Bcbs nc provider lookup
Bcbs nc provider lookup. For more details view our Provider Fee Schedules in Blue e Q&A (PDF) . 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. Search for specialized care local to Texas. Shop plans for Medicare, Medical, Dental, Vision & Employers. Only providers with a Blue Cross NC contract can receive direct payment. Many of the health care providers in our network join quality programs. You can also contact Customer Service at 1-877-258-3334 for assistance locating a provider or to obtain a paper copy of a directory. Explore the health insurance options offered by Blue Cross and Blue Shield insurance agencies. Prior Authorization Lookup Tool. Have you already registered your NPI? 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. Virgin Islands. The organization does not use quality measures, member experience measures, or cost related measures to select any of our practitioners or hospitals for participation in the network, this includes those treating our Marketplace members. You can search by name, specialty, location and more. Important notice. Our public Find Care tool is only for plans not in a Select Network. Ask your doctor for a recommendation or referral. Contact Network Management to obtain information about credentialing, provider numbers, contracts and sample fee schedules. Blue Cross and Blue Shield (BCBS) members can search for doctors, hospitals and dentists. Physical address: Blue Cross NC 5901 Chapel Hill Road Durham, NC 27707 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. Blue Cross NC members have access to wellness resources, information about their health insurance plan, dedicated customer service support and more. Within 90 days of claim adjudication date, complete and submit the level I provider commercial appeal form. However, a lot of providers practice at multiple locations and different practices. Find out how to join the network of providers who partner with BCBSNC to deliver quality health care to our members. Members are still expected to select a primary care physician (PCP). Provider data last updated: Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association. S. Healthy Blue’s provider manual provides key administrative information including the quality improvement program, the UM program, quality standards for participation, claims appeals, and reimbursement and administration policies. Specialty Pharmacy Services include injectables and infusion therapies, and high-cost and complex care therapies. Use our search tool below to find a plan provider close to home. 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. If not using the search field, the steps below outline Blue Cross NC health insurance and Blue Connect for members lets you choose from a comprehensive network of thousands of caring doctors and providers. If the drug is listed in the Drug Search, these requirements may still apply. Ready to become a provider in the Anthem network? We look forward to working with you to provide quality service for our members. Learn how to qualify for these programs, the benefits of participating plus how to use quality reports to identify care gaps. Your doctor can also find pre-approval forms on our provider prior authorization page . Get the Blue Cross NC forms and documents for providers that you need all in one place. Forms and resources 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. If using the search field, type your practice or provider name in the search field. Getting a referral from your primary care provider is important if you have an HMO plan and want to save money. As an alternative, you may enter a ZIP code. Get Started We are committed to supporting you in providing quality care and services to Healthy Blue members. BlueCross BlueShield of South Carolina members. Feb 24, 2021 · BCBS Prefix List Lookup: BCBS prefix list lookup is a three character prefixes followed by the id number except for the following products and programs. com. See important dates, forms, resources, policies and more. Email: ProviderUpdates@BCBSNC. That CPP designation DOES need to be noted in the Find a Doctor tool for the provider to be a CPP Primary Care Provider (PCP). Members may also wish to discuss their questions and individual medical situation with their physician. Use the Find Care tool above or the BCBSTX mobile app to search for in-network doctors who specialize in your diagnosis. Participating physicians who wish to view a special or supplemental fee schedule can contact their Network Management service representative to request a hard copy of the fee schedule. Search for a doctor, hospital, dental and vision providers or pharmacies in your area. Find Care Near You with the Find a Doctor Tool. O. Box 2291 Durham, NC 27702-2291. Access tools, policies and the latest information to help you care for our members. Shop Plans. View or download the provider manual. View or download the Quick Reference Guide. Join the Blue Cross NC provider network, trusted by doctors, dentists, pharmacists and hospitals across North Carolina for more than 90 years. Through this search tool, you can also search for health care facilities, including hospitals, urgent care and labs. Get insurance delivered through your local BCBS agency. Learn about Experience Health, a new and innovative insurance company owned by Blue Cross NC. For example, to search for all dentists in cities starting with "C," enter "C" for the city. To confirm the specific name of your plan, please check your member ID card. Provider Manual. Use the right search tools to find a doctor. In-network D/HME providers should participate in the Blue Plan in the state the equipment is shipped to, or the location of the store if it is purchased at a retail location. Payments for services from a non-participating provider are generally sent to the member, except where federal or state mandates apply, or negotiated agreements are in place. Providers joined the CPP at the practice level, so members should be able to see any provider in that listed CPP practice. Log in to My Health Toolkit ® to search the provider directory and view search results specific to your insurance plan. You can also search providers outside the U. You will need to contact Blue Cross NC Provider Service at 800-777-1643. Important notices about your plan Medicare Advantage members can get up-to-date information about in-network providers in your area by following the questions below. Medicare Risk Adjustment Provider Documentation and Coding Guide (PDF) MCG Care Guidelines 28th Edition (PDF) New Resources to Improve Your Quality Rates (PDF) Notification of Specialty Pharmacy Medical Step Therapy Updates (PDF) Osteoporosis Screening in Older Women (OSW) (PDF) Outpatient Antibiotics Provider Toolkit (PDF) Use the Eye Doc Locator from Eye Med Vision Care to search for an eye care professional in your Blue 20/20℠ plan. Get in touch with your local Blue Cross and Blue Shield company. Better care starts here. Find out if your doctor, drug, or pharmacy is in-network, or explore other care options. It allows you to quickly and easily identify your insurance home plan, saving you time and hassle. 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 Providers looking for past allowed fee schedule amounts should contact Network Management. Outside the United States *Select Blue Cross Blue Shield Global™ or GeoBlue if you have additional international coverage and need to find care outside the United States. 