Healthy blue nc provider phone number
Healthy blue nc provider phone number. Integrated health care. to 5 p. ; Select Cancel My Plan as your message Email Provider. We review network adequacy for each product annually. Healthy Blue providers should contact Carelon starting April 17, 2023, to obtain a prior authorization for any therapy services There are three ways providers can Blue Cross NC makes health insurance easy. Skip to main content. 1-800-952-8462. updating panels can be found on the CCH secure provider portal. Help in any language. Provider News. Please have the servicing provider national provider ID ready when calling. Pharmacy medication intake team. What happens if I don't register for EFT? The Healthy Blue provider manual will be available January 1, 2021, at https://provider. - 5 p. Getting Care 24/7. Contact. Eastern time (except public and/or bank holidays) Email: support@payeehub. For questions related to your NCTracks provider information, please contact the GDIT Call Center at 800-688-6696. Their phone number and address are on your ID card. com or calling 803-264-4730. Blue Cross NC provides information about this program for your convenience Amendments (CLIA) of 1988 for Healthy Blue providers. healthybluemo. Local Division of Social Services Directory. Clinical intake team & behavioral health professionals. Healthy Blue is administered by Missouri Care, Inc. Side Nav. The Center for Medicare and Medicaid Services (CMS) approved up to $650 million in state and federal Medicaid funding to cover the cost of providing select pilot services that address non-medical drivers of health in four priority domains: housing, Blue Cross and Blue Shield of North Carolina Healthy Blue + Medicare (HMO D-SNP) General Precertification Request 2 Precertification requests may be entered via fax, phone or web: • Fax — Remit to 1-866-959-1537. gov, to cancel any plans you purchased there. - 8 p. No. To find a doctor, you can use the NC Medicaid Provider and Health Plan Lookup Tool to find a primary care provider (PCP). The purpose of the CLIA program is Please be advised, effective August 1, 2022, the CLIA number, and if applicable, the appropriate modifiers must be submitted on each CMS Have questions? Call or write us! Member Services: 844-594-5070 (TTY 711) Already a member? Log in to your account and send us a message. Callers choose from a series of prompts to obtain information needed such as eligibility, primary medical group assignment verification, prior authorization Healthy Blue Provider Services: 1-833-388-1406 Monday to Friday 8 a. Call 844-594-5070 (TTY 711) or email Blue Cross NC Medicare providers can find D-SNP (Special Needs Plans) and Model of Care training, formulary resources, forms and coding docs all in one place. Blue Cross and Blue Shield of North Carolina is an independent licensee of Visit the Healthy Blue of North Carolina official site for quick, easy access to information and tools to help you reach your health goals. The North Carolina Division of Mental Health, Developmental Disabilities and Substance Use Services (DMH/DD/SUS) received one-time funding as a part of the Online: NC Medicaid Division of Health Benefits Medicaid Providers. to 6 p. O. ® Marks of the Blue Cross and Blue Shield Association. Healthy Blue Medical Policies. * Availity, LLC is an independent company providing administrative support services on behalf of Healthy Blue. https://provider. Provider News North Carolina Find contact information below for the individual or department you need. If you have a life-threatening emergency, please contact 911. CT. BNCPEC-0521-21. Have you already registered your NPI? If you are an out-of-network provider who previously received payment for services from Blue Cross NC, you have already registered your NPI with us. Forms & Downloads. Box 6170 Columbia, SC 29260-6170 Back to Top. Please contact Availity Client Services with any questions at 1-800-AVAILITY (1-800-282-4548) Monday to Friday, Interested in becoming a provider in the Healthy Blue network? You may already be working with a care manager and know how to contact them. Questions and Answers (Q&A) – View answers to important and frequently asked questions. WellCare of North Carolina Providers 1-866-799-5318. Contact & Links. ) to ModivCare securely at ncnetwork@modivcare. AmeriHealth Caritas North Carolina Provider Service Line: 1-888-738-0004: PerformRx ® (Pharmacy Provider Services) 1-866-885-1406: Advance Health Care Directive Registry: 1-919-814-5400 Monday through Friday, 8 a. Healthy Blue 1099 FAQ 2 Q: Will 1099s be viewable in Availity or some other platform? A: No, 1099s are not viewable in Availity or other online platforms. Get the latest 1-844-545-1427 (TTY 711) Health issues can come up when you least expect them. Click on the drop-down arrow beside the name of each health plan for contact information and resources specific to each plan. Individual and family plans (under age 65) Blue Cross and Blue Shield of North Carolina (Blue Cross NC) retains the right to add to, delete from, and otherwise modify this provider manual. Proof of prior dental coverage with less than 63 days lapse in coverage is required. Phone: 888-245-0179 Monday - Friday 8 a. Additional provider training resources Healthy Opportunities Pilot Provider Training Resources. They will work with the pharmacy and Healthy Blue to review your case and replace your medicines as needed. Submitting electronic claims through Availity or a clearinghouse of your choice has specific If you have questions related to EDI, contact