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HealthCare.gov Provider Naming Discrepancy: How to Accurately Confirm Provider Network Status with Blue Cross NC December 03, 2021 Pharmacy

Provider naming discrepancies often exist between the provider names found on www.HealthCare.gov and how those same names are listed on health insurance companies’ websites. When identifying providers who are contracted with our company, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) may utilize the name associated with the provider’s contract to list the provider within the Find Doctor / Drug / Facility tool on www.bluecrossnc.com. To avoid confusion, providers and members who want to confirm a provider’s in-network status need utilize the Find A Doctor tool to confirm if providers are in-network with Blue Cross NC.  

Provider Naming Discrepancy with HealthCare.gov 

Some providers have their name listed differently on HealthCare.gov than on health insurance companies’ websites because HealthCare.gov uses the name that correlates to the provider’s National Provider Identifier (NPI) from the National Plan and Provider Enumeration System (NPPES). Health insurance companies may use a different name, such as the name associated with their provider contract.  

Unfortunately, in some cases, this causes some providers that are in-network with Blue Cross NC to incorrectly appear as out-of-network on HealthCare.gov.  

Example: Davie County 

Health carriers and Healthcare.gov use different names for the general acute care center in Davie county. 

  • Blue Cross NC displays Davie County Hospital in its online provider search.  
  • Healthcare.gov displays the name Davie Medical Center. 
  • Other health plans use the name Wake Forest Baptist Healthcare Center – Davie in their directories. 

To confirm a provider’s network status with Blue Cross NC, please use the ‘Find Doctor / Drug / Facility’ link on www.bluecrossnc.com to accurately search for providers.