Board Certified & Non-Board Certified:
- Doctor of Dental Surgery
- Doctor of Maxillofacial Surgery
- Doctor of Medical Dentistry
- Doctor of Osteopathy
- Doctor of Podiatry
- Medical Doctor
Board Certified & Non-Board Certified:
Other:
Optometry and Ophthalmology commercial networks are closed in all counties. Optometrist and ophthalmologist participation for routine vision is managed by Community Eye Care (CEC). Contact CEC for participation inquiries and to initiate credentialing and/or recredentialing by email at providers@cecvision.com and by phone. (CEC 888-254-4290)
Reference Laboratory commercial networks are managed by Avalon Health Care Solutions. Please contact Avalon for participation inquiries by email at NetworkTeam@AvalonHCS.com.
All practitioners applying for credentialing and recredentialing have the following rights:
All initial credentialing files for Physicians
All recredentialed files for Physicians
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) Provider Data Portal (formerly known as CAQH ProView) universal credentialing application. The upcoming changes to our processes will improve quality and timeliness in onboarding our new providers/practitioners to Blue Cross NC. Providers will be required to do the following:
or
This initial step of integrating automation and streamlining onboarding processes will improve turnaround times for credentialing and enrollment.
We appreciate your cooperation and look forward to partnering with you as we transition to a more automated and digitized workflow. Please see the FAQ which provides further guidance and instructions for utilizing these electronic processes.
Reference Laboratory commercial networks are managed by Avalon Health Care Solutions. Please contact Avalon for participation inquiries by email at NetworkTeam@AvalonHCS.com.
Effective Oct. 1, 2020, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) will begin using Verifide, a credentialing verification organization, to conduct primary source verification. Here’s what this means for you:
If you have questions, contact Provider Services at 800-777-1643, option 6.
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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© 2023 Blue Cross and Blue Shield of North Carolina. ®, SM Marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. Blue Cross NC is an abbreviation for Blue Cross and Blue Shield of North Carolina. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association.