In-State Eligibility, Benefits and Claim Status Information
Provider Blue LineSM
Blue eSM
https://bluee.bcbsnc.com/providers/web/login
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
Blue e
https://bluee.bcbsnc.com/providers/web/login
800.487.5522
Blue e
https://bluee.bcbsnc.com/providers/web/login
800.676.BLUE (2583)
Chiropractic Services
Health Network Solutions, Inc.
(Blue Cross NC HMO & Blue Cross NC PPO)
704.895.8117
Contractual Updates
Updates to Notice Contract Address
Credentialing and Enrollment
Credentialing
Enrollment
(to obtain billing numbers)
https://www.bluecrossnc.com/providers/network-participation/apply-credentialing
800.777.1643
Monday-Friday 9 a.m. - 4 p.m.
919.765.7016 Fax
Credentialing@bcbsnc.comhttps://www.bluecrossnc.com/providers/network-participation/become-blue-cross-nc-provider-or-recredential/apply-provider-number
800.777.1643
Monday-Friday 9 a.m. - 4 p.m.
919.765.7016 Fax
Credentialing@bcbsnc.comDemographic Updates
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)
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Benefits
-
Claims
-
Eligibility
Health Management (case management)
Healthy Endeavors (disease management)
Behavioral Health (mental health and substance use disorder)
Precertification and Prior Approval
Retail Pharmacy
Blue eSM
https://bluee.bcbsnc.com/providers/web/login
800.222.4739
888.234.2415
888.392.3506
800.288.3976
https://bluee.bcbsnc.com/providers/web/login
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
https://www.bluecrossnc.com/about-us/policies-and-best-practices/fraud-and-abuse
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://bluee.bcbsnc.com/providers/web/login
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://bluee.bcbsnc.com/providers/web/login
800.672.7897
Behavioral Health (Mental Health and Substance Use Disorder)
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:
https://www.bluecrossnc.com/providers/pharmacy-program/specialty-pharmacy-network
Diagnostic Imaging Management Program
CT/CTA scans
MRI/MRA scans
PET scans
Nuclear cardiology studies
Blue eSM
https://bluee.bcbsnc.com/providers/web/login
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
State Health Plan (SHP)
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
https://bluee.bcbsnc.com/providers/web/login
888.333.8594
Blue Connect