Availity Client Services at 800-282-4548 or visit Only providers with a Blue Cross NC contract can receive direct payment. Healthy Blue Providers. BNCPEC-0636-21 October 2021 This form should be completed by Behavioral health providers. From 13. ; Select Cancel My Plan as your message NORTH CAROLINA MEDICAID PROVIDER QUICK REFERENCE GUIDE PROVIDER SERVICES CONTACT NUMBER Toll Free 1-833-552-3876 PROVIDER PORTAL Website: provider. com or may request authorization by calling 855-397-3604. org; Note: EnrollSafe is an independent company providing electronic funds transfer (EFT) services for Healthy Blue + Medicare providers on behalf of Blue Cross and Blue Shield of North Carolina. However, a newly credentialed practitioner should be assigned a Blue Cross NC Provider Identifier Number by Network Management, Please contact Blue Cross NC by using the Provider Blue Line at 800-214-4844. Monday to Saturday, 7 a. Blue Cross and Blue Provider TIN: Provider contact information: Cost containment information Healthy Blue Provider Authorization to Adjust Claims and Create Claim Offsets 2 Claim number: Your payer name is Healthy Blue North Carolina, and the payer ID is 00602. For Healthy Blue members, regardless of age, coverage for outpatient behavioral Blue Cross and Blue Shield of North Carolina. 16 Updated number of days for submitting disputes 7/1/23 1. Email: CarolinasPRTeam@uhc. This page provides a listing of NC Medicaid provider health plan contacts and resources. Phone: 866-757-8286 Email: HBProviderService@healthybluesc. Additionally, providers and their office staff can contact Healthy Blue Provider Services at 844-594-5072 and follow the prompts for extra Provider Appeal Request Form https://provider. Access tools, policies and the latest information to help you care for our Medical: 1-844-445-6649. Waste, Fraud and Abuse. The NPI is a unique identification number for covered health care providers. an independent licensee of the Blue Cross and Blue Shield Association. If you suspect fraud, waste, or abuse within the NC Managed Care Program as it relates to a UnitedHealthcare representative or the Healthy Blue Provider Services phone number at 844-594-5072. Reach us by phone . PIN, and National Supplier Clearinghouse or NSC). to 5p. Notes: Availity is an independent company pr oviding administrative support services fo r Healthy Blue providers on behalf of Blu e Cross and Blue Shield of North Carolina. Members are encouraged to visit their PCP before seeing a specialist. Receive Healthy Blue emails from Blue Cross and Blue Shield of North Carolina. Through 14. Find resources for Blue Cross NC Providers in- and out-of-network to manage patient claims and appeals, eligibility, prior authorization and more. These vendors do not offer Have questions? Call or write us! Member Services: 844-594-5070 (TTY 711) Already a member? Log in to your account and send us a message. 1-866-588-6967 — Freedom Blue SM PPO Provider Service Center. BNEPEC-0386-20 December 2020 State approval: 12/08/2020 One Call Health Care Provider Line: 877-598-7602 / One Call Transportation Provider Line: 877-598-7640 If you are helping a member arrange transportation, call the PHP Member Services line on the member’s Medicaid ID card. In this way, Blue Medicare HMO and Blue Medicare Contact Healthy BlueProvider ServicePhone: 866-757-8286Email: HBProviderService@healthybluesc. Care Management staff Official Site of Anthem Blue Cross Blue Shield, a trusted health insurance plan provider. 2021, for Healthy Blue providers with Blue Cross NC. Our provider search can help you find the best PCP for you and your family. com (Look for “Providers” on the homepage) Electronic data interchange (EDI) Email EDI. Availity, LLC is an independent company providing administrative support services on behalf of Healthy Blue. ; Click the Compose button. Medicaid customer service. All other marks and names are property of their respective owners. Providers with internet access will find helpful information online at highmarkbcbs. BNCPEC-0711-21 December 2021 Resources and information for Healthy Blue Dual Advantage (D-SNP) providers. NC Medicaid, Division ModivCare: Transportation provider shall submit a W-9, Account Setup Agreement, and the trip information (run sheet, driver log, etc. 4 Provider Healthy Blue providers on behalf of Blue Cross® and Blue Shield® of North Carolina. By Phone: Call the number on the back of the member’s ID card or dial 800-676-BLUE (2583) to speak to a Provider Service representative. You can easily contact our Provider Education team to connect with a consultant or to request training. 12 Solutions to Yes, Blue Cross NC may waive or reduce any applicable dental waiting period by the number of months of prior dental coverage. Providers interested in contracting with WellCare of North Carolina Email: ProsProvNC@Wellcare. Inpatient admissions, services and procedures received on an Joining the Healthy Blue provider network is easy! Skip to header Skip Our National Contact Center offers: A dedicated provider line for when you can’t access the internet. 1, 2023, for any Brighton-administered member benefits, so there is no need to act on any previously scheduled and authorized services/procedures. Both will allow you to speak with a representative. com Monday through Friday, 8:30 a. Shop Plans. Have questions? Call or write us! Member Services: 844-594-5070 (TTY 711) Already a member? Log in to your account and send us a message. For provider questions and claims issues: Phone: 1-844-594-5072. Services@bcbssc. Getting a checkup now will help your NC Medicaid 2021 Provider Playbook State of North Carolina • Department of Health and Human Services • Division of Health Benefits (NC Medicaid) www. com • Patient care forms Behavioral Health Crisis Line (24 hours, 7 days/week) Toll Free 1-855-798-7093 The Provider Ombudsman contact information is also published in each health plan’s provider manual. HealthyBlueSC. 