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. Search for specialized care local to Illinois. Welcome to BCBSNC Browse by Category. The full text or spelling is not required for the city and dentist name fields. Explore dental network resources through Blue Cross and Blue Shield of North Carolina, including filing claims, benefit eligibility and information, and provider news. Use the Find Care tool above or the BCBSIL mobile app to search for in-network doctors who specialize in your diagnosis. From the Payer Spaces homepage, select the Final Remarks about BCBS Prefix Lookup Directory. Discover employer, individual, family, Medicare & Medicaid plans from Blue Cross NC. Quality-based programs recognize providers offering outstanding quality care to members. 800-777-1643. Here you will find frequently used forms, PDFs, provider manuals and guides, prior authorization information, practice policies, and support for delivering benefits to Healthy Blue members. We would like to show you a description here but the site won’t allow us. Select the health plan. Get information on your policy using the state website found on your membership ID card. In the United States, Puerto Rico and U. Before you make your appointment for these services, have your doctor or provider call us at 800-222-4739. Choose option 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. 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. 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. Prior review (prior plan approval, prior authorization, prospective review or certification) is the process Blue Cross NC uses to review the provision of certain behavioral health, medical services and medications against health care management guidelines prior to the services being provided. The new tool offers a more straight-forward way to get the information you need. Ask your employer if you're in a Select Network or check your ID Card for your network. BCBS prefix lookup directory is a valuable resource for anyone who is looking for right Blue Cross Blue Shield home plan. A file should now be available. Stand-alone dental products, vision and pharmacy when delivered through an intermediary model. These tools are offered for your convenience and should be used only as reference tools. This includes Provider Blue Books, enrollment forms and more. To locate a provider within your plan’s network, you will need to know the name of your plan. BCBS FEP – It’s indicated with letter R followed by the id number. Here, you can locate providers by name, specialty, county or zip code The Provider Search information is updated weekly. A PCP is a doctor, nurse practitioner or physician assistant. Your provider's office will submit claims for Go to Report Search, select the program, complete the required fields and select Search. Important information about Changes to this Directory. Learn more about our coverage options including health, Medicare, dental and vision options for you, your family or your employees. Health plans have a provider network (group). Find resources for Blue Cross NC Providers in- and out-of-network to manage patient claims and appeals, eligibility, prior authorization and more. . Finding a CPP Provider (BCBS) Step-by-step instructions for finding a Clear Pricing Project provider in the Blue Cross NC network for 2024. Search for many different types of providers, like: Some prescriptions may require prior authorization or prior plan approval. In most cases, you must get care from a provider in your health plan’s provider network, such as a primary care provider (PCP). Use the Prior Authorization Lookup Tool within Availity or; Call Provider Services at 1-844-594-5072. Within the United States, to search for a dentist by location, supply your city (optional) and state. Search Now Blue Care: Any service received at an out-of-network provider 1 Notice of mastectomy benefits As required by the Women's Health and Cancer Rights Act of 1998, your health insurance policy provides benefits for mastectomy-related services, including all stages of reconstruction and surgery to achieve symmetry between the breasts, prostheses and Find and search for healthcare providers and services offered by Blue Cross Blue Shield Association. To request authorizations: From the Availity home page, Search our nationwide directory of Preferred providers—those providers in our network. To access provider online reporting for all users once registration is completed: From the Availity homepage, select Payer Spaces from the top navigation. As the doctor or provider, you must send all your details, and your signature on the Medical Necessity PA Request Fax Form (PDF), to Blue Cross NC; For questions or to check the status of your review, call us at 800-672-7897 Official Site of Anthem Blue Cross Blue Shield, a trusted health insurance plan provider. If you have any questions about EFT, please contact your Healthy Blue Provider Relations representative or call Provider Services at 844-594-5072 for more information. Provider News Get the latest articles and announcements on claims filings, products, benefits, administrative updates, new and revised procedures and guidelines, prescription Search Tips ×. A: Access the most up-to-date provider information with our online Provider Search. This tool provides general information for outpatient services performed by a participating provider. Type a Current Procedural Terminology (CPT) code or a Healthcare Common Procedure Coding System (HCPCS) code in the space below to get started. The BCBSNC Fee Schedule transaction is available only for participating professional medical doctors. You can search by specialty, location or network to find the healthcare provider that meets your needs. 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. Find results using these care categories. Fax: 919-765-4349. 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. If the member’s group is not enrolled in the Carelon program indicated, PPA is not required for that procedure/drug in the specified place of service. Anthem - Provider Finder is a platform to locate in-network Anthem providers and estimate healthcare costs. 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. Find out if a service needs prior authorization. Use the Look up Doctor or Drug search to find an in-network doctor or facility. They care for your health, coordinate your needs and refer you to specialists when you need them. These programs also help direct members to participating providers who embrace quality improvement. Find A Doctor – Provider Directory - Blue Cross and Blue Shield's Federal Employee Program Skip to main content Jul 3, 2024 · To initiate post service review, please contact Carelon or log on to the Provider Portal within 10 days The results of the approved procedure will be required to complete the post service review. Access resources, forms, and more. Mail: Blue Cross NC P. Licensee Search Request Verification; Roster; Search Tips; Glossary of Terms BCBS members can search for doctors, hospitals and dentists. Blue Cross NC makes health insurance easy. Once you have selected your practice or provider name that meets your search, click on the provider name to find more details on the profile, and verify BlueHPN par status under the plans accepted section. Here's what you need to know about Blue Cross and Blue Shield of North Carolina's coverage. Read your plan information carefully to know which network your health plan falls in. nvuchq vorkx zgkvmt fgzwp bgjmtlt bolb kmhn boehrf ucroo jiar