BCBS of TEXAS – Alpha Prefix Importance
Most members with coverage through a Blue Cross Blue Shield Plan are assigned a three letter alpha prefix as a part of their unique identification number. The alpha prefix can easily be identified as it is the first three characters.
The alpha prefix is very important to the identification number. The prefix acts as a key element in confirming the members’ eligibility and coverage information. Prefixes are also used to identify and correctly route claims to the appropriate Blue Cross Blue Shield Plan for processing.
There are two types of alpha prefixes: plan-specific and account-specific.
Plan-Specific alpha prefixes are assigned to each plan. The first two characters of the prefix identifies each plan and the third character identifies the type of product the member is enrolled in.
Example: Prefix “ZGP” (Blue Cross Blue Shield of Texas – PPO Product)
1st Character “Z” Plan Specific (letter assigned to the BCBS Plan)
2nd Character “G” Plan Specific (letter assigned to the BCBS Plan)
3rd Character “P” PPO Product (letter assigned by the BCBS Plan to identify product type elected by the member)
Account-Specific alpha prefixes are assigned to national accounts. National accounts are employer groups that have offices across multiple states but offer standardized coverage to their employees. Normally, the alpha prefix assigned to national accounts will associate to the employer group name.
Example: Prefix “UTS” (University of Texas – National Account)
Identification Cards without an Alpha prefix:
Some identification cards may not include an alpha prefix, which may indicate that the claim filing instructions for these type policies are different. We suggest that you verify claim filing instructions during the time eligibility information is obtained. If not, please follow the instructions on the back of the member’s ID card or contact the plan directly. Member eligibility can be obtained at 1 (800) 676-BLUE (2583). Once connected, you will then simply provide the alpha prefix and the operator will then route you to the member’s plan.
Helpful Tips Related to the Alpha Prefix:
* Do not omit or randomly select an alpha prefix.
* Do not substitute another Blue Cross Blue Shield Member’s prefix.
* Include the alpha prefix and all alpha numeric characters preceding the alpha prefix on all correspondence and claims submitted to Blue Cross Blue Shield of Texas.
* The alpha prefix is always three letters followed by the member’s ID number which can be from 6 up to 14 characters total.
* If possible, make copies of the member’s ID card (front and back) for your records.
* We recommend that you obtain a copy of the ID card any time there has been a coverage or policy change. If there are no changes, we suggest that you obtain card copies annually.
