Blue cross nc provider portal. Get the Blue Cross NC forms and documents for providers that you need all in one place. About Blue e Provider Portal Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association. Get information on your policy using the state website found on your membership ID card. Jul 3, 2024 · 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. As a reminder, Care Affiliate is the provider portal for managing authorizations that is accessed via Blue e. Please enable it to continue. It also means not having to worry if a check is lost, stolen or damaged. By choosing Student Blue, you get several important benefits: 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. See important dates, forms, resources, policies and more. Mar 1, 2021 · March 1, 2021 Update: This communication has been updated to include information on Two Factor Authentication. If your claim includes a reason code, you’ll find it here with a red icon pointing you to more information about the alert. Sep 27, 2021 · September 27, 2021 Update: This communication has been updated to include details on age requirements for eligible members. Blue Cross NC has a free app that allows members to securely connect to their health plan from a mobile device. Submit medical claims through Blue e and view eligibility. 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. Blue Cross NC helps you find a formulary, search for meds, and get prior approvals. By participating in the Blue Cross and Blue Shield of North Carolina (Blue Cross NC) plan, you now have access to BCBS FEP Dental members. 16, 2003, as well as Providers can submit claims for members with FEP plans electronically. HQIP was inspired by the Institute for Healthcare Improvement's "Triple Aim" initiative to improve health system performance in three areas: Patient experience (including quality and satisfaction), Health outcomes and reducing Blue Cross and Blue Shield (BCBS) members can search for doctors, hospitals and dentists. HQIP is Blue Cross NC's Pay-for-Performance program for acute care hospitals. 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. Independent licensees of the Blue Cross Blue Shield Association serving 21 counties in Central Pennsylvania and the Lehigh Valley. Blue e is a portal for providers to access member eligibility, electronic claims, ID cards, patient summaries and more. . Find out the requirements, documents, and steps for different provider and facility types. Hospitals can earn a reimbursement increase if they meet quality and performance targets. We are committed to supporting you in providing quality care and services to Healthy Blue members. About Blue e Provider Portal Blue Cross and Blue Shield of North Carolina is an Yes, Blue Cross NC may waive or reduce any applicable dental waiting period by the number of months of prior dental coverage. Medicaid Expansion Tools and Resources. Learn how to join or update the Blue Cross NC network, which includes commercial, Medicare, Medicaid, and other programs. Enrollment in Blue Cross and Blue Shield of North Carolina Senior Health depends upon contract renewal. These tools are offered for your convenience and should be used only as reference tools. The designation is based on rigorous, evidence-based selection criteria established in collaboration with expert physicians and medical organizations. Virgin Islands. Blue Distinction is a designation awarded by Blue Cross NC and other Blue Cross and Blue Shield companies to medical facilities that have demonstrated expertise in delivering quality health care. ®, SM Marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans. Brighton is a national Third-Party Administrator (TPA). <strong>We're sorry but Blue E doesn't work properly without JavaScript enabled. Dec 6, 2023 · Effective December 13, 2023, Care Affiliate, the prior authorization portal for Blue Cross and Blue Shield of North Carolina (Blue Cross NC), will be open for providers to submit authorization requests for Medicare Advantage members. ©2024 Blue Cross and Blue Shield of North Carolina. Provider portal Get answers to questions, access real-time patient information, check claims status, enter and view authorizations, and more. As of December 1, 2023, more North Carolinians are able to get health coverage through Medicaid. Participating physicians already using Blue e can view their current fee schedule in the portal. HIPAA stands for the Health Insurance Portability and Accountability Act of 1996. S. This includes Provider Blue Books, enrollment forms and more. Nov 1, 2022 · Blue Cross and Blue Shield of North Carolina (Blue Cross NC) has partnered with Brighton Health Plan Solutions (Brighton) to administer claims and member and provider services on behalf of Blue Cross NC to select self-insured employer group customers. Sign Up for Dental Blue Email Newsletter. Proof of prior dental coverage with less than 63 days lapse in coverage is required. Medical provider portal. About Blue e Provider Portal Medical Record Submission Blue Cross and Blue Shield of North Carolina does not discriminate on the basis of race, color, national Sep 13, 2021 · In October 2021, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) will launch upgrades to our Care Affiliate portal to create a modern and streamlined design meant to enhance navigation and information display. 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. Members are still expected to select a primary care physician (PCP). Blue Cross NC makes health insurance easy. Stay up to date with the latest information and announcements for Blue Cross NC dental providers. 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 Cross NC provides fee schedule information electronically to participating physicians. Electronic Funds Transfer (EFT) allows providers to receive electronic payments directly in their bank account. As an independent licensee of the Blue Cross and Blue Shield Association, we are a trusted health insurance leader 2 and our network is dedicated to our communities. Better care starts here. 