4. contact Healthy Blue Provider Services at 844-594-5072. About Mental Health (cdc. Providers. For phone and fax numbers related to submission of prior authorzations, Appeals and Grievances (non-claims) Attn: Appeals and Grievances 1701 North Graham St Suite 101 Charlotte, NC 28206: Carolina Complete Health Network Office: 4309 Emperor ©2024 Blue Cross and Blue Shield of North Carolina. Call us if you are experiencing emotional or mental pain or distress. Healthy Blue is now sending some bulletins, policy change notifications, prior authorization Have questions? Call or write us! Member Services: 844-594-5070 (TTY 711) Already a member? Log in to your account and send us a message. in cooperation By Phone: Call the number on the back of the member’s ID card or dial 800-676-BLUE (2583) to speak to a Provider Service representative. AmeriHealth Caritas North Carolina Fraud, Waste and Abuse Hotline: 1-866-833-9718: NC Medicaid Fraud, Waste and Notice of Changes to Pharmacy Benefits as of July 1, 2021. We have licensed clinicians available If you have an issue with completing the attestation form online after reviewing the Model of Care training, you can print a copy of the form, complete all required information and fax Health care providers, find a Blue Cross NC phone number for info on eligibility, benefits and claims status, plus medical policies, contract updates and more. Choose Healthy Blue is a Medicaid plan offered by Blue Cross and Blue Shield of North Carolina. org . The following organizations serve as Network Leads, two in eastern North Carolina and one in western North Contact Information: Phone: 877-882-0384, from 9 a. Provider News North Carolina. We help you get the care you need like doctor visits, medicines, therapy and more. Provider Network Specialists – Contact your assigned network development specialist. Contracted Providers 1-866-799-5318. When the anchoring health systems and Blue Cross NC developed these networks, we did an intensive analysis of network adequacy, accessibility, and marketability, incorporating both CMS and NCDOI guidelines. Blue Cross and Blue Shield of North Carolina facilitates integrated physical and behavioral health services as a vital part of health care. Identify yourself Have questions? Call or write us! Member Services: 844-594-5070 (TTY 711) Already a member? Log in to your account and send us a message. Find a Doctor. 4 %âãÏÓ 185 0 obj > endobj xref 185 65 0000000016 00000 n 0000002122 00000 n 0000002296 00000 n 0000006498 00000 n 0000006926 00000 n 0000007392 00000 n 0000007784 00000 n 0000007898 00000 n 0000010165 00000 n 0000010681 00000 n 0000011158 00000 n 0000011460 00000 n 0000011572 00000 n 0000011831 00000 n The Blue Cross NC Care Management Department works with physicians and members to facilitate the most medically appropriate, cost-effective, quality care for our members. Blue Cross and Blue Shield of North Carolina is now sending some Healthy Blue bulletins, policy change notifications, prior authorization update information, educational opportunities, and more to providers via email. Provider Services. Those provisions will be considered first in determining eligibility for coverage before the Medicare. By calling 800-672-7897, Care Management staff are available to assist with arranging care for services for our commercial and State Health Plan members. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA. Effective 1/1/2008, Blue Medicare HMO and Blue Medicare PPO members have the freedom to choose in-network providers and specialists without a referral. Facebook; Twitter; Instagram; Healthy Blue is a Medicaid plan offered by Blue Cross and Blue Shield of North Carolina. You will need to contact Blue Cross NC Provider Service at 800-777-1643. Interested in becoming a Healthy Blue provider? Begin the process through My Provider Enrollment Portal (MyPEP). You’ll use it for doctor visits, prescriptions, and hospital stays. Blue Cross and Blue Shield of North Carolina will require prior authorization (PA) for Healthy Blue outpatient behavioral health services in alignment with the Outpatient Behavioral Health Services Clinical Coverage Policy 8C, beginning July 1, 2023. Member Services: 844-594-5070 Provider Services: 844-594-5072 Behavioral Health Crisis Line: 844-594-5076. Providers are encouraged to use this tool to confirm the availability and accuracy of information contained in their NCTracks provider enrollment record. Find the right place to get care. Service information . Medical Policies are used by all plans and lines of business unless Federal or State law — as well as contract language, including definitions and specific contract provisions or exclusions — take precedence over a medical policy. Good eyesight is a critical part of your quality of life. For questions about eligibility, benefits, authorizations, Provider Services Phone Number Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional. The public version of the Medicaid and NC Health Choice Provider and Health Plan Lookup Tool is now available. o Use the PA fax number (855-817-5788) if you would like to fax a paper Medical Policies. healthybluela. Find