Bcbs nc provider lookup
Bcbs nc provider lookup. From the Payer Spaces homepage, select the Medicare Risk Adjustment Provider Documentation and Coding Guide (PDF) MCG Care Guidelines 28th Edition (PDF) New Resources to Improve Your Quality Rates (PDF) Notification of Specialty Pharmacy Medical Step Therapy Updates (PDF) Osteoporosis Screening in Older Women (OSW) (PDF) Outpatient Antibiotics Provider Toolkit (PDF) Shop Plans. Search for a doctor, hospital, dental and vision providers or pharmacies in your area. Get insurance delivered through your local BCBS agency. Welcome to BCBSNC Browse by Category. Search our nationwide directory of Preferred providers—those providers in our network. With Teladoc Health, care for your non-emergency health needs is just a few clicks away, 24/7, 365 days a year by phone, app, or web. The new tool offers a more straight-forward way to get the information you need. In the United States, Puerto Rico and U. Linking your Blue Connect account helps you quickly access:. Enter Keyword Search Management Department at 1-833-863-1310. Email: ProviderUpdates@BCBSNC. Find A Doctor – Provider Directory - Blue Cross and Blue Shield's Federal Employee Program Skip to main content Use the Look up Doctor or Drug search to find an in-network doctor or facility. Important information about Changes to this Directory. Jul 28, 2024 · John Griffin, MD, is an ABIM board-certified Internal Medicine Physician at Genesis in Westfield, New Jersey. Outside the United States *Select Blue Cross Blue Shield Global™ or GeoBlue if you have additional international coverage and need to find care outside the United States. Search by location, specialty, or name and compare quality and cost of care. Ask your employer if you're in a Select Network or check your ID Card for your network. Official Site of Anthem Blue Cross Blue Shield, a trusted health insurance plan provider. To request authorizations: From the Availity home page, Quality-based programs recognize providers offering outstanding quality care to members. Prior Authorization Lookup Tool. 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. Final Remarks about BCBS Prefix Lookup Directory. Choose option BlueCross BlueShield of South Carolina members. Get Started Apr 23, 2020 · 800-713-4173 (Blue Card Preferred Provider Organization - Claims) 800-676-2583 (Blue Card Prferred Provider Organization - Eligiblity) Excellus: 800-920-8889: Blue Care: Any service received at an out-of-network provider 1 Notice of mastectomy benefits As required by the Women's Health and Cancer Rights Act of 1998, your health insurance policy provides benefits for mastectomy-related services, including all stages of reconstruction and surgery to achieve symmetry between the breasts, prostheses and Welcome to the CAQH Provider Data Portal formerly known as CAQH ProView. Blue Cross NC health insurance and Blue Connect for members lets you choose from a comprehensive network of thousands of caring doctors and providers. Get detailed estimates for procedures or services (not available with some plans). Note: Blue Value is available with an effective date of 1/1/2013 or later. A: Access the most up-to-date provider information with our online Provider Search. Find out if a service needs prior authorization. Find a provider near you with Empire Blue's online tool. Managed care products include Keystone HMO/POS, Personal Choice® PPO, national BlueCard® PPO, and our Medicare Advantage plans. Statement Regarding GLP-1 Coverage . Search for many different types of providers, like: Join the Blue Cross NC provider network, trusted by doctors, dentists, pharmacists and hospitals across North Carolina for more than 90 years. National Provider Directory. Blue Cross NC members have access to wellness resources, information about their health insurance plan, dedicated customer service support and more. Use these tools to find a network doctor, dentist, or health care facility such as a hospital or urgent care clinic. Find a doctor or health care provider that fits your personal needs. Here's what you need to know about Blue Cross and Blue Shield of North Carolina's coverage. SpecialtyPharmUpdates@bcbsnc. 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 worldwide, through a single electronic network for claims processing and reimbursement. Contact Network Management to obtain information about credentialing, provider numbers, contracts and sample fee schedules. Search Now Search Tips ×. Jul 3, 2024 · To initiate post service review, please contact Carelon or log on to the Provider Portal within 10 days The results of the approved procedure will be required to complete the post service review. gov) Telehealth benefits are available on all plans either from Blue Cross NC or through the provider network. Blue Cross and Blue Shield of North Carolina (Blue Cross NC) offers several decision-support tools to aid you in making decisions around your health care experience. Stand-alone dental products, vision and pharmacy when delivered through an intermediary model. Prior review explained Blue Cross and Blue Shield of North Carolina (Blue Cross NC) must approve a prior review before your plan will help cover the cost of certain prescription medications, medical For all other inquiries, including member support questions, please contact Blue Cross NC at 800-214-4844 or PNC. Depending on the search conducted, the results are expected to display the following applicable Blue Cross and Blue Shield of Alabama's online guided search tool helps match you to the best mental