NC Provider Contact Information

In-State Eligibility, Benefits and Claim Status Information

 

Provider Blue LineSM

Blue eSM

https://providers.bcbsnc.com/providers/login.faces

800.214.4844

Representative Availability

Monday-Thursday 8 a.m. - 5 p.m.
Friday 8 a.m. - 4 p.m.


Out-of-State (BlueCard®) Eligibility and Claim Status Information

 

Claims

 

 

 

Eligibility


Chiropractic Services

 

Health Network Solutions, Inc.

(Blue Cross NC HMO & Blue Cross NC PPO)

704.895.8117

 

 


Contractual Updates

 


Credentialing and Enrollment

 

Credentialing

 

 

 

 

 

 

Enrollment

(to obtain billing numbers)

http://www.bcbsnc.com/content/providers/application/
index.htm

 

800.777.1643

Monday-Friday 9 a.m. - 4 p.m.

919.765.7016 Fax

Credentialing@bcbsnc.com

 

http://www.bcbsnc.com/content/providers/provider-number/index.htm

800.777.1643

Monday-Friday 9 a.m. - 4 p.m.

919.765.7016 Fax

Credentialing@bcbsnc.com

Demographic Updates

 


Disease Management

 

Healthy Outcomes

Tools for managing specific health conditions such as asthma, diabetes, or cardiovascular disease

800.218.5295

 

 

 


Electronic Claim Submissions

 

Electronic claims submission

Tools for managing specific health conditions such as asthma, diabetes, or cardiovascular disease


Federal Employee Program (FEP)

 

  • Benefits

  • Claims

  • Eligibility

 

Health Management (case management)

 

Healthy Endeavors (disease management)

 

Magellan: Mental Health/ Substance Abuse visit approvals

 

 

Precertification and Prior Approval

 

 

 

Retail Pharmacy

Blue eSM

https://providers.bcbsnc.com/providers/login.faces

800.222.4739

 

888.234.2415

 

 

888.392.3506

 

 

800.288.3976

 

 

https://providers.bcbsnc.com/providers/login.faces

800.672.7897

919.765.2081

 

800.624.5060

877.727.3784 (prior approval)


Fraud and Abuse

 

If you suspect healthcare fraud and abuse, please report the problem immediately to Blue Cross NC

http://www.bcbsnc.com/content/corporate/fraud/index.htm

800.324.4963

24 hours a day, 7days a week

919.765.7753


Healthcare Management and Operations (HM&O)

 

Prospective review

Prior review

Admission certification

Discharge planning

Case management

Continuity of care

 

 

Submitting Precertification/Admission Notification or Continued Stay Review

Blue e

https://providers.bcbsnc.com/providers/login.faces

800.672.7897

Monday-Thursday 8 a.m. - 7 p.m.

Friday 8 a.m. - 5 p.m.

Voice Messaging System is available outside of regular business hours.

 

 

Blue e

https://providers.bcbsnc.com/providers/login.faces

800.672.7897


Mental Health and Substance Abuse

 

Magellan Behavioral Health

 

Value Options (for members enrolled in SHP)

800.359.2422

 

800.367.6143

 


Office-Administered Specialty Drug Network

 

Member-specific, dose-specific drugs delivered directly to your practice.

For a complete listing of vendors and their contact information:

http://www.bcbsnc.com/content/providers/injectable-drugs/injectmed.htm


Diagnostic Imaging Management Program

 

CT/CTA scans

MRI/MRA scans

PET scans

Nuclear cardiology studies

Blue eSM

https://providers.bcbsnc.com/providers/login.faces

American Imaging Management (AIM)

866.455.8414

800.610.0050

Monday-Friday, 8 a.m. - 5 p.m.


Spanish Speaking Patients

 

Blue Cross NC offers a Spanish speaking customer service line for your patients

www.bcbsnc.com/azul

877.258.3334

Monday - Friday 8 a.m. - 5 p.m


State Health Plan (SHP)

 


 Strategic Provider Relationships

 

Questions regarding policies, procedures or guidelines (non-claims related)

800-777.1643

919.765.4349

 


Web Self Service Tools

 

eSolutions HelpDesk