Bcbs of north carolina providers. Individual and family plans (under age 65) Healthy Blue is a Medicaid plan offered by Blue Cross and Blue Shield of North Carolina. If you're a provider looking for information about eligibility, claims status or other details, log in or register with Blue e. %PDF-1. . Blue Cross Blue Shield of North Carolina Provider Refund Return This form serves as a remittance advice to assist in properly adjusting your account/claim with either Blue Cross NC or the NC State Health Plan. The Blue Book is an online reference manual for products, value-added programs and services for providers participating in the Blue Cross and Blue Shield of North Carolina (Blue Cross NC) network. Please contact 888-206-4697 ( TTY : 711) for assistance. Providers looking for past allowed fee schedule amounts should contact Network Management. ® Marks of the Blue Cross and Blue Shield Association. Here's what you need to know about the Blue Cross and Blue Shield of North Carolina specialty pharmacy network. Blue Cross NC has robust search tools to help you find in-network doctors, hospitals, specialty pharmacies and urgent care in your state or across the country. Blue Cross and Blue Shield of North Carolina 4615 University Drive Durham, NC 27702. With Blue Cross and Blue Shield of North Carolina (Blue Cross NC ©2024 Blue Cross and Blue Shield of North Carolina. If yes, and you want to contract with Blue Cross and Blue Shield of North Carolina (Blue Cross NC), you will need to confirm your supervising physician (if required for licensure) is already credentialed with Blue Cross NC by calling 800-777-1643 option 6. Blue E. Join the Blue Cross NC provider network, trusted by doctors, dentists, pharmacists and hospitals across North Carolina for more than 90 years. Each medication plan comes with a list (or formulary) that shows you what medications are covered. To find one near you or schedule Receive Healthy Blue emails from Blue Cross and Blue Shield of North Carolina. Blue e is available for direct data entry of claims, claim correction, and inquiries in the Blue Cross NC local proprietary format and will continue to be available for as long as the CMS contingency plan is in place and the local proprietary format can be accepted. When using out-of network providers, in addition to deductible and coinsurance amounts, you may be responsible for the difference between the BCBSNC allowed amount and the provider's actual charge. Blue e Provider Access - Blue Cross and Blue Shield of North Carolina | BCBSNC If you're a provider looking for information about eligibility, claims status or other details, log in or register with Blue e. Healthy Blue is a Medicaid plan offered by Blue Cross and Blue Shield of North Carolina. The examples provided on this page relate to in-network services only. Blue Cross and Blue Shield of North Carolina is an independent licensee COVID-19 tests that are administered by a provider, consistent with Centers for Disease Control (CDC) guidance and cleared, approved or given EUA by the Food and Drug Administration (FDA) are covered based on each individual’s insurance plan, and members may be responsible for a portion of their costs 1 to include copayments, coinsurance and deductible amounts. This effort resulted in more than 28,000 providers partnering with the Plan for transparent and affordable health care. As a Blue Cross and Blue Shield of North Carolina member, you have two options for hearing aid discounts: Beltone and TruHearing. Your provider's office will submit claims for you when you visit an in-network eye doctor. Claims/Customer Service. North Carolina’s Health Information Exchange Network, NC HealthConnex, is a secure, computer-based electronic network for doctors, hospitals and other health care providers to share information that can improve your care – so that no matter where you are providers can access your information. Behavioral health. It is a participating provider’s/group’s contractual obligation to notify Blue Cross and Blue Shield of North Carolina (BCBSNC) of any change in demographic information. These tools are offered for your convenience and should be used only as reference tools. Blue Cross and Blue Shield of North Carolina is an independent If you have any problems logging in to the Blue e network or Blue Premier, please call the eSolutions HelpDesk at 1-888-333-8594 Option 1 or your system administrator. Providers. Blue Cross and Blue Shield of North Carolina does not discriminate on the basis of race, color, national origin, sex, age or disability in its health programs and activities. Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is expanding the Blue High Performance Network ℠ (BlueHPN ℠). Inquiries about our medical policies can be made by mail to the addresses listed below or you can call our Customer Service Department at 877-258-3334. You can also call us to learn more about purchasing a plan. If you have any problems logging in to the Blue e network or Blue Premier, please call the eSolutions HelpDesk at 1-888-333-8594 Option 1 or your system administrator. SM, ® marks of the Blue Cross and Blue Shield Association. Blue Cross and Blue Shield of North Carolina is an independent licensee Some prescriptions may require specialty handling, administration, or require ongoing clinical monitoring. Blue Cross and Blue Shield of North Carolina offers three drug formularies (drug lists) so Medicare beneficiaries can have options for their prescription needs. BlueHPN is a national quality-based network that provides members with access to high-quality doctors, hospitals and specialists across the state and country - all while lowering costs. This is critical to ensure BCBSNC and Blue Medicare HMO and Blue Medicare PPO members can access Blue Cross NC Provider Appeal Department PO Box 2291 Blue Cross and Blue Shield of North Carolina does not discriminate on the basis of race, color, national Welcome to the Blue Connect and Blue Cross of North Carolina Member Self-Service Portal. Through our history, we’ve grown to better serve our members and meet North Carolina’s biggest health challenges. It also means not having to worry if a check is lost, stolen or damaged. Integrated health care Have questions? Call or write us! Member Services: 844-594-5070 (TTY 711) Already a member? Log in to your account and send us a message. Together, we can help the whole person thrive by bringing physical and behavioral health together. Enrollment in Blue Cross and Blue Shield of North Carolina Senior Health depends upon contract renewal. Provider Services. Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is working with providers to improve how and when behavioral health concerns are identified and treated. Find out if your doctor, drug, or pharmacy is in-network, or explore other care options. Call us to get answers to your Blue Cross and Blue Shield of North Carolina (Blue Cross NC) plan, bill or claims questions. Effective 1/1/2008, Blue Medicare HMO and Blue Medicare PPO members have the freedom to choose in-network providers and specialists without a referral. In-network providers in North Carolina are responsible for requesting prior review when necessary. Blue Cross and Blue Shield of North Carolina is an independent Blue e services are available for both the local proprietary format and HIPAA compliant transactions. Blue Medicare HMO Enhanced, HMO Essential and Blue Medicare PPO Enhanced share the same Medicare prescription drug list. ©2024 Blue Cross and Blue Shield of North Carolina. Members may also wish to discuss their questions and individual medical situation with their physician. Better care starts here. • Provider office staff loses office time completing and submitting the second claim. Blue e provides details regarding how claims were adjudicated by BCBSNC, including If you have any problems logging in to the Blue e network or Blue Premier, please call the eSolutions HelpDesk at 1-888-333-8594 Option 1 or your system administrator. Find resources for Blue Cross NC Providers in- and out-of-network to manage patient claims and appeals, eligibility, prior authorization and more. bcbsnc. This will help us properly identify and credit the funds appropriately and If medical records are needed to support a medical necessity review and are not received by Blue Cross NC before the claim adjudicates, the member will receive an Explanation of Benefits (EOB), the provider will receive an Explanation of Payment (EOP), and both will receive a claim denial letter addressing the specific reason(s) for the denial. 7 %âãÏÓ 163 0 obj > endobj 181 0 obj >/Filter/FlateDecode/ID[6C7DDC7A967A8447BC1EBC98FD409020>689133792C9FEC40BF2B9F865733C38F>]/Index[163 47]/Info 162 0 R Have questions? Call or write us! Member Services: 844-594-5070 (TTY 711) Already a member? Log in to your account and send us a message. As a result of the calendar year (CY) 2024 policy and technical changes to theMedicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly, changes have been made to the Blue Cross and Blue Shield of North Carolina Blue Medicare Advantage ℠ medical policies. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association. Access tools, policies and the latest information to help you care for our members. Whether you are searching by a provider’s name, a particular specialty, a specific treatment, or your condition, you’ll be able to get accurate results that will help you make more informed care decisions. Explore dental network resources through Blue Cross and Blue Shield of North Carolina, including filing claims, benefit eligibility and information, and provider news. These provider partners are included in the North Carolina State Health Plan Network, which is made up of providers who signed up for the Plan’s Clear Pricing Project, and Blue Cross NC’s Blue Options network. The Blue Book is designed to assist you in understanding and administering Blue Cross NC health insurance products, health coaching and intervention Providers. Blue Cross NC offers wellness programs as a convenience to aid members in improving their health; results are not guaranteed. As part of our focus on value and quality in provision of health care to North Carolinians, Blue Cross NC is implementing a special provider incentive program, focused on closing care gaps Blue Cross and Blue Shield Plans. Blue Cross and Blue Shield of North Carolina (BCBSNC). Learn more about our non-discrimination policy and no-cost services available to you. This results in faster payment than paper checks. Forgot User ID? Forgot Password? Don’t have an account? Register Now. Healthy Blue North Carolina Providers. Blue Cross NC may contract with independent third-party vendors for the provision of certain aspects of our wellness programs and is not liable in any way for goods or services received from them. Focused on the health of each member. Blue Cross and Blue Shield of North Carolina (Blue Cross NC) offers several decision-support tools to aid you in making decisions around your health care experience. Blue Cross and Blue Shield of North Carolina (Blue Cross NC) provides free aids to service people with disabilities as well as free language services for people whose primary language is not English. ®, SM Marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans. Discover employer, individual, family, Medicare & Medicaid plans from Blue Cross NC. Click to learn more. Find a doctor, facility, drug or pharmacy in your network today. L33, 3/20 Medicare Advantage Provider Appeal Form NOT to be used for Federal Employee Program (FEP) or Commercial. Since 1933, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) has been committed to making health care easier to navigate, more affordable and more accessible to all. Member Services: 844-594-5070 Provider Services: 844-594-5072 Behavioral Health Crisis Line: 844-594-5076. All other marks are the property of their respective owners. Please use one form per claim, complete the form in its entirety and include with your payment. Providers can proactively send medical records and other required documents to Blue Cross and Blue Shield of North Carolina (Blue Cross NC) before claims are processed to help avoid denials or delays. www. Electronic Funds Transfer (EFT) allows providers to receive electronic payments directly in their bank account. Most patients with Blue Cross and Blue Shield of North Carolina (Blue Cross NC) health insurance also have a medication plan to cover the medications they get at their pharmacy. Blue Cross and Blue Shield of North Carolina Senior Health DBA Blue Cross and Blue Shield of North Carolina is an HMO-POS D-SNP plan with a Medicare contract and a NC State Medicaid Agency Contract (SMAC). Jun 6, 2024 · At Blue Cross and Blue Shield of North Carolina (Blue Cross NC), we appreciate all that you are doing to care for the health and well-being of our members. Members are still expected to select a primary care physician (PCP). For provider questions and claims issues: Phone: 1-844-594-5072. com . By mail to Blue Cross and Blue Shield of North Carolina Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association. Welcome! Healthy Blue is the Medicaid plan offered by Blue Cross and Blue Shield of North Carolina (Blue Cross NC) to serve North Carolinians who participate in the state Medicaid program. • Providers may be paying a billing service to resubmit a claim that was already in process to pay within a few days. 1/24 Blue Cross and Blue Shield of North Carolina does not discriminate on the basis of race, color, national origin, sex, age or disability in its health programs and activities. hav iezqu gljic zlvu pfoszs hzysk jamhk mvi cao glqw