Blue cross nc provider search

Blue cross nc provider search. Find out if your doctor, drug, or pharmacy is in-network, or explore other care options. You can also search providers outside the U. To obtain prior review, always enter the Carelon Provider Portal in Blue e, regardless of Blue Cross NC COB carrier status (primary, secondary or tertiary). Better care starts here. The vendor will bill Blue Cross NC directly. Box 551, Minneapolis, MN 55440-0551. 1, 2023, for any Brighton-administered member benefits, so there is no need to act on any previously scheduled and authorized services/procedures. Calling Blue Cross Blue Shield FEP Dental at 1-855-504-BLUE (2583), dial 711 for TTY relay services. Shop plans for Medicare, Medical, Dental, Vision & Employers. Blue Cross NC and Duke Health, two of the most trusted and innovative names in health care, have come together to create Experience Health, a locally owned and operated, non-profit health plan for seniors. Find A Doctor – Provider Directory - Blue Cross and Blue Shield's Federal Employee Program Skip to main content Explore the health insurance options offered by Blue Cross and Blue Shield insurance agencies. HIPAA affects almost the entire health care industry, including employers. If a member-specific, dose-specific injectable drug is ordered from a network vendor - do not file a claim with Blue Cross NC for the drug. Health care providers, find a Blue Cross NC phone number for info on eligibility, benefits and claims status, plus medical policies, contract updates and more. If you get health coverage through an employer: Contact your group administrator or HR department to make changes to your account. Providers can continue any previously scheduled and approved services/procedures. Get insurance delivered through your local BCBS agency. Explore dental network resources through Blue Cross and Blue Shield of North Carolina, including filing claims, benefit eligibility and information, and provider news. Log in to My Health Toolkit ® to search the provider directory and view search results specific to your insurance plan. Members may also wish to discuss their questions and individual medical situation with their physician. . Log in or register now. Providers and practices who are going through an acquisition or are acquiring another practice are required to report any changes to Blue Cross and Blue Shield of North Carolina (Blue Cross NC). 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. Healthy Blue is a Medicaid plan offered by Blue Cross and Blue Shield of North Carolina. Find a doctor or health care provider that fits your personal needs. BlueCross BlueShield of South Carolina members. Locate vision care providers, mental health professionals, virtual care options, and more. Parents, universities and colleges have trusted Blue Cross NC health insurance to protect their students, post docs, TAs, and RAs for more than 90 years. Blue e services are available for both the local proprietary format and HIPAA compliant transactions. Discover employer, individual, family, Medicare & Medicaid plans from Blue Cross NC. Experience Health Providers. Through its Physician Advisory Group and Quality Improvement Committee, Blue Cross NC has established Urgent Care Facility and Medical Record Standards so that you'll know you can get the quality care you need. Get an Enrollment and Change Application from Customer Service (call the number on the back of your member ID card) or through your employer. Search. Find resources for Blue Cross NC Providers in- and out-of-network to manage patient claims and appeals, eligibility, prior authorization and more. When BlueHPN patients search for healthcare providers using their member ID card or number, only BlueHPN healthcare providers will be returned in the search. This list is subject to change at least once per quarter. gov) Telehealth benefits are available on all plans either from Blue Cross NC or through the provider network. Jan 17, 2024 · FastMed locations in North Carolina will continue serving all North Carolinians and those visiting the state regardless of their health insurance or carrier, not just Blue Cross NC members. Be advised that certain self-administered drugs have been excluded from Blue Cross NC's medical benefits but are covered under the prescription drug benefit. Blue Medicare HMO Enhanced, HMO Essential and Blue Medicare PPO Enhanced share the same Medicare prescription drug list. How do I find my network? There are three ways to find your network when you're using the search tool: Log in (or register) and the system will know your network Enter the group number shown on your member ID card into the group number field before you search Official Site of Anthem Blue Cross Blue Shield, a trusted health insurance plan provider. Access tools, policies and the latest information to help you care for our members. Join Blue Cross NC for provider coding education to learn about HCC risk adjustment ICD10 coding diagnoses and services, chart retrieval and disease coding. Your choice of providers. Blue Access Choice. 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. S. Go to our Find Care page to search for a doctor or hospital. Blue Cross NC is made up of multiple networks, including FEP, Medicare and Medicaid. 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. Blue Cross and Blue Shield (BCBS) members can search for doctors, hospitals and dentists. Blue Connect is your online portal to manage your BCBSNC health plan, view your benefits, claims, interests and profile. BCBS members can search for doctors, hospitals and dentists. 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 Care Near You with the Find a Doctor Tool. Blue Cross NC and Blue Cross NC contracting physicians are committed to meeting these standards in order to provide the best service ©2024 Blue Cross and Blue Shield of North Carolina. 