Explore provider resources, self-service tools, and network details.
Access the resources, documents, and tools you need to complete common provider tasks faster.
Want to join our network or make changes to your practice information?
Find information on how the No Surprises Act protects patients from balance billing and the steps for disputing a qualifying payment amount. This includes how to initiate the open negotiation process by completing the Qualifying Payment Amount (QPA) Dispute Form.
Stay informed about important provider updates. This includes changes to health insurance rates, application dates, deadlines, billing and reimbursement, incentives, immunization and behavioral health programs, and more.
Use Blue e to look up patient eligibility, submit claims, check claim statuses, and more. Whether you’re part of a small practice or a large hospital system, the Blue Cross and Blue Shield of North Carolina (Blue Cross NC) provider portal lets you manage your critical patient and administration tasks. Plus, there's no cost to use it.
What’s required depends on whether you send transactions directly to us or transmit them through another organization.
If you send transactions directly to Blue Cross NC:
You’ll need to complete the following steps:
- Complete a Blue Cross NC Trading Partner Agreement (TPA). A TPA is required even if testing isn’t needed.
- Return an original copy of the TPA, signed by authorized personnel, to Blue Cross NC EDI Services.
- Complete an Electronic Connectivity Request (ECR) form for each transaction type you want to transmit.
If you send transactions through a clearinghouse, billing service, or service bureau:
- Complete an ECR form for each transaction type you want to submit or receive.
Your clearinghouse or service bureau may complete and submit the ECR form on your behalf.
TPA and ECR forms and additional instructions are available on the HIPAA information page.
Blue Cross and Blue Shield of North Carolina does not discriminate on the basis of race, color, national origin, sex, age or disability in its health programs and activities. Learn more about our non-discrimination policy and no-cost services available to you.
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