additional provider-specific contact information and resources here. Behavioral Health Crisis Line. Important Phone Numbers. com. Getting started with us. Make checks payable to Blue Cross NC or the State Health Plan, depending on which company paid the claim. Get South Carolina Medicaid coverage and extra benefits through Healthy Blue. For provider questions and claims issues. healthybluenc. Alliance Health; AmeriHealth Caritas North Carolina; Carolina Complete Health; Eastern Band of Cherokee Indians Tribal Option * Availity, LLC is an independent company providing administrative support services on behalf of Healthy Blue. If you are deaf, hard of hearing, or have a speech disability, dial 711 for TTY relay services. With this process, an explanation of benefits statement is sent to a random number of members. NO. Get Provider Education. Take care of your dental health by making the most of your Dental Blue Select℠ plan. Receive email from Healthy Blue. Member Services 1-833-552-3876 (TTY: 711 To contract with the Community Plan of North Carolina – Medicaid please contact the NC Health Plan Provider Call Center at 800-638-3302. Get answers to your medical questions. Please note, this communication applies to Healthy Blue + Medicare ℠ (HMO D-SNP) offered by Blue Cross and Blue Shield of North Carolina (Blue Cross NC). Email: NC_Provider@healthybluenc. Phone: 1-833-388-1406. Providers can submit claims for members with FEP plans electronically. Billing Provider Name: Billing National Provider Identifier: Billing Provider Tax ID Number: Claim Number: Subscriber ID Number: Date of Service(s): (include prefix) Subscriber Name: Patient Blue Cross and Blue Shield of North Carolina (Blue Cross NC)knows how •Phone: 828-467-8815 •Fax: 828-367-7827 https://provider. Here you will find frequently used forms, PDFs, provider manuals and Please view the full overview of the Healthy Blue Medicaid and Healthy Blue + Medicare comparison flyer (PDF). Or write us at: Member & Guest Services BlueChoice HealthPlan P. com Healthy Blue is the trade name of Community Care Health Plan of Louisiana, Inc. Call to set up a visit with your PCP as soon as you can. ' Select 'Drug or pharmacy' option. What is Telehealth and how does it work? Participating Blue Cross NC providers can be paid electronically. in cooperation Have questions? Call or write us! Member Services: 844-594-5070 (TTY 711) Already a member? Log in to your account and send us a message. For help with Blue Premier registration or account management, please contact your account administrator. to 8 p. NC Healthy Blue Medicare (MCR): 1-855-397-3608. Setting up EFT is easy to do if you already use Blue e. Medicare plans Call 800-457-4708 (TTY: 711), daily, 8 a. We are committed to supporting you in providing quality care and services to Healthy Blue members. For questions regarding benefits or provider inquiries for the 2025 benefit year. Prior authorizations by phone: You can reach Provider Services at 844-594-5072. Our toll-free 24/7 NurseLine lets you talk with a registered nurse whenever you have health questions or need medical advice. Bank Draft: You can set up automatic recurring payments with a bank draft by entering your bank account information in the Billing & Payments area of Blue Connect, our secure member site. Discover employer, individual, family, Medicare & Medicaid plans from Blue Cross NC. Blue Cross NC members can visit any licensed dentist they choose but can save money using in-network providers. Healthy Blue providers should contact Carelon starting April 17, 2023, to obtain a prior authorization for any therapy services There are three ways providers can providers on behalf of Blue Cross and Blue Shield of North Carolina. Better care starts here. Prior authorizations by fax: You can also fax your request to our Pharmacy Department. Place of Service 12. •Providers who are registered Availity users can enroll to receive electronic remittance advice (ERA) files from several payers. And more! If you cannot locate information on our website or through MIM, you can also call Provider Service at 866-757-8286 to speak with a contact Healthy Connections at 877-552-4642 or TTY 877-552-4670. Connect you to legal help if you need it to help resolve a problem with your health care needs; You can contact the NC Medicaid Ombudsman at 877-201-3750 from 8 a. Close. 4 Provider What's New for 2024. Select 'Look Up a Drug or Doctor. Members can send us a secure note using the Message Center anytime of day. 9. Health benefits and health insurance plans contain exclusions and limitations. contact Healthy Connections at 877-552-4642 or TTY 877-552-4670. Blue Cross NC may contract with independent third-party vendors for the provision of certain aspects of our wellness programs and is not liable in any way for goods or services received from them. https://providers. You can find your PCP’s phone number on your member ID card. Archived BlueBlasts and Bulletins. Procedure code 11. For any %PDF-1. To find a dentist in North Carolina using the Insure Kids Now Website (for both adults and Skip to main content An To find a dentist in North Carolina using the Medicaid Provider and Health Plan Lookup Tool, please use the following link: NC Medicaid Contact Center Phone: 888-245-0179 Local Division of Social Services Directory . in cooperation •Contact Provider Services at 1-844-594-5072. Access tools, policies and the latest information to help you care for our members. Provider Services Phone Number: 1-844-521-6942. ET. com For more information: Contact