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. HIPAA stands for the Health Insurance Portability and Accountability Act of 1996. ©2024 Blue Cross and Blue Shield of North Carolina. Patients may be covered for a restricted medication if providers tell Blue Cross NC in writing that: Apr 15, 2024 · On May 23, 2024, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) submitted the Prescription Drug Data Collection (RxDC) Report to the Centers for Medicare & Medicaid Services (CMS) for plan year 2023. Changes will be posted to the Blue Cross and Blue Shield of North Carolina (Blue Cross NC) website by the 10th day of January, April, July, and October. Your office manager or 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. Close 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). Blue Cross NC makes health insurance easy. As a part of this effort, Blue Cross NC will be implementing an annual provider assessment survey. Learn about Experience Health, a new and innovative insurance company owned by Blue Cross NC. The form below is the easiest way to report acquisitions and buyouts and provide us with the necessary information to process your acquisition. For health plans, providers and health care clearinghouses, the critical portions of the act are the Administrative Simplification provisions, which include new standards for electronic transactions that took effect Oct. Blue Cross and Blue Shield of North Carolina is now sending some Healthy Blue bulletins, policy change notifications, prior authorization update information, educational opportunities, and more to providers via email. Prior to the acquisition, Blue Cross NC was a non Sep 27, 2021 · September 27, 2021 Update: This communication has been updated to include details on age requirements for eligible members. Jan 4, 2024 · Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is committed to improving collaboration with providers / ACOs in our value-based reimbursement programs (Blue Premier ℠ and Medicare Advantage Quality Incentive Program). 16, 2003, as well as 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. Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is expanding the Blue High Performance Network ℠ (BlueHPN ℠). ®, SM Marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans. 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. See important dates, forms, resources, policies and more. Select 'Look Up a Drug or Doctor. Home; Find a Doctor (Blue Cross NC 2024) Enhanced PPO Plan (80/20) Base PPO Plan Blue Cross and Blue Shield of North Carolina offers three drug formularies (drug lists) so Medicare beneficiaries can have options for their prescription needs. A process by which the organization provides members with access to health care information and tools to better manage their health. Choose your Select Network from the list below to find a doctor near you. On the 'Select your Rx letter code screen,' choose which letter code matches the drug you're searching for. Medical Oncology Program resources Get more information on the program, worksheets, an interactive tutorial and other helpful tools on Carelon's Blue Cross NC provider page . Blue Cross NC requires that patients first try a medication or device that is not restricted before a restricted medication will be approved. Blue Cross NC contracts with health care providers to be in BlueHPN. 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. Search for a doctor in your area. O. 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. Or, log into Blue Connect, choose Find a Doctor, and we'll show you doctors in your network automatically. Communicating information to member's that specifies their rights and responsibilities related to a mutually respectful relationship with the organization, addressing complaints and appeals, benefits and access to medical services, choosing physicians and Blue Cross and Blue Shield of North Carolina provides fee schedule information electronically to participating physicians. 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. Proof of prior dental coverage with less than 63 days lapse in coverage is required. Learn more about our non-discrimination policy and no-cost services available to you. ' Select 'Drug or pharmacy' option. Members are still expected to select a primary care physician (PCP). Flexible and convenient care options Of course, you can use our search tools to find doctors and hospitals that take your insurance. Enrollment in Blue Cross and Blue Shield of North Carolina Senior Health depends upon contract renewal. Blue Cross NC provides the telehealth program for your convenience and is not liable in any way for the goods or services received. A federal regulation called the Health Insurance Portability and Accountability Act (HIPAA) changes the way in which health care companies and medical care providers are permitted to use and disclose information about our Members. Blue Choice Advantage Open Access. These tools are offered for your convenience and should be used only as reference tools. Blue Cross NC Provider Internal Data; percentages indicated represent Blue Cross NC's PPO network as of July 28, 2022. About Mental Health (cdc. Oct 11, 2021 · healthcare providers. Nov 1, 2022 · For existing Blue Cross NC groups, Blue Cross NC will transfer medical and pharmacy authorizations to Brighton by Jan. Blue Cross NC members can search for in-network care locations through the Blue Connect portal. Sending a letter to Blue Cross Blue Shield FEP Dental, P. Sep 9, 2024 · Effective October 10, 2024, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is implementing a change to our fee schedule functionality on the Blue e portal which allows ancillary and professional providers to pull a fee schedule by selecting an individual practitioner NPI from their registered list. You can also find a range of health care providers to help you care for the whole you. 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. In the United States, Puerto Rico and U. 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. The original communication was posted on January 22, 2021. 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. The percentage of medical doctors and hospitals is based upon the number of providers that applied for a Blue Cross NC provider number and then contracted with us versus the total number of providers who applied. The Blue Book is designed to assist you in understanding and administering Blue Cross NC health insurance products, health coaching and intervention Join the Blue Cross NC provider network, trusted by doctors, dentists, pharmacists and hospitals across North Carolina for more than 90 years. Blue Access PPO. Together, we can help the whole person thrive by bringing physical and behavioral health together. Providers looking to join can find out more about these networks. The Blue Cross NC library of news articles helps providers stay up to date on health insurance rates, billing and reimbursement, incentive programs and more. Care for Visit the Find Care page. 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. Use our search tool below to find a plan provider close to home. ' Then select 'Browse as a guest of a group plan. Anthem - Provider Finder is a platform to locate in-network Anthem providers and estimate healthcare costs. Virgin Islands. 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. Search our nationwide directory of Preferred providers—those providers in our network. Yes, Blue Cross NC may waive or reduce any applicable dental waiting period by the number of months of prior dental coverage. Jul 3, 2024 · Last updated July 3, 2024. nssdl isegh erbyz dewj xqfr lknrda pjdpsd jzllo jlt tffblrr