Contact Us | BlueCross BlueShield of South Carolina Forgot username or password? Blue Cross NC is an abbreviation for Blue Cross and Blue Shield of North Carolina. Olvido su contrasea? Chico, CA 95927-2630 Call us Healthy Blue Member Services 844-594-5070 (TTY 711) Monday through Saturday, 7 a.m. to 6 p.m. Eastern time. For assistance completing the provider appeal form, please use the following Instructions for Provider Appeals. Go to Availity Portal and select Anthem from the payer spaces drop-down. Amount Satisfied: The total amount of the deductible, coinsurance, and/or out-of-pocket expenses you and/or your family has met for the benefit period as of the date of the EOB. Check subscriber ID for three-letter prefix before sending.
Ambetter from Arkansas Health and Wellness Member and Provider Services Phone Number: Ambetter from Coordinated Care Washington, 1145 Broadway, Suite 300 Tacoma, WA 98402. Chico, CA 95926, Blue Shield of California Ambetter NH Healthy Families Member and Provider Services Phone Number: Ambetter from PA Health & Wellness Pennsylvania, 300 Corporate Center Drive, Suite 600, Camp Hill, PA 17011. Box 35
Learn more about our non-discrimination policy and no-cost services available to you. Phone:(800) 662-5502 Reason Code: Indicates an explanation is available in the "What Our Codes Mean" section at the end of the EOB. 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. Save my name, email, and website in this browser for the next time I comment. Raleigh NC 27699-2501, Questions: Medicaid.Transformation@dhhs.nc.gov, Jay LudlamPhone: 919-527-7000Fax: 919-832-0225, John E. ThompsonPhone: 919-855-4100Fax: 919-733-6608, Eva Fulcher, Deputy Director Level I post-service provider appeals for billing/coding disputes and medical necessity determinations are available to physicians, physician groups, physician organizations and facilities and are handled by Blue Cross NC. All Excellus plans use this mailing address: Excellus BCBS Attn: Claims P.O. Use this form to submit a claim to be reimbursed for services that are covered under Service Benefit Plan dental benefits. The provision is designed so that the payments of both plans do not exceed 100% of the covered charges. During the second and third month of your grace period, any claims you submit will be put on hold. Heres everything you need to know about it. 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. Use our Claims-Routing Tool to find out where to send your claims by mail. Privacy Policy Claims may be denied retroactively, even after the enrollee has obtained services from the provider based on retroactive changes to eligibility, which include, but are not limited to failure to pay premiums and instructions from the Marketplace. The Automated Voice Response System is encouraged to obtain claims status using a touch-tone phone. Learn more about Healthcare Fraud. Phone: 919-855-4100 Your Provider Billed: The amount your health care provider submitted for the services you received. Question? Box 35 Durham, NC 27702 Customer Service 1-800-222-4739 Precertification 1-800-672-7897 Case Management 1-888-234-2415 1-919-765-2081 Fax Care Management Programs Asthma Chronic Obstructive Pulmonary Disease Congestive Heart Failure Coronary Artery Disease Diabetes 1-800-222-4739 Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association.
PDF Local Blue Cross and Blue Shield Mailing Addresses State/Alpha Prefix Call the National Information Center at 1-800-411-BLUE (2583) weekdays from 8 a.m. to 8 p.m. Eastern time.
Blue Connect - Blue Cross and Blue Shield of North Carolina About BCBSNC.com
For each step in this process, there are specified time frames for filing an appeal and for notification of the decision.
