- Bcbsnc federal provider phone number. A Google Maps powered search that will help you find providers and facilities that are close by; The ability to access more information about a provider without having to begin a separate search; The new tool offers a more straight-forward way to get the information you need. By Phone: Call the number on the back of the member’s ID card or dial 800-676-BLUE (2583) to speak to a Provider Service representative. That’s Dental Blue® from Blue Cross NC. 800-777-1643. You can contact us in a couple of ways: Check the back of your membership card for your specific customer service phone number . • Attach Explanation of Benefits if these services are covered by another insurance policy. Don’t have your ID card? Call: 1-888-206- Blue Cross NC members have access to wellness resources, information about their health insurance plan, dedicated customer service support and more. Apr 25, 2020 · Find the statewise customer service, precertification, mental health and case management phone numbers for BCBS Federal providers and members. . Electronic Data Interchange A specific customer service center supports each member. Primary Care Medical Home (PCMH) Certification for Joint Commission Accredited ambulatory care organizations focuses on care coordination, access to care, and how effectively a primary care provider and interdisciplinary team work in partnership with the patient (and where applicable, their family). This page may have documents that can’t be read by screen reader software. providers, or health care clearing houses subject to the Health Insurance Portability and Accountability Act (HIPAA), or other federal health information privacy laws, they may further disclose my PHI and it may no longer be protected by HIPAA or federal health information privacy laws. Your Commercial agreement with us must contain a “Notice Contact” provision listing the Inpatient services and nonparticipating providers always require prior authorization. Omaha Headquarters 1919 Aksarben Drive Omaha, NE 68106 (Wheelchair accessible) P. 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. Claims/Customer Service. 855-462-1781. Email customer service or call 1 800-492-8872. , experimental procedures, cosmetic surgery, etc. To find out which services and providers (including hospital based physicians) are covered under your policy, or to learn about Local Blue Plan Criteria, contact your Local Blue Plan; and contact your provider before making an appointment to verify its current Network and Blue Distinction Centers status. Try our Find Care search tool to find them. Apr 23, 2020 · BCBS Provider Phone Number. If you are in need of more information about your plan you should contact customer service Monday-Friday, 8:00 a. Friday 8 a. Learn how to contact your local Blue Cross and Blue Shield company, as well as other key areas. Your provider's office will submit claims for you when you visit an in-network eye doctor. Contact Information BCBSNC Customer Service . Medical drug requests submissions are preferred electronically through MHK Provider Portal (accessed via Blue e) only. You can search by name, specialty, location and more. Visit any of our locations for help understanding or purchasing a new health plan from Blue Cross NC. Your health care provider will submit the prior authorization to your health insurance company. Please contact the Provider Blue Line at 800-214-4844 if you have any further questions. bcbsnc. Here, providers are located by name, specialty, county or zip code. ®, SM Marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans. If you are a participating provider other than a Blue Cross NC contracted medical doctor or doctor of osteopathy, you need to contact BCBSNC Network Management to obtain a current copy of your fee schedule. 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. - 9:00 p. You can submit commercial claims electronically as a trading partner or with a third-party clearinghouse. Get the Blue Cross NC forms and documents for providers that you need all in one place. to 6 p. But if you go to an out-of-network eye doctor, you'll be responsible for filing your own claims and may have to pay a higher fee for services. Claim adjustments call 800-451-0287* *interactive voice response (IVR) system – to access, you must have document control number (claim number) Blue Cross Medicare Advantage. eSolutions Help Desk. Your ID card gives you access to participating providers outside the state of North Carolina through the Blue Card® Program, and benefits are provided at the in-network benefit level. 833-690-1037 TTY: 711 (#833-690-1037) M-F 8AM to 5PM Blue Cross NC health insurance and Blue Connect for members lets you choose from a comprehensive network of thousands of caring doctors and providers. You're not just getting exclusive discounts on the latest fitness gear; you're also getting the tools and tips to keep you and your family healthy! Independent Clinical Lab (ICL) services are provided by any non-hospital-based laboratory and generally include, but are not limited to, blood tests, urine analysis, etc. Medical Records for the Federal Employee Program (FEP) are requested by an Explanation of Payment (EOP) with the remark code, “EMR”. to noon, CT on weekends and holidays Blue Cross NC makes health insurance easy. Better care starts here. Your provider and / or your insurance company will let you know if it is approved. Or by fax at 888-348-7332. The Blue Cross NC Care Management Department works with physicians and members to facilitate