COVID-19 Provider Resources

Here's everything you need to know about how we're supporting you and your patients during this time.

Have you switched to telehealth? We’re paying at parity.

4 steps we’re taking to make it easier for you to provide care to your patients.

When referenced, the following information applies to all Medicare Advantage plans offered or administered by Blue Cross NC, including Experience Health

1. VIRTUAL CARE

Switch to Virtual ASAP: We will pay for virtual visits at parity including visits through secure video or by phone through December 31, 2020. On March 6th, we announced we were making telehealth easier for our members and clinicians to use. And, we meant it.

You can even use telehealth options with hospital and ED physicians. Behavioral health too. Click for a detailed guide on clinical scenarios and how to file claims here.

This measure applies to all Blue Cross NC commercial plans and Medicare Advantage plans offered and administered by Blue Cross NC, including Experience Health. 


2. COSTS

Clinical Visits and Testing

Blue Cross NC will waive member cost-sharing (including deductibles, copayments, and coinsurance) for allowed charges for COVID-19 testing or for a doctor visit or call to determine if testing is necessary as long as COVID-19 testing meets all three criteria:

  1. Ordered by a licensed health care provider,
  2. Determined as medically necessary by a licensed health care provider for the diagnosis and management of a member’s medical condition
  3. Have been cleared, approved or given emergency use authorization (EUA) by the U.S. Food and Drug Administration  (FDA)

Specifically, there will be no member cost-share for COVID-19 testing or clinical visits to determine if a testing is needed through virtual care visits, outpatient office visits, urgent care visits or ER visits. These changes are in line with the federal coronavirus relief package approved and signed into law on March 18, 2020.

We continue to encourage the use of virtual visits as the first step to seeking testing. For details and coding guidance, please click here.

This measure applies to all Blue Cross NC commercial plans and Medicare Advantage plans offered and administered by Blue Cross NC, including Experience Health.

COVID-19 Related Treatment

The following changes are in effect through October 31, 2020.

Blue Cross NC will waive member cost-sharing for COVID-19 related treatments for both in-network and out-of-network providers. The company will reimburse providers in full at its in-network or Medicare rates in an effort to support them financially and administratively during this emergency.

Blue Cross NC will also work to shield members from balance billing and will work with providers to ensure access to affordable care during this crisis. Blue Cross NC encourages out-of-network providers to accept our payment in full and to work together to shield North Carolinians from financial harm. 

Please note that when submitting treatment claims, providers must use designated COVID-19 codes.

This measure applies to all fully insured, State Health Plan, Federal Employee Program, and all Medicare Advantage plans offered or administered by Blue Cross NC, including Experience Health. Self-funded employer groups will be given the option to apply these changes to their employees' plans.

The member cost-share waivers for COVID-19 related treatments are effective immediately through October 31, 2020. We are committed to carrying out actions to assist our members and community in the face of COVID-19. We will continue to re-evaluate this and other measures. For details and coding guidance, please click here.


3. WAIVING PRIOR AUTHORIZATION

Blue Cross NC will not require prior authorization for diagnostic tests and covered services that are medically necessary and consistent with CDC guidance for members with a confirmed or suspected COVID-19 diagnosis. For details and coding guidance, please click here.

Additionally, Blue Cross NC will waive prior authorization requirements for emergent non-elective inpatient admissions, durable medical equipment and post-acute care services that are medically necessary for COVID-19 related services through September 30, 2020.


4. WAIVING MEDICARE ADVANTAGE COPAYS

Blue Cross NC is waiving all copays for in-network primary care and outpatient behavioral health visits for Medicare Advantage members from June 1 through the end of 2020. Visits do not have to be related to COVID-19 and can be done in person or virtually through telehealth.

The copay waiver is specific to the primary care medical visit or behavioral health therapy visit. Members may have costs for other services unless they are related to COVID-19 treatment or testing.

Behavioral Health Providers

OVERVIEW

You can provide any services covered under your existing Blue Cross NC contract using telehealth (video and/or audio) in accordance with the Temporary Expansion of Reimbursement for Telehealth Services. Services can be provided for conditions not related to COVID-19. Member cost sharing continues to apply. 

If you would like to be added to this directory of behavioral health providers using telehealth in response to COVID-19: Complete this survey.

CLARIFICATION ON CLAIMS AND REIMBURSEMENT FOR TELEHEALTH

We have received numerous questions related to claims and reimbursement for our expanded telehealth measures. Please see below for additional guidance

  • Any claims for telehealth submitted on or after March 6, 2020, will be reprocessed and paid at parity to in-person visits. You do not need to take additional actions. 
  • You can use any face-to-face CPT codes for telehealth. However, you must also list place of service (POS) 02. Additionally, if you used telephone only (no video), you must use the modifier CR. Please note that any prior authorization requirements still apply when services are performed via telehealth. 

We thank you for your patience and continued service to our members. Our priority is to address these issues as quickly as possible to ensure that both providers and members are able to utilize our expanded telehealth benefit.  

Provider COVID-19 Triage Listing – How to Get COVID-19 Care

We want to help members find the right care, at the right place, at the right time.  

This is especially important in the case of COVID-19. We can prevent the spread of infection. We can protect our members and you on the front lines.   

Our recommendation to members is to always first call your primary care provider (PCP).  

We will continue to update this list. If you are a health system or practice that would like to be on this list, complete this form.  

North Carolina Department of Health and Human Services (NC DHHS) 

Below, we’ve made a list of resources from health care systems and practices throughout NC.  We’ve included the right first steps for our members to engage appropriately in triage protocols.   