Forgot username or password? Complete the form following the instructions on the back. 2023 Blue Cross and Blue Shield of North Carolina. Ambetter Sunshine Health Member and Provider Services Phone Number: Ambetter from Superior HealthPlan Texas. State Government websites value user privacy. This does not include copayments or non-covered services. In an emergency, in situations where in-network providers are not reasonably available as determined by Blue Cross NC's access to care standards, or in continuity of care situations, out-of-network benefits will be paid at the in-network benefit level. Site Map Please note that some policies require that a specific number of family members must meet their individual deductibles first before the family deductible is met. Medical necessity is used to describe care that is reasonable, necessary, and/or appropriate, based on evidence-based clinical standards of care. Provider websites Public website: https://provider.healthybluenc.com Secure website: https://www.availity.com Prior authorizations/ notifications (medical/behavioral health) Phone:844-594-5072 Fax: Inpatient: Medical: 855-817-5788 All continued stay requests/discharge planning notifications/updates: 844-451-2694 Blue Shield of California, FEP Phone: 888-245-0179 Monday - Friday 8 a.m. - 5 p.m. Closed on State Holidays Medicaid Claims and Billing Download and complete the appropriate form below, then submit it by December 31 of the year following the year that you received service. These providers will also be able to check and see if you've paid your bill before they submit more claims for services. The advantage of being a member of your plan is that the provider has agreed to accept a reduced amount (allowed amount) for the services you received and your liability is based on the allowed amount and not the billed amount. Save time and money when you submit your claims electronically using Electronic Data Interchange (EDI). Box 2291, Durham, NC 27702. Attaching supporting medical information will expedite the handling of the provider appeal. Phone:(800) 824-8839, Blue Shield Life & Health Insurance Company Additionally, Blue Shield will send an Explanation of Benefits (EOB) to the billing provider as notification that the claim was forwarded to the appropriate capitated provider. P.O. Learn More Already a Member? For help with benefits, claims, billing, ID cards, and more you can go online or call us to get the help you need. You have a right to an urgent review when the regular time frames for a decision: (i) could seriously jeopardize your life, health, or safety or the life, health or safety of others, due to your psychological state; or (ii) in the opinion of a practitioner with knowledge of your medical or behavioral condition, would subject you to adverse health consequences without the care or treatment that is the subject of the request. (LogOut/ Claims for non-capitated services provided to a Blue Shield HMO member that are erroneously submitted to the capitated IPA or Medical Group for processing are required to be forwarded by the capitated IPA or Medical Group to Blue Shield within 10 working days.
Contact Us | Medicare - Blue Cross NC Note: Your plan may have different deductible amounts for services in and out of the Blue Cross NC provider network. Help
Log in to Blue Connect to view your plan info and contact information. If you are in an area that has participating providers and you choose a provider outside the network, you will receive the lower out-of-network benefit. Listed below, by county, are the addresses of medical foundations with which Blue Shield is affiliated. Plan's Maximum: This is the specific deductible, coinsurance, or out-of-pocket amount for your plan, and what you may owe cannot exceed these amounts. Value Options (for members enrolled in SHP). Privacy Policy An EOB is generated after a claim has been received and processed. Defining a "Corrected Claim" The corrected claims process begins when you receive a notification of payment (NOP) or explanation of payment (EOP) from BCBSNC detailing the claims processing results.
BCBS Provider Phone Number - Anthem Blue Cross and Blue Shield List Blue Cross NC will make a decision on your request within a reasonable time but no later than 48 hours after receipt of requested information or the end of the time period given to the provider to submit necessary clinical information, whichever comes first. Type at least three letters and we will start finding suggestions for you. (For example, if your service was provided on March 5, 2022, you have until December 31, 2023 to submit your claim). Mail Applications and Correspondence to: Blue Cross Blue Shield of Arizona P.O Box 13466 Phoenix AZ 85002-3466. We use cookies on this website to give you the best experience and measure website usage. Fax: (559) 734-3828, Foundation for Medical Care of Mendocino-Lake Counties If you are unable to return to the pharmacy within 14 days, mail claims in time to be received within 18 months of the date of the service in order to receive in-network benefits. All rights reserved. Instructions: 1. Learn more about our non-discrimination policy and no-cost services available to you. You will be going to a new website, operated on behalf of the Blue Cross and Blue Shield Service Benefit Plan by a third party. Code Set; Paper Claim Filing; Dental Providers. What you need to know about the disease and our commitment to ensuring you have access to the right care at the right time. Mail Claims or Claims Correspondence to: Blue Cross Blue Shield of Arizona P.O. Learn more about our non-discrimination policy and no-cost services available to you. Register Now, Ancillary and Specialty Benefits for Employees. The unpaid balance is usually paid by the secondary plan to the limit of its responsibility. Chico, CA 95927-2510 Blue Cross NC is an abbreviation for Blue Cross and Blue Shield of North Carolina. Box 272630 Ukiah CA 95482-5482 Customer Service: 1-888-206-4697. Phone: 1-844-594-5072. Submit a separate claim for each member. Lastly mail the completed claim form to the address provided. - Leave a reply here! Family Deductible: Your family has a deductible for all covered members on your policy, if applicable. , SM Marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans.