Healthy Blue Provider Support Services Phone: 844 Blue Cross and Blue Shield of North Carolina uses Availity, a secure, full-service web portal that offers a claims clearinghouse and real-time transactions at no charge to Healthy Blue providers. separate identifiable Healthy Blue ID number. EDI, including electronic remittance advices (ERAs) and electronic funds transfers (EFTs), allows for a faster, more efficient and cost-effective way for providers and employers to do business. This means your provider must ask Healthy Blue to approve the services they want you to have. If you have any questions, please contact Healthy Blue Provider Services at 844-594-5072, Monday to Saturday, 7 a. Questions? Call or write us! Member Services: 1-844-521-6941 (TTY 711) Open Monday-Friday 7 a. If you have any questions about your pharmacy benefit, call Pharmacy Member Services at 1-844-594-5084 (TTY 711). Healthy Blue Missouri has plans for adults enrolled in Medicare, a federal health care program for adults 65 and older and people with certain conditions. That’s why Healthy Blue uses My Insurance Manager SM Send us a secure message through the “Ask Provider Services” feature. C. 2 . Public website: https://provider. BLAPEC-0644-17 November 2017 For Healthy Blue to process an overpayment refund in a timely manner, please complete and At Healthy Blue, we value you as a provider in our network. HIGHMARK 1-800-547-3627. Please feel free to call Healthy Blue Provider Services at 844-594-5072 with any suggestions, comments and/or questions. But, because we often add new providers to our network North Carolina (Blue Cross NC). Phone: 844-594-5072. , seven days a week. • Phone — Please dial the Customer Service number on the back of the member’s card. Find out more today. They can also submit claims for Federal Employee Program members via mail. The quickest way is by emailing Provider. Contact eSolutions Help Desk: 888-333-8594, option 1. The Healthy Blue behavioral health provider network includes psychiatrists, psychologists, social workers, psychiatric nurses, and other mental health and employee assistance healthcare professionals. Telehealth Program . to the upcoming changes, use the new Healthy Blue Provider Services phone number 1-833-405-9086. com Help Desk 800-868-2505 13 For existing Blue Cross NC groups, Blue Cross NC will transfer medical and pharmacy authorizations to Brighton by Jan. Provider websites. All other marks are the property of their respective owners. Contact Healthy Blue provider services at 833-405-9086. But if you need to contact us, below are the telephone numbers exclusively for providers. Providers may request the Account Setup Agreement using the same email address or Healthy Blue is a Medicaid plan offered by Blue Cross and Blue Shield of North Carolina. The Provider Services phone number is 1-833-388-1406. – Prepaid Health Plan; Statewide. Phone: 833-405-9086. Provider Services. Blue Cross NC reserves the right to discontinue or change the program at any Healthy Blue . For assistance with any other item, contact the number on the back of your patient’s Healthy Blue Dual Advantage member ID card. Author: Washko, Amanda C. 11 https://provider. On the 'Select your Rx letter code screen,' choose which letter code matches the drug you're searching for. com North Carolina State Health Plan. Medicaid plan for Medicaid members in North Carolina, known as Healthy Blue. Please Select Your State The resources on this page are specific to your state. Blue Cross NC provides the telehealth program for your convenience and is not liable in any way for the goods or services received. ' Then select 'Browse as a guest of a group plan. Visit HealthCare. This includes Provider Blue Books, enrollment forms and more. Humana National Behavioral health. Contact Us. Call Healthy Blue Member Services at 844-594-5070 (TTY 711). Contact Information. . More Have questions? Call or write us! Member Services: 844-594-5070 (TTY 711) Already a member? Log in to your account and send us a message. Do you want to learn more about our programs? Our provider education consultants serve as liaisons between Healthy Blue and the health care community. Provider Services Phone Number How Can We Help? If you're a member: You can call us at 800-868-2528 8:30 a. Need a printed provider directory? 844-594-5076 (TTY 711) 24 hours a day, seven days a week. Blue Cross and Blue the Healthy Blue Provider Services phone number at 844-594-5072. Providers can proactively send medical records and other required documents to Blue Cross and Blue Shield of North Carolina (Blue Cross NC) before claims are processed to help avoid denials or delays. Healthy Blue is the trade name of Community Care Health Plan of Louisiana, Inc. Behavioral health: 1-844-429-9636. You can also call us toll free at 1-844-594-5070 (TTY 711) to get connected with a care manager. North Carolina State Health Plan (SHP) or Federal Employee Program (FEP) please contact Blue Cross NC at 800-214-4844 or UHC contact numbers: Medicare Advantage, Prescription drug or Medicaid: call number on ID card. 0513 — Psychiatric clinic (authorization Back to Top You should have received your Healthy Blue member ID card in the mail. There are two available options. Shop plans for Medicare, Medical, Dental, Vision & Employers. Protect it by making the most of your vision plan benefits. ) directly, please use the appropriate toll-free number for the respective health plan. – Blue Cross and Blue Shield of North Carolina (Blue Cross NC) has enrolled its first members in Healthy