverage under prefix OPX

Traditional Indemnity

Traditional indemnity coverage under this prefix is a fee-for-service plan. Members can see any provider without network restrictions or referral requirements. The plan reimburses a set percentage of usual and customary charges. Claims are submitted directly to the payer listed above.

Medicare Advantage

This prefix is associated with Medicare Advantage. MA plans combine hospital (Part A) and medical (Part B) coverage, and many include prescription drug coverage (Part D). When billing, confirm whether the plan uses the same payer ID for MA claims as for commercial claims, as many BCBS companies use separate IDs.

HMO

This prefix is linked to an HMO plan. Health Maintenance Organization coverage requires members to use in-network providers and coordinate care through a designated primary care physician. Referrals are typically required for specialist visits. Claims submitted without proper referral documentation may be denied.

About Anthem Blue Cross and Blue Shield of Wisconsin

Independent licensee providing commercial, Medicare and Medicaid plans to Wisconsin members.