the most medically appropriate, cost-effective, quality care for our members. Box 2291 Durham, NC 27702-2291. through Fri. Federal Employee Program State Health Plan c/o BCBSNC PO Box 30085 Durham, NC 27702: Base PPO Plan (70/30) & Enhanced PPO Plan (80/20) Members: Third Party Administrator Aetna Health Concierge (Customer Service) as of 1. Please Select Your State The resources on this page are specific to your state. If you get health coverage through an employer: Contact your group administrator or HR department to make changes to your account. We have consolidated our resources for dental providers to make it easier to find the tools and information you need. O. Dec 22, 2021 · It's important we treat you fairly! That's why we follow federal civil rights laws in our health programs and activities. Physical address: Blue Cross NC 5901 Chapel Hill Road Durham, NC 27707 Learn how to submit claims for Federal Employee Program® (FEP) plans through Blue e, EDI, and mail. This includes Provider Blue Books, enrollment forms and more. Availity 800-282-4548: Eligibility and Benefits ©1996-2024 Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross Blue Shield Association. To obtain benefits, eligibility, or adjust a claim. Get fast answers to your plan, billing and coverage questions. Providers should bill with an ADA form, using the appropriate CDT code The 2012 ADA form is encouraged; however, we will still accept the 2006 version until IDC-10 goes into effect on October 1, 2015. For general inquiries and questions about the Service Benefit Plan, our overseas and pharmacy coverage or fraud assistance, you can call us toll-free nationwide. Telephone. The best dental plans make it easy for you to find a trusted dentist and know what’s covered before you see them. I’m a member and I have questions about my plan, coverage or claims. For other languages or TTY relay services, call the customer service number for your local Blue Cross and Blue Shield company. Members are still expected to select a primary care physician (PCP). Eligibility verification — Prompt 1; Authorizations and precertification — Prompt 2; Claims status — Prompt 3; Provider relations — Prompt 4; Pharmacy department — Prompt 5; Care management — Prompt 6; Inpatient coordination — Prompt 7 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. ET. For all other inquiries, including member support questions, please contact Blue Cross NC at 800-214-4844 or PNC. Carelon Provider Portal. About Mental Health (cdc. Linking your Blue Connect account helps you quickly access:. For help with these documents, please call 1-800-442-4607. federal dental plan,Blue Dental,BlueDental,FEP,Federal Employee Program,Federal Government,BCBS,Federal Provider Login contact the customer service number 1 Claim status inquiries contact Availity or other electronic connectivity. 25: For questions regarding benefits or provider inquiries for the 2025 benefit year. These tools are offered for your convenience and should be used only as reference tools. Claim adjustments call 1-800-451-0287* I need the BlueCross address or phone number. For Blue Medicare HMO/PPO: contact 800-266-6167 Certain durable medical equipment ( DME ) Blue Medicare HMO / PPO DME and Experience Health Medicare Advantage ( HMO ) DME : Prior approval codes for DME are available from Customer Service, Utilization Management or your Blue Cross NC Network Management representative. Box 3248 Omaha, NE 68180 402-390-1820 If you are a Blue Distinction Specialty Care (BDSC) or Total Care designated healthcare provider and have a signed agreement to participate in BlueHPN, you are considered a BDSC and/or Total Care Designated Health Care provider. Contact Information BCBSNC Customer Service. However, you will need to file claims for any lenses, frames and dental products or services received. Use My Health Toolkit ®. Blue Cross NC provides the telehealth program for your convenience and is not liable in any way for the goods or services received. Take care of your dental health by making the most of your Dental Blue Select℠ plan. Get the health and fitness products you've always wanted with a little help from Blue Cross NC's member discount program - Blue365. This tool does not reflect benefits coverage* nor does it include an exhaustive listing of all noncovered services (i. Use our search tool below to find a plan provider close to home. com. O. The new program will consider the medical necessity of studies and the clinical appropriateness of a facility- or home-based test. Applicable for Medicare PPO and Blue Medicare HMO + With HealthTrio, providers can: Verify member eligibility and benefits information Verify provider information Check claim status + Participation in our Blue Medicare HMO and Blue. Contact Blue Cross NC FEP Customer Service for questions and support at 888-333-8594. to 4 p. m. You will need to contact Blue Cross NC Provider Service at 800-777-1643, choose option 6 to continue the enrollment process. For questions about your plan, bills or claims, call the Customer Service number on the back of your Blue Cross NC member ID card. Call for verification of benefits, confirmation of coverage, and claims issues. Call us. Contact Us National Information Center 1 (800) 411-BLUE Providers and admins can submit claims for members with SHP and commercial plans electronically with EDI or Blue e. The Provider Search information is updated weekly. Find the phone numbers for general inquiries, claims, customer service, precertification, case management, and care management