Blue, its Medicaid managed care plan, and has developed a provider network with more than 48,000 physicians and other practitioners, including most of the state’s hospitals and health systems. ®, SM Marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans. If you have an urgent medical situation please contact your doctor/provider. Healthy Blue is a Medicaid product offered by Missouri Care, Inc. com Healthy Blue is a Medicaid plan offered by Blue Cross and Blue Shield of North Carolina through a managed care contract with the North Yes. Join the Blue Cross NC provider network, trusted by doctors, dentists, pharmacists and hospitals across North Carolina for more than 90 years. As of June 2023, 2,360,473 North Carolinians are enrolled in the program. Monday to Friday, 8 a. CT Monday to Friday. In Louisiana, the overall Medicaid program is called Healthy Louisiana. Here's what you need to know about the Blue Cross and Blue Shield of North Carolina specialty pharmacy network. Find A Doctor. Providers Demographic and contact information . Get the latest What's Healthy Blue? We’re a health plan — or insurance company — for Medicaid. com Healthy Blue is a Medicaid plan offered by Blue Cross and Blue Shield of North Carolina. please contact your Healthy Blue Provider Relations representative or call Provider Services at 844-594-5072 for more information. Learn More Have questions? Call or write us! Member Services: 844-594-5070 (TTY 711) Already a member? Log in to your account and send us a message. On July 1, 2021, certain beneficiaries were enrolled in NC Medicaid Managed Care health plans, which include the beneficiary’s pharmacy benefits. At Carelon Behavioral Health, formerly Beacon Health Options, our whole-person approach comes with smart, everyday practices and future-forward solutions. Hours: 7 a. Provider payment integrity (PPI) Humana clinical pharmacy review. gov) Telehealth benefits are available on all plans either from Blue Cross NC or through the provider network. Created Date: 12/24/2020 11:11:09 AM Healthy Blue is the Medicaid plan offered by Blue Cross and Blue Shield of North Carolina (Blue Cross NC) to serve North Carolinians who participate in the state Medicaid program. Commercial customer service. Ref. ncdhhs. Try our Find Care search tool to find them. You can also call us to learn more about purchasing a plan. until 5 p. , a MO HealthNet Managed Care health plan contracting with the Missouri Department of Social Services. If you misplace your medicine or it is stolen, contact your provider. 3200 Atlantic Ave Healthfirst Customer Service-Health First Provider Phone Number-Address and Timely Filing Limit; (Blue Card Provider Phone Number) 855-854-1438 (Exchange Kentucky/Indiana) 800-456-3967 (FEP) North Carolina: 888-206-4697 800-672-7897 800-214-4844: North Dakot: 800-368-2312: Ohio: 888-290-9160 Provider News North Carolina. Avoid Rejected Claims To avoid claims from being rejected, Blue Cross and with $0. 1-844-521-6942 Healthy Blue Medicaid Managed Care Provider Manual https://providers. Member’s DOB (mother)*: Member’s Healthy Blue ID (infant): Member’s phone number*: Member’s name (infant): Member’s shipping address*: NPI number (if applicable): Provider signature: Today Visit HealthCare. ® Marks of the Healthy Blue is the Medicaid plan offered by Blue Cross and Blue Shield of North Carolina (Blue Cross NC) to serve North Carolinians who participate in the state Medicaid program. Blue Cross and Blue • Provider tax ID number • Provider name according to contract additional support. Forms: Phone: 1-833-607-6516. Use Availity to submit claims, check the status of all your claims, appeal a claim decision and much more . Stay on top of your health care with helpful member resources. m. Provider Find out how to reach Healthy Blue Member Services, NurseLine, Behavioral Health Crisis Line and other resources by phone or online. Countless North Carolina Medicaid beneficiaries have transitioned into an NC Medicaid Managed Care Plan. Contact Healthy Blue. 00. If you didn’t choose a PCP, you may have been auto-assigned a PCP or AMH provider, but it’s easy to switch if you need to. This site hosts forms, help, and FAQs for North Carolina members and caregivers who use our services at Modivcare. every you may contact the provider directly to verify participation status with UnitedHealthcare's network, or contact Customer Care at the toll-free number shown Blue 20/20 providers℠ If you have a Blue Cross and Blue Shield of North Carolina (Blue Cross NC) plan, tax advisor or personal physician as applicable throughout your health care experience. Medical Medicare customer service. Blue Cross and Blue Shield of North Carolina is an If you are a provider, contact NetworkRelations@CCH-Network. com or contact Provider Services at 844-594-5072, Monday to Saturday, 7 a. In Advanced Medical Home (AMH) provider to help manage your health care needs. Live agents to assist you. Patient 360 is an independent company providing CMS r egistry reporting se rvices on behalf of Blue Cross and Blue Shield of North Carolina. 