Effective Apr. 1, 2023, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) will insource behavioral health provider referrals. The current vendor managing these referrals, Quartet Health, will continue to manage behavioral health referrals for Blue Cross NC through Mar. 31, 2023. Quartet has been notified of this change, and the transition process is underway.

By insourcing behavioral health referrals, Blue Cross NC will have a stronger, holistic view of member health needs – with the end goal of supporting better health outcomes for members.

Below is a summary of changes for the behavioral health referral process effective Apr. 1, 2023:

New Apr. 2023 behavioral health referral process

Blue Cross NC is establishing a team of Care Navigators within its Behavioral Health Care Management organization who will begin processing behavioral health provider referrals effective Apr. 1, 2023. Care Navigators will support the referral lifecycle, with responsibility for:

• Accepting a referral, member outreach if additional information is needed for a referral and matching the referral to a behavioral health provider that closely matches the members' needs and criteria.
• Direct member communication when a behavioral health provider is identified.
• Member follow-up to confirm that appointments are scheduled. And should a member need help with scheduling, Care Navigators will assist.
• Member follow-up to determine their experience with an identified behavioral health provider to ensure a good match.

In addition to supporting our behavioral health provider network, Care Navigators will also support member and Case Manager behavioral health referrals.

Submission process for behavioral health provider referrals

Effective Apr. 1, 2023, providers who have access to Blue e will be able to use this secure site to submit a behavioral health referral. A similar process will be available to Blue Cross NC members on our member portal to handle member self-referrals for behavioral health providers.

Furthermore, closer to the Apr. 1 effective date, additional information will be provided on the behavioral health referral process, including a new 800-number that will connect behavioral health providers directly to a Care Navigator.

If you have questions, please email BehavioralHealth@bcbsnc.com.