programs for federal employees in North Carolina. Mail: Blue Cross NC P. To find a provider in the Healthy Blue network, click the search for a provider button below or contact Member Services at 844-594-5070 or TTY 711. ©2024 Blue Cross and Blue Shield of North Carolina. Required for Ancillary claims. Physical address: Blue Cross NC 5901 Chapel Hill Road Durham, NC 27707 Contact. By calling 800-672-7897, Care Management staff are available to assist with arranging care for services for our commercial and State Health Plan membe 1-800-952-8462. In-network ICL providers should participate in the Blue Plan in the state in which the specimen is dra (17) Name of Referring Provider or Other Source: Qualifier and Name Optional field. Federal Employee Program® (FEP®) — PPO. SpecialtyPharmUpdates@bcbsnc. I’m a health care provider caring for a BlueCross member. Blue Cross Blue Shield of North Carolina Contact Us. If your employer has chosen a Blue Cross NC Select Network, you have access to quality health care with a network of local doctors and hospitals in your area. Your health insurance company will review the prior authorization and decide if it should be approved or denied. All NC Providers must provide their 5-digit BCBSNC provider ID# below. Get an Enrollment and Change Application from Customer Service (call the number on the back of your member ID card) or through your employer. (b) NPI: Optional field. If you need a claim form or help on how to file a claim, call BCBSNC's Customer Service at 1-877-258-3334 or write to: BCBSNC Customer Service P. I’m an agent looking for information on selling BlueCross plans. Don't have your member ID card? Please call: 888-206-4697. Email: ProviderUpdates@BCBSNC. Office Locations Omaha Headquarters. com . Contact Anthem Customer Service by phone, Live Chat, or log in to your account for information specific to your plan. This Agreement is between _____ (herein referred to as "you" and "your") and Blue Cross and Blue Shield of North Carolina, an independent licensee of the Blue Cross and Blue Shield Association, (herein referred to as "Plan"). The web page also provides links to other resources and information for BCBS Federal plans. , 8 AM to 6 PM ET. If you are deaf, hard of hearing, or have a speech disability, dial 711 for TTY relay services. Customer Service 877-774-8592. All 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. Discover employer, individual, family, Medicare & Medicaid plans from Blue Cross NC. EST. Federal Employee Program providers and facilities: 1-800-482-3600 Note: The FEP phone system has a different set of prompts than the others. Join the Blue Cross NC provider network, trusted by doctors, dentists, pharmacists and hospitals across North Carolina for more than 90 years. Search for many different types of providers, like: Blue Cross NC makes health insurance easy. I would like to report a suspected fraud. • Do not file a claim if the provider is filing for the same services or if the provider is in-network. Blue Cross and Blue Shield of North Carolina (Blue Cross NC) will implement a new Sleep Management Program. Contact us if you have a specific Alabama-related question or would like additional information about the products and services available through the Federal Employee Program. Mail completed appeal form and any supporting documents to: Blue Cross NC Provider Appeal Department PO Box 2291 Durham, NC 27702 Or fax the completed form and supporting documents to: Billing/coding denials: 919-287-8708 the Notice Contact is the name or title and address that you and BCBSNC are required to use to send certain notices regarding your provider agreement. Visit Anthem. After selecting the appropriate qualifier, enter up to 28 characters for the name. Eligibility and benefits contact Availity or other electronic connectivity vendor or call 1-800-442-4607* Claim status inquiries contact Availity or other electronic connectivity. For general inquiries and questions about the Service Benefit Plan, overseas and pharmacy coverage, call the National Information Center at 1-800-411-BLUE. When you visit a provider in the Blue Cross NC network, you’ll save on out-of-pocket Please contact 1-888-206-4697 (TTY: Federal and state-mandated Access the forms you need to make service requests requiring prior plan approval, pre-certification, or certification when being reimbursed through the benefits of members of Blue Cross and Blue Shield of North Carolina. You can also contact Customer Service at 1-877-258-3334 for assistance in locating a provider or to obtain a paper copy of a directory. Get help with all your health care needs at the Blue Cross NC Centers. National Information Center 1 (800) 411-BLUE; Download the fepblue App; Provider Services. 