4 Provider Blue Cross and Blue Shield of North Carolina (Blue Cross NC) retains the right to add to, delete from, and otherwise modify this provider manual. That's why we’ve redesigned the provider site to make it more useful for you and easier to use. of Blue Cross and Blue Shield of North Carolina. Vision plans from Blue Cross NC support early detection of diseases that could affect both your eyesight and your overall health. Healthy Blue . NC Medicaid, Division of Health Benefits 2501 Mail Service Center Raleigh, NC 27699-2501. - 7 p. Education@bcbssc. Log in to your account to se Provider Services. Get the free mobile app If you have any problems logging in to the Blue e network or Blue Premier, please call the eSolutions HelpDesk at 1-888-333-8594 Option 1 or your system administrator. Service Location address/phone number: Accepting Siblings: Healthy Blue is a Medicaid plan offered by Blue Cross and Blue Shield of North Carolina. Labs. comMonday through Friday, Contact Healthy Blue Provider Service. Note: Availity, LLC is an independent Contact Healthy Blue. JUNE 2021 Fact Sheet . Does each member of my family need to have the same primary care provider? Family members who are Healthy Blue members can choose the same primary care provider (PCP). Call the 24/7 NurseLine at 1-844-545-1427 (TTY 711). Get more information Contact Information. Call 1-877-201-3750 or visit ncmedicaidombudsman. If you’re pregnant, take these important steps: Step 1: Schedule an appointment with your obstetrics (OB) provider Who is your OB provider? If you don’t have one, you can call us at 844-594-5070 (TTY 711), and we can help you find one near you. com Call the NC Medicaid Enrollment Broker at 833-870-5500 (TTY 833-870-5588), 7 a. Blue Cross and Blue Shield of North Carolina (Blue Cross NC) will procedures can be found in the Healthy Blue Provider Manual phone or fax number to facilitate a return of the authorization and clarifications as necessary. com; Contract #30-2022-007-DHB MD PIHP Amendment Number 6 HOP R equirements Only; NC Medicaid Contact Center - Provider and beneficiary information on Medicaid policies and procedures. With Blue Cross and Blue Shield of North Carolina (Blue Cross NC), you can explore resources, wellness programs, and more to get the most out of your plan. BNCPEC-0711-21 December 2021 View information and resources for South Carolina Medicaid providers in network with Healthy Blue. Blue Cross and Blue If you would like to sign up for EFT before November 1, 2021, contact your Healthy Blue Provider Relations representative or call 844-594-5072 for You’ll be issued a trace number with your EFT deposit that matches up with your Behavioral health. com ; Phone: 844-594-5072; UnitedHealthcare of North Carolina, Inc. Healthy Blue facilitates integrated physical and behavioral health services as a vital part of health care. Healthy Blue is a Medicaid plan offered by Blue Cross and Blue Shield of North Carolina. Our team can: Give medical advice. For other language assistance or translation services, please call Learn how to file an appeal or a grievance with Healthy Blue of North Carolina, a Medicaid managed care plan. With the implementation of Healthy Blue Medicaid Managed Care plan on July 1, 2021, and Healthy Blue + Medicare on January 1, 2021, Blue Cross and Blue Shield of North Call us to get answers to your Blue Cross and Blue Shield of North Carolina (Blue Cross NC) plan, bill or claims questions. Eligibility verification — Prompt 1; Authorizations and precertification — Prompt 2; Claims status — Prompt 3; Provider relations — Prompt 4; Pharmacy department — Prompt 5; If you have any questions about EFT, please contact your Healthy Blue Provider Relations representative or call Provider Services at 844-594-5072 for more information. com Healthy Blue is the trade name of Community Care Health Plan of Nebraska, Inc. Medicare supplement: 1-800-523-5800, Plans through work: 1-866-801-4409 Whether you have a question or are interested in learning more about how we can best support you, please call our National Provider Services Line at 800-397-1630, Monday to Friday, 8 a. Update your contact information. Contact Healthy Blue; Have questions? Call us at 866-781-5094 (TTY: Contact Cigna Healthcare Customer Service at 1 (800) 997-1654 or visit this page to find phone numbers for plan and coverage questions or a claims mailing address. If you purchased your own plan elsewhere, you can ask to cancel that plan in the Blue Connect ℠ member portal. Members are still expected to select a primary care physician (PCP). Here's what to do next: Send a Secure Message to Customer Service through your Blue Connect Inbox. Hirsch Created Date: 7/23/2021 8:31:20 AM Healthy Blue is a Medicaid plan offered by Blue Cross and Blue Shield of North Carolina. If you or a family member is having these kinds of problems, we can help. Healthy Blue providers on behalf of Blue Cross® and Blue Shield® of North Carolina. Providers may bill Blue Cross NC - Healthy Blue for the administration fee for Medicaid and eligible AI/AN NC Health Choice beneficiaries. will prevent us from returning your payment. Healthy Blue After submitting an MCR to NCTracks, if providers need additional assistance, please contact Healthy Blue at NC_Provder@healthybluenc. Durable Medical Equipment/Home Health Infusions: 1-844-451-2793. Blue Cross and Blue Shield of North Carolina is an Healthy Blue uses Availity as its exclusive partner for managing all electronic data interchange (EDI) transactions. Members can submit their renewal form via web (preferred), phone, fax, mail, or in person. carolinacompletehealth. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association. , Eastern time. 833-405-9088 (TTY 711) 24 hours a day, seven days a week. Author: Robyn M. Your benefits include medically needed Services billed with the following revenue codes always require prior authorization: 0240–0249 — All-inclusive ancillary psychiatric. com--14-2 The Pilots will operate in three geographic regions of the state, which were defined by the three Healthy Opportunities Network Leads (the Network Leads) that the Department procured through a Request for Proposal (RFP). to 9 p. com Phone 800-288-2227, ext. BNCPEC-0658-21 November 2021 PCP Change Request Form Instructions These are our most frequently asked questions by and for Blue Cross NC doctors and health care providers. The start of EVV and Claims Billing for North Carolina’s State Medicaid Prepaid Health Plan (PHP) Carolina Complete Health, AmeriHealth Caritas of North Carolina, UnitedHealthcare Community Plan of North Carolina, and WellCare of North Carolina (the PHPs) have partnered with HHAeXchange to provide software that allows providers to have a single Authorization Call Center Phone Numbers If you wish to contact Evolent (formerly National Imaging Associates, Inc. com Phone: 1-855-599-3814 Fax: 813-865-6503. , an independent licensee of the Blue Cross and Blue Shield Association. Prior Authorization Request . Blue Cross NC wants to make sure you have the most accurate and up-to-date information. ET, Monday through Friday. Providers can continue any previously scheduled and approved Parents, universities and colleges have trusted Blue Cross NC health insurance to protect their students, post docs, TAs, and RAs for more than 90 years. o Use the PA fax number (855-817-5788) if you would like to fax a paper Healthy Blue is the trade name of Community Care Health Plan of Louisiana, Inc. Credit or Debit Card: You can set up automatic recurring payments by credit or debit card by entering your credit or debit card information in the Billing & Payments Healthy Blue is a Medicaid plan offered by Blue Cross and Blue Shield of North Carolina. 12 Solutions to Healthy Blue . Blue Cross and Blue Shield of North Carolina (Blue Cross NC) for Healthy Blue providers. A Carolina Complete Health representative may contact you regarding your inquiry. The program links participating health care providers with the independent Blue Cross and Blue Shield Plans across the country, and in more than 200 countries and territories Healthy Blue . ET; voice portal — 24/7. If you’re a new Healthy Blue member, expect a call from someone on our team to get you started with care management. Skip to header Skip to navigation Viewing Fax & Phone Cases (Auth Inquiry) Provider Services Phone Number: 1-844-521-6942. For routine health questions, call your primary care provider. 24/7 NurseLine. Please contact Blue Cross NC by using the Provider Blue Line at 800-214-4844. Blue Cross NC offers wellness programs as a convenience to aid members in improving their health; results are not guaranteed. 833-690-1037 TTY: 711 (#833-690-1037) For premiums invoices for September 2024 and prior contact Blue Cross of NC: (888) 234-2416 TTY: (800) 442-7028 stateppoinvoice@bcbsnc. gov • NCDHHS is an equal opportunity employer and provider. Visit the NC Medicaid Enrollment Broker website; Questions Blue Cross and Blue Shield of North Carolina (Blue Cross NC) retains the right to add to, delete from, and otherwise modify this provider manual. Forms to add or remove a Blue e user or NPI. Join a network trusted by health care providers and facilities across North Carolina for more than 90 years. NC Medicaid Contact Center Phone: 888-245-0179. Dental. BlueCard ® is a national program that allows members of one Blue Plan to obtain health care service benefits while traveling or living in another Blue Plan's service area. healthybluene. If it’s been more than two weeks since For contracting questions, call Healthy Blue Provider Services at 1-844-594-5072 or via email at nc_provider@healthybluenc. Information is believed to be accurate as of the production date; however, it is subject to change. Call Provider Services at 800-868-2510 and select option 5. medicaid. One option is Blue Cross and Blue Shield of North Carolina’s Healthy Blue of North Carolina plan, exclusively for the state’s eligible Medicaid members. 1-866-675-8635 — Freedom Blue PFFS Have questions? Call or write us! Member Services: 844-594-5070 (TTY 711) Already a member? Log in to your account and send us a message. Resources and information for Healthy Blue Dual Advantage (D-SNP) providers. Healthy Blue of North Carolina – Prepaid Health Plan; Statewide. Healthy Blue is the trade name of Community Care Health Plan of Nebraska, Inc. Will providers be able to access a member’s Healthy Blue ID number if they do not have Providers can also contact Provider Services at 844-594-5072 for additional assistance. – 8 p. Check out the changes and updates to our plan in 2024. Email is the quickest and most direct way to receive important DURHAM, N. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Visit the Find Care page. Find which documents are required and where to send them based on your patient’s health plan. (1-800-AVAILITY). In North Carolina, the NPI replaces the Prior review (prior plan approval, prior authorization, prospective review or certification) is the process Blue Cross NC uses to review the provision of certain behavioral health, medical services and medications against health care management guidelines prior to the services being provided. II. 10. In Louisiana, we: Work with over 13,000 doctors; Have over 160 hospitals to choose from You can also contact the NC Medicaid Ombudsman if you have questions or problems your health plan or provider could not answer. 44730 Healthy Blue Provider Relations and Education Educational support for Healthy Blue plans Website www. oiklnv pts dqzr gknl ktnno vlaq hhzzz shujl dltim bxqndy