Bcbs nc provider credentialing phone number. This allows you to access self-service tools or connect to a chat advocate for support. Title: Microsoft Word - U12992 EDI Intake Form r001. Credentialing is used to evaluate and select licensed independent practitioners to provide care to our members. org Blue Advantage ® /Part D Provider Inquiry: 1-877-878-8668; Other. Should I go through the provider credentialing process or provider contracting upon initial contact with BlueChoice HealthPlan? You should go through the credentialing process first if you want to be in network. Beginning January 1, 2025, Aetna® will administer the North Carolina State Health Plan network, and members will need to re-choose a primary care provider (PCP) in the fall of 2024. CAQH Provider Data Portal eliminates duplicative paperwork with organizations that require your professional and practice information for claims administration, credentialing, directory services, and more. Apr 25, 2020 · BCBS Federal Phone Number - FEP List Statewise Customer Service Precertification Mental Health/Substance Abuse Case Management Hospital; Alabama (800) 248-2342 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. Calling the phone number on the back of your member ID card provides the fastest and most direct service for questions. Let us know how we can Before starting the application process, we’ll need some information from you to confirm that you meet the basic guidelines to apply for credentialing. 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. For Benefits & Eligibility questions, check Availity first. Web site created using create-react-app Also use these forms to add a tax ID to your contract. com once they have been notified that the CAQH application is in a “completed” status c. Convenient self-service prompts available. Please Select Your State The resources on this page are specific to your state. For help with Blue Premier registration or account management, please contact your account administrator. Please provide contact information of the person at your practice who Horizon BCBSNJ can work with to address credentailing and recredentialing questions/requests. 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"). To check the progress, enter your National Provider Identifier (NPI) or state license number where indicated in the Credentialing Status Checker. 1-866-588-6967 — Freedom Blue SM PPO Provider Service Center. If you're a provider looking for information about eligibility, claims status or other details, log in or register with Blue e. Forgot User ID? Forgot Password? Don’t have an account? Register Now. Here's what you need to know about Blue Cross and Blue Shield of North Carolina's coverage. COVID-19 Information ; Update: Coverage and Reimbursement for COVID-19 Testing to change Update: Coverage and Reimbursement for COVID-19 Testing to change Contact Anthem Customer Service by phone, Live Chat, or log in to your account for information specific to your plan. You can reach our Blue Cross NC team by chat, phone, secure message or visiting a store. If you cannot complete your eligibility/benefits inquiry online, please contact us at 800-842-5975. For provider questions and claims issues: Phone: 1-844-594-5072. To check the status, enter the case number in our Case Status Checker. Health plan support All Savers® Health Plan 800-291-2634. Provider News Get the latest articles and announcements on claims filings, products, benefits, administrative updates, new and revised procedures and guidelines, prescription If you choose to review each payor’s request individually, please first contact CareFirst directly at 410-872-3500 or our toll-free number at 877-269-9593 to be added to the CAQH roster before beginning the CareFirst CAQH questionnaire. View our Healthy Blue + Medicare D-SNP resources for the provider claims support you need, including forms, policies, contact information and more. Please contact the Provider Blue Line at 800-214-4844 if you have any further questions. Contact our Healthcare Quality Coordinator team for more information on HEDIS. Members are still expected to select a primary care physician (PCP). Number To Give the Requester . Don't have your member ID card? Please call: 888-206-4697 Our mailing address is: Highmark Fifth Avenue Place 120 Fifth Avenue Pittsburgh, PA 15222-3099 (412) 544-7000 (TTY/TDD: 711) Get the Blue Cross NC forms and documents for providers that you need all in one place. Choose the credentialing option and a representative will assist you. docx Created Date: 20170427155229Z Credentialing frequently asked questions for professional providers participating in the CareFirst BlueCross BlueShield network. 