888-333-8594, Option 1. Hearing or speech impaired? Our free app makes it easy to search for in-network providers, pharmacies and urgent care centers near you. For provider questions and claims issues: Phone: 1-844-594-5072. The program links participating health care providers with the independent Blue Cross and Blue Shield Plans across the country, and in more than 200 countries and territories worldwide, through a single electronic network for claims processing and reimbursement. Phone: 1-877-258-3334 Fax: 1-919-765-1920. Mon. Explore dental network resources through Blue Cross and Blue Shield of North Carolina, including filing claims, benefit eligibility and information, and provider news. Have your member ID card? Calling the phone number on the back of your member ID card provides the fastest and most direct service for questions. )— refer to your Provider Manual for coverage/limitations. This address is the “Notice Contact” listed in your agreement with us. Fax: 919-765-4349. Incomplete forms may delay processing. to 5 p. Welcome to the Blue Connect and Blue Cross of North Carolina Member Self-Service Portal. gov) Telehealth benefits are available on all plans either from Blue Cross NC or through the provider network. Within 90 days of claim adjudication date, complete and submit the level I provider commercial appeal form. 1. We don't discriminate, exclude people, or treat them differently on the basis of race, color, national origin, sex, age or disability. • Claims must be filed within 18 months from the date services were received, or they will be denied. , CT; and 9 a. If you are an out-of-network provider who previously received payment for services from Blue Cross NC, you have already registered your NPI with us. Find a doctor, dentist or hospital near you. For other language assistance or translation services, please call the customer service number for your local Blue Cross and Blue Shield company. You can reach our Blue Cross NC team by chat, phone, secure message or visiting a store. Care Management Programs. e. Contact Us National Information Center 1 (800) 411-BLUE Contact us for more details about our plans, coverage, costs and more. We do this to ensure personalized service for every member. I’m interested in learning about BlueCross health plans. If you are in an area that has participating providers and you choose a provider outside the network, you will receive the lower out-of-network benefit. Claims information and online EOBs; Up-to-date information about your deductible and coinsurance; Estimated out-of-pocket costs for specific providers and services 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. Instructions. Monday through Thursday 8 a. Apr 25, 2020 · BCBS Federal Phone Number - FEP List Statewise Customer Service Precertification Mental Health/Substance Abuse Case Management Hospital; Alabama (800) 248-2342 Contact Network Management to obtain information about credentialing, provider numbers, contracts and sample fee schedules. Enter the National Provider Identifier (NPI) Number of the referring Provider. Blue Cross NC members can visit any licensed dentist they choose but can save money using in-network providers. Box 2291 Durham, NC 27702-2291 The BCBSNC Fee Schedule transaction is available only for participating professional medical doctors. Find the phone number for your local BCBS company for specific questions regarding your benefits, including claims, prior approval and care management. Explore Aetna's health insurance plans for individuals and families in Oregon. A medical drug is a medication that will be billed under a member's medical benefit, including "buy and bill" scenarios (IV medications, injections administered in a provider’s office). 800-835-8699: Availity ® Register with Availity to verify eligibility and benefits, submit prior authorization requests, obtain claim status, view provider claim summaries and more. Learn about Experience Health, a new and innovative insurance company owned by Blue Cross NC. Web portal connecting providers real-time for BCBSNC Medicare Advantage members. HOW IMPORTANT IS IT FOR PROVIDERS TO MAINTAIN THEIR CONTACT INFORMATION FOR BCBSNC MEDICAL RECORD REQUESTS? BCBSNC network providers are required to report how they wish to Helpful plan information for Blue Medicare HMO, Blue Medicare PPO and Blue Medicare Rx (PDP) members. www. Contact Network Management to obtain information about credentialing, provider numbers, contracts and sample fee schedules. Contact Name Phone/E-mail/URL; Provider Service Unit. See important dates, forms, resources, policies and more. com to register for our web portal and find policies, forms, and the latest newsletter. Get access to your statements, health records, provider directories, real-time nurse chats and more. Approved prior reviews are sent back to your provider. Requesting Provider Information Servicing Provider Or Facility Location (for services to be performed outside of the physician office) Provider Name Servicing Provider/ Facility Name Provider #, Tax ID # or NPI Servicing provider or Primary Care and OB/GYN practices may apply for The Joint Commission PCMH Certification. A: For the most up-to-date provider information, access our online Provider Search. Find resources for Blue Cross NC Providers in- and out-of-network to manage patient claims and appeals, eligibility, prior authorization and more. BCBS Federal Phone Number; 866-594-0521 (Blue Card Provider Phone Number) 855-854-1438 (Exchange Kentucky/Indiana) 800-456-3967 (FEP) If you are a Blue Distinction Specialty Care (BDSC) or Total Care designated healthcare provider and have a signed agreement to participate in BlueHPN, you are considered a BDSC and/or Total Care Designated Health Care provider. 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. Specialty pharmacies wanting more information on the Free Market Health program or in need of program assistance can contact the FMH team at 877-787-0520 or via email at Support@FreeMarketHealth. The participating provider will file claims for you. How to sign up to submit FEP claims through EDI. Carelon Contact Center – 866-455-8415 (Monday through Friday, 6 a. Contact Us ©2024 Blue Cross and Blue Shield Association. 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. qtj njye rxcjv ccfwm jgbb chzfjcsp myof jkwbmg rdxsj sipip