Contact Us | Blue Cross Blue Shield For help with Blue Premier registration or account management, please contact your account administrator. 800-972-808 (IVR-Claims/Eligiblity) 877-860-2837 (Blue Cross Community Health Plans) 877-723-7702 (Blue Cross Community MMAI) 877-774-8592 (Blue Cross Medicare Advantage) 800-676-2583 (Eligiblity - Out of State BCBS) 800-972-8382 (Eligibility - FEP) Indiana: 888-802-2160 855-251-8827 (Health Maintenance Organization) Box 35 Durham, NC 27702 North Dakota BCBS . NC Provider Contact Information; Forms and Documentation; eSolutions. The decision will be made and communicated to you and your provider within three business days after Blue Cross NC receives all necessary information but no later than 15 calendar days from the date Blue Cross NC received the request. Customer Service Agents are available to answer questions at this toll-free number: Phone: 800-688-6696. These appeals include dissatisfaction with a claim denial for post-service issues that may be either provider or member liability. Health Claims:803-264-2215 in Columbia, or toll-free 888-410-2227. Technical Information Electronic Solutions; What is Blue e? Blue Shield of California Member Savings: The amount you saved by visiting an in-network provider or facility and being a member of your plan, entitling you to receive these negotiated discounts. Generally, members may submit requests: Once Blue Cross NC has all necessary information to make a decision, Blue Cross NC will provide a response to the member and their provider approving or denying their request (if approved, notice will provide duration of approval) within applicable timeframes. Ambetter Sunflower Health Plan Member and Provider Services Phone Number: 1301 International Parkway, Suite 400, Sunrise, FL 33323. Fraud & Abuse. Learn more and enroll in EDI on our Manage electronic transactions page. Forms to add or remove a Blue e user or NPI. Best Practices to reduce the chance of retroactive denials: Enrollee recoupment of overpayments is the refund of a premium overpayment by the enrollee due to the over-billing by the issuer. Physicians, physician groups, and facilities may file a Level I Provider Appeal of Blue Cross NC's application of coding and payment rules to an adjudicated claim or of Blue Cross NC's medical necessity determination related to an adjudicated claim. Call the National Information Center at 1-800-411-BLUE (2583) weekdays from 8 a.m. to 8 p.m. Eastern time. If you have any excluded services, (services your plan does not cover) they will appear in this column as well. Your Plan Paid: The amount your plan paid for the services you received. Home
Ambetter from Buckeye Health Plan Member and Provider, Ambetter Indiana Member and Provider Services Phone, Medical Coder Salary -the Best Paying Jobs in Healthcare Industry (2023), Amerihealth Caritas provider Phone Number, Payer ID and Claims mailing address list (2023), Ambetter from Absolute Total Care South Carolina, 1441 Main Street, Suite 900, Columbia, SC 29201. (See Filing Claims below for additional information.). You are responsible for ensuring that you or your out-of-network provider, in or outside of North Carolina, requests prior review by Blue Cross NC or its designee when necessary.
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