PROVIDER COVID-19 TRIAGE LISTING

If you want your health system or practice’s listing to be included below, please provide the right first step for members to engage with your triage protocol.  This is not for a provider directory.  This is a specific listing to support your COVID-19 triage efforts. To provide these right first steps, complete this form

North Carolina’s Regional Sites

Charlotte

Atrium Health

Phone Hotline 

For community physicians only: 704-512-7878 

Virtual Care 

​​​Website 

 

Novant Health

Phone Hotline 

If your patient does not have a PCP at Novant Health, call helpline 877-9NOVANT  

Virtual Care 

Website 

 

CaroMont

Iredell Health System

Lake Norman

Triad

Wake Forest Baptist Health

Phone Hotline

For community physicians only: 336-716-7654 or 800-277-7654. 

Website: https://www.wakehealth.edu/coronavirus

Cone Health

Virtual Care

Make a free MyChart COVID-19 e-Visit at  http://conehealth.com/appointments  

Website: www.conehealth.com/wellness/covid-19-information/

Novant Health

Phone Hotline 

If your patient does not have a PCP at Novant, call helpline 877-9NOVANT  

Virtual Care 

Self-assessment chat bot: www.novanthealth.org/coronavirus 

Website: ​www.novanthealth.org/coronavirus 

 

Randolph Health

Triangle: Durham, Chapel Hill, Raleigh

UNC Health

Phone Hotline 

If your patient does not have a PCP at UNC Health, call helpline 1-888-850-2684  

Virtual Care: ​http://www.uncurgentcare247.com/ 

Website: https://www.unchealthcare.org/coronavirus/ 

Testing: You may refer your patient to a UNC Health Respiratory Diagnostic Center or to a UNC Virtual Care center; patients must be scheduled by a clinician. 

WakeMed & WakeMed Key Community Care (WKCC)

Phone Hotline 

WakeMed Health Help Line at 919-350-5200 

Virtual Care: Set up a virtual urgent care visit: https://www.wakemed.org/virtual-urgent-care 

Website: https://www.wakemed.org/concerned-about-the-coronavirus-covid-19   

Testing: Respiratory Diagnostic Centers (RDC) open, but patients must first call the WakeMed Health Help Line to receive screening and an order from a physician to make an appointment 

Duke Health

Phone Hotline: If your patient does not have a PCP at Duke Health, call COVID-19 Hotline 919-385-0429 

Virtual Care: www.dukehealth.org/treatments/virtual-urgent-care

Website: www.dukehealth.org/covid-19-update

Testing: At this time widespread testing including drive-up testing is not available. Duke Health is currently building capabilities to offer drive-up testing and will continue to follow CDC and State guidance on who to test.

Granville Health

Avance Care

Virtual Care: Book a visit online at www.avancecare.com/contact-us/book-online or call your office; specify that you would like a telehealth visit and you will be contacted

Website: www.avancecare.com/covid-19

Coastal

Wilmington Health

Phone Hotline 

  • If your patient is established with Wilmington Health, have them text “APPT” 839894 
  • If you are a Blue Cross NC member and a NEW patient to Wilmington Health, have them text “BCBS” to 839894.  
  • Or have them call 910.341.3400 — always call before leaving home.  

Website: https://www.wilmingtonhealth.com/coronavirus-defense 

 

New Hanover

Carteret

Phone Hotline: Public Information Recorded Hotline 252-726-7177 by the Carteret County Health Department. Includes # of confirmed cases, what to do if feeling sick, and information on sheltering in place. Public Inquiry Phone 252-726-7060 – Staffed by the Carteret County Health Department.

Website: www.carterethealth.org/Coronavirus-COVID-19-Resources

CarolinaEast

Dosher

Phone Hotline: Brunswick County Public Health Department at 910-253-2339 or NC DHHS at (866) 462-3821

Website: www.dosher.org/getpage.php?name=COVID-19_Patient%2FCommunity_Information

Sentara Albemarle

Phone Hotline: Call nurse line at 1-833-945-2395 to direct to appropriate resources

Website: https://sentaraupdates.com

Western

Mission/HCA

Advent Hendersonville (formerly Park Ridge)

Phone Hotline: 24-hour AdventHealth Triage Nurse Hotline: 828-681-2300

Virtual Care: Download the AdventHealth app for a virtual urgent care visit (details at )

Website:

 

Hugh Chatham Memorial

Phone Hotline: If you have nonurgent questions, call the Care Line at 336-527-CARE

Website: https://www.hughchatham.org/hugh-chatham-memorial-hospital-updates-on-covid-19-novel-coronavirus/ 

Catawba Valley Medical Center

Appalachian Regional Health System

Virtual Care: If you have symptoms, connect with a RelyMD doctor at .

Website: https://apprhs.org/covid19/ 

Testing: Two alternative COVID-19 testing sites in Avery or Watauga County; the RelyMD physician will help you make an appointment if you have symptoms

Northern Regional Hospital (Surry County)

Erlanger Murphy Medical Center

Phone Hotline: If you don’t have a PCP, call the closest urgent care center

Website: www.erlanger.org/about-us/coronavirus-response

Eastern

Vidant Health

Phone Hotline: General community resource hotline: 252-847-8000 or NC DHHS hotline at 866-462-3821

Website: www.vidanthealth.com/COVID-19-Updates/Overview

ECU Physicians

Phone Hotline: Call 252-744-1111 for instructions

Website: www.ecu.edu/cs-dhs/ecuphysicians/coronavirus.cfm

Martin General

Sampson Regional

Sandhills

First Health

Cape Fear Valley

Phone Hotline: If your patient has COVID-19 symptoms, call the Carelink line at 910-615-LINK 

Website: www.capefearvalley.com/news/article.aspx?id=105

Southeastern Health

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