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. Aug 6, 2024 · As part of Blue Cross NC’s NCQA accreditation requirements, the Provider Network Operations department will be conducting an annual assessment of its provider directories for: accuracy of office locations and phone numbers. Blue e is a free online tool for providers to check patient eligibility, submit claims, and more. To help North Carolinians know who is eligible and how to apply, the North Carolina Department of Health and Human Services (NCDHHS) has a website that contains a bilingual toolkit and a sign-up form to stay updated on the most current information about how ©2024 Blue Cross and Blue Shield of North Carolina. </strong> If you're a provider looking for information about eligibility, claims status or other details, log in or register with Blue e. As a Blue Cross and Blue Shield of North Carolina (Blue Cross NC) member, you have access to benefits and extras. View claims history and view details of a member's plan coverage. Unlisted and Miscellaneous health service codes should only be used if a specific code has not been established by the American Medical Association. Welcome to the Blue Connect and Blue Cross of North Carolina Member Self-Service Portal. 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. 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). 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. Join the Blue Cross NC provider network, trusted by doctors, dentists, pharmacists and hospitals across North Carolina for more than 90 years. View our provider manual for information about claims, referrals and provider networks and programs. 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. Please complete forms related to pre-certification, behavioral health treatment, and other similar cases before rendering service. Get in touch with your local Blue Cross and Blue Shield company. 100% coverage for preventive care Annual physicals and many other routine screenings and services covered at no additional cost. Blue Cross and Blue Shield of North Carolina (Blue Cross NC) has developed clear Fast Healthcare Interoperability Resources (FHIR) to allow members to share their data with registered applications. Review Blue Cross and Blue Advantage medical and pharmacy Oct 11, 2021 · As a reminder, beginning October 15th, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) will launch upgrades to our Care Affiliate portal to create a modern and streamlined design meant to enhance navigation and information display. BCBS FEP Dental members can utilize the GRID+ network as an in-network provider source. Effective November 1, 2021, EnrollSafe replaces CAQH Enrollhub as the electronic funds transfer (EFT) enrollment portal for providers. 1 Feb 10, 2021 · The Blue Cross Blue Shield Association (BCBSA) has partnered with the GRID+ Dental Network to administer BCBS FEP Dental. Manage Your Plan; Prescription Drugs; Find Care; See Plan Perks; Live Jun 21, 2024 · Effective July 1, 2024, Carelon is changing the functionality of its Provider Portal. The original communication was posted on January 22, 2021. Due to the rise in health care fraud and abuse activity, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) will soon be enabling Two Factor Authentication on its provider portal, Blue e. Care Affiliate is the provider portal for managing authorizations that is accessed via Blue e. Healthy Blue is a Medicaid plan offered by Blue Cross and Blue Shield of North Carolina. Get an Enrollment and Change Application from Customer Service (call the number on the back of your member ID card) or through your employer. Learn how to join, recredential, or register for payment with Blue Cross NC network. Providers looking to join can find out more about these networks. These forms are specific to Healthy Blue + Medicare HMO D-SNP and are required when doing business with Blue Cross and Blue Shield of North Carolina (Blue Cross NC). Student Blue ℠ from Blue Cross and Blue Shield of North Carolina (Blue Cross NC) provides quality health insurance that meets the specific needs of college and university students. It is designed to be user friendly and gives you flexibility when scheduling Healthy Blue training for yourself and your staff. If you're a provider looking for information about eligibility, claims status or other details, log in or register with Blue e. 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. Dental Blue ACS portal. Learn how to register, use features, get help and manage users for Blue e. The vendor will bill Blue Cross NC directly. About Blue e Provider Portal Blue Cross and Blue Shield of North Carolina Please contact Blue Cross NC by using the Provider Blue Line at 800-214-4844. This results in faster payment than paper checks. 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. Communications issued by Capital Blue Cross in its capacity as administrator of programs and provider relations for all companies. If you get health coverage through an employer: Contact your group administrator or HR department to make changes to your account. On the overview page you’ll find the highlights of your EOB, including your name, subscriber ID, name of your health plan, service date, and general claims details. Discover employer, individual, family, Medicare & Medicaid plans from Blue Cross NC. Designed to be simple and convenient, Blue Connect Mobile helps customers get up-to-the-minute information about their health plan and helping them manage costs. 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. In the United States, Puerto Rico and U. Provider Pathways is a 24/7 educational resource that offers a foundation for doing business with Blue Cross and Blue Shield of North Carolina (Blue Cross NC). Navigation. The Blue Book is designed to assist you in understanding and administering Blue Cross NC health insurance products, health coaching and intervention 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. Developers can register for access here and find the resources they need to build an application programming interface ( API ) to a member’s Blue Cross NC is made up of multiple networks, including FEP, Medicare and Medicaid. The new program will consider the medical necessity of studies and the clinical appropriateness of a facility- or home-based test. Dental provider news. Agents have been choosing Blue Cross and Blue Shield of North Carolina (Blue Cross NC) since 1933. MHK Provider Portal (accessed via Blue e), SureScripts, or fax. 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 (Blue Cross NC) will implement a new Sleep Management Program. Beginning July 1, Carelon will retire the “Check Order Status” on the portal, and providers should instead use “Order Search” going forward. HIPAA affects almost the entire health care industry, including employers. Learn about Experience Health, a new and innovative insurance company owned by Blue Cross NC. Nov 1, 2021 · Please note, this communication applies to Healthy Blue + MedicareSM (HMO D-SNP) offered by Blue Cross and Blue Shield of North Carolina. axhqpx hta yrkc wqpffnq yvam qkpb tengdo xanpjp hupq rkifn