1-888-234-5374 — Community Blue Medicare HMO Provider Please complete this form and return to us via email at credentialing@bcbsnc or by fax at 919-765-7016. Please call Cigna Healthcare SM Provider Services at 1 (800) 88Cigna (882-4462). Improving Cost | 75-400 points Welcome to the CAQH Provider Data Portal formerly known as CAQH ProView. Improving Cost | 75-400 points 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 enter your username. Contact eSolutions Help Desk: 888-333-8594, option 1. Highmark continually seeks ways to make its network credentialing process easier for our providers. To add a line of business or request participation in another AZ Blue network, contact your Provider Relations Contact. Finding a provider near you; Choosing or changing your PCP; Getting your ID card; Member handbooks; Free translation services; 24/7 NurseLine. If you are in need of more information about your plan you should contact customer service Monday-Friday, 8:00 a. Contact@excellus. Vision and hearing providers: 1-800-482-4047; Federal Employee Program providers and facilities: 1-800-840-4505; While our automated response system is available to any provider who needs it, we strongly encourage providers to log in or learn how to get an account. Call for verification of benefits, confirmation of coverage, and claims issues. Direct provider access afterhours (50 points) – offer a direct phone number to provider-on-call for urgent issues (doesn't include nurse line triage) Not Available for OB/GYN practices. If you have questions about the provider credentialing process, please fill out the Provider Credentialing Question form. 1-866-675-8635 — Freedom Blue PFFS Provider Service Center. This includes Provider Blue Books, enrollment forms and more. Provider Credentialing FAQs. If you can’t find the information you need, you’ll get a Fast Path phone number that moves you to the top of the calls received list. for guidelines on whose number to enter. 25: For questions regarding benefits or provider inquiries for the 2025 benefit year. com Nov 1, 2022 · BCBS NC: New Provider (Individual/Group) Credentialing and Enrollment Process Change. Our credentialing program is accredited by the Utilization Review Accreditation Commission (URAC). 833-690-1037 TTY: 711 (#833-690-1037) M-F 8AM to 5PM 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. All other providers will use E-cred Central. Have these things handy for each provider listed on the enrollment form: NPI; Group tax ID number or the last four digits of each provider's Social Security number; The provider's primary address and phone number Find resources for Blue Cross NC Providers in- and out-of-network to manage patient claims and appeals, eligibility, prior authorization and more. Get answers to your medical questions anytime, day or night. Contact us; Email customer service; Number; Arkansas Blue Cross Doctor and Hospital Service: 501-378-2307 or 800-827-4814 Provider Services. For Iowa dental providers interested in network participation, contact Blue Dental at 877-258-3685 877-258-3685. Non-participating providers can also use Blue e after registering their NPI to sign up for EFT. But if you need to contact us, below are the telephone numbers exclusively for providers. Credentialing Status Checker The Credentialing Status Checker provides information on the progress of your credentialing request. Don't have a secured provider portal account yet? Providers who don't have an account can mail a claim to one of the following: Medicare Plus Blue SM PPO claims Blue Cross Blue Shield of Michigan Mar 25, 2021 · Toggle menu. 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. If you have questions or need assistance, please contact your Provider Relations representative or contact Provider Services: Contact Us. Social security number – – or. Contact Network Management to obtain information about credentialing, provider numbers, contracts and sample fee schedules. com. Send their CAQH ID to credentialing@bcbsnc. Contact us. %PDF-1. Risk. Adjustment. You can get advice about: Symptoms you or your child are having; Medications you are Some prescriptions may require prior authorization or prior plan approval. 7 %âãÏÓ 62 0 obj > endobj xref 62 36 0000000016 00000 n 0000001392 00000 n 0000001519 00000 n 0000002696 00000 n 0000002756 00000 n 0000002891 00000 n 0000003026 00000 n 0000003162 00000 n 0000003299 00000 n 0000003436 00000 n 0000003572 00000 n 0000004001 00000 n 0000004621 00000 n 0000005073 00000 n 0000005108 00000 n 0000005747 00000 n 0000005860 00000 n 0000006433 00000 n Contact Customer Support by phone or Live Chat. Join the Blue Cross NC provider network, trusted by doctors, dentists, pharmacists and hospitals across North Carolina for more than 90 years. To request a provider application, check application status, add a new location or update provider information, please use one of the following methods: If you are deaf, hard of hearing, or have a speech disability, dial 711 for TTY relay services. Blue Cross NC may choose to pay non-contracted providers. Provider. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and 2. For other language assistance or translation services, please call the customer service number for your local BCBS company. Apr 23, 2020 · United States List BCBS Provider Phone Number; Alabama: 800-517-6425 (Benefits/Eligibility) 800-327-3994 (PEEHIP) 800-760-6851 (Customer Service) 800-492-8872 (Federal Employee Program) 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. Provider Services. To reach the right team,please select from below. Please have the care provider’s full name, Tax ID, and National Provider Identifier (NPI) available. 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 For contracting questions, call Healthy Blue Provider Services at 1-844-594-5072 or via email at nc_provider@healthybluenc. 1. How can I check credentialing status? Call us at 1-800-822-2761. 844-545-1427 (TTY 711) 24 hours a day, seven days a week. BACK back to www. Blue e services are available for both the local proprietary format and HIPAA compliant transactions. Physical address: Blue Cross NC 5901 Chapel Hill Road Durham, NC 27707 You will need to contact Blue Cross NC Provider Service at 800-777-1643. Get Organizational Credentialing Authentication Required 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. O. EST. Effective November 1, 2022, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) will begin utilizing the Council for Affordable Quality Healthcare (CAQH) ProView universal credentialing application. m. HEDIS Quality. Fax: 919-765-4349. Effective 11/1/22, practitioners and provider groups will have to: a. We're here to help answer your questions. Under penalties of perjury, I certify that: 1. Find information to help you get ready and stay updated. UnitedHealthcare Oxford Health Plan 800-666-1353 Dental providers menu. Contact us for more details about our plans, coverage, costs and more. My Provider Enrollment Portal Laboratory* Patient-Centered Medical Home Electronic Funds Transfer and Remittances *Avalon is an independent company that manages lab benefits on behalf of BlueCross BlueShield of South Carolina. Reference Contact Guide. - 9:00 p. Mail: Blue Cross NC P. caqh. Log in to find contact information specific to your area and plan. Find the forms you need to become part of the BlueChoice ® network on our website. Box 2291 Durham, NC 27702-2291. 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. CAQH ProView secure portal reduces the amount of paperwork you need to fill out to complete the credentialing process. HIGHMARK 1-800-547-3627. Here you will find frequently used forms, PDFs, provider manuals and guides, prior authorization information, practice policies, and support for delivering benefits . To update other provider information, please use the Provider Information Change Form (login and go to “Provider Resources > Forms > Provider Information Change”). Complete a separate application for: • Each site location Contact Information BCBSNC Customer Service . Other Blue Cross and Blue Shield Plans Outside Alabama: 1-800-676-2583; Provider Enrollment/Credentialing. Medicare Advantage and Community Plan 800-600-9007. Go to the CAQH ProView website and complete the CAQH application and process for credentialing and/or for recredentialing b. Employer identification number – Part II Certification. Additional Resources CAQH Contact Information Help Desk : 888-599-1771: Online Application System URL: CAQH website: Help Desk Email Address: providerhelp@proview. New Provider (Individual/Group) Credentialing and Enrollment Process Change Effective November 1, 2022 November 01, 2022. Contact name Contact Title Contact Phone Contact Email Health care providers and administrators, get access to verify eligibility and benefits, submit claims, and more. 800-777-1643. horizonblue. Find the information and forms you'll need to get your organization credentialed. com; PROVIDERS ; COVID-19 Information COVID-19 Information. Contact By: Call: 1-800 North Carolina Help Center: Important contact information for Blue Cross and Blue Shield of North Carolina. Email: ProviderUpdates@BCBSNC. Welcome to Blue Cross and Blue Shield of Louisiana Provider Credentialing Since 1996, we have been dedicated to fully credentialing providers who apply for network participation. Phone: 1-877-258-3334 Fax: 1-919-765-1920. yjxwa vcoyc ggnvba sjtrg oeypvgde emyhax ppsim wgtpfo oklid tfwix