health providers for your specific needs. As the doctor or provider, you must send all your details, and your signature on the Medical Necessity PA Request Fax Form (PDF), to Blue Cross NC; For questions or to check the status of your review, call us at 800-672-7897 As a result of the calendar year (CY) 2024 policy and technical changes to theMedicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly, changes have been made to the Blue Cross and Blue Shield of North Carolina Blue Medicare Advantage ℠ medical policies. As an alternative, you may enter a ZIP code. A limited network for those who don't have a strong provider preference; Lower monthly premiums; A plan that doesn't require a primary care provider or referrals for service; Search for a provider or pharmacy in the limited network. You can also search providers outside the U. www. Read your plan information carefully to know which network your health plan falls in. Log in to My Health Toolkit ® to search the provider directory and view search results specific to your insurance plan. If using the search field, type your practice or provider name in the search field. Members may also wish to discuss their questions and individual medical situation with their physician. Feb 24, 2021 · BCBS Prefix List Lookup: BCBS prefix list lookup is a three character prefixes followed by the id number except for the following products and programs. A file should now be available. Access tools, policies and the latest information to help you care for our members. BlueDental Provider Directory. Learn how to qualify for these programs, the benefits of participating plus how to use quality reports to identify care gaps. Access the forms you need to make service requests requiring prior plan approval, pre-certification, or certification when being reimbursed through the benefits of members of Blue Cross and Blue Shield of North Carolina. BlueCross BlueShield of Tennessee is a Qualified Health Plan issuer in the Health Insurance Marketplace. Discover employer, individual, family, Medicare & Medicaid plans from Blue Cross NC. • For Compass Group Gold Plus, Silver Plus or Bronze PPO Plans - enter "CGQ" as the identification prefix to find participating providers in the Blue Options PPO Network or click here The Blue Book is an online reference manual for products, value-added programs and services for providers participating in the Blue Cross and Blue Shield of North Carolina (Blue Cross NC) network. Healthy Blue is a Medicaid plan offered by Blue Cross and Blue Shield of North Carolina. To confirm the specific name of your plan, please check your member ID card. Our public Find Care tool is only for plans not in a Select Network. Your provider's office will submit claims for 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. Explore the health insurance options offered by Blue Cross and Blue Shield insurance agencies. This includes Provider Blue Books, enrollment forms and more. Forms and resources Explore dental network resources through Blue Cross and Blue Shield of North Carolina, including filing claims, benefit eligibility and information, and provider news. See important dates, forms, resources, policies and more. There was an error processing your request. com. Care Right from Your Smart Phone or Computer. ®, SM Marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans. Use the right search tools to find a doctor. Generate a list of providers in minutes with this easy step-by-step process, and start your journey toward mental health healing today. Important notices about your plan Medicare Advantage members can get up-to-date information about in-network providers in your area by following the questions below. 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. Use our search tool below to find a plan provider close to home. Physical address: Blue Cross NC 5901 Chapel Hill Road Durham, NC 27707 Providers looking for past allowed fee schedule amounts should contact Network Management. In most cases, you must get care from a provider in your health plan’s provider network, such as a primary care provider (PCP). A PCP is a doctor, nurse practitioner or physician assistant. Box 2291 Durham, NC 27702-2291. Before you make your appointment for these services, have your doctor or provider call us at 800-222-4739. Griffin delivers excellence in the care of Telehealth patients with a broad range of conditions, including sprains, UTI, coughs, colds, shingles, toothache, yeast and bacterial infection such as sinus or ear infections, hypertension, diabetes, other acute and chronic disease states Providers Disclosure of Ownership & Control Interest Form Requirements Contract With Us Join Our Network Provider Portal Registration Value-Based Program (VBP) Secure Email Portal Provider Resource Library Directory Information Validation (DIV) Provider TeleDentistry Resources Provider COVID-19 Resources Clinical Criteria Guidelines & Practice Mar 20, 2020 · Prior Plan Approval - BCBSNC Prior Plan Approval - Out of Area Preventive Service Coding PROVIDER LOOKUP Find a Doctor FORMS Find a Form eSolutions Forms PLANS Plan Information Tiered Networks PRESCRIPTION HELP CoverMyMeds NEWS Provider News Digest Sign for Provider News Email List What's New MAR 25, 2020 COVID19 Additional Details ©1998-BlueCross BlueShield of Tennessee, Inc. Select the health plan. For more details view our Provider Fee Schedules in Blue e Q&A (PDF) . You can also contact Customer Service at 1-877-258-3334 for assistance locating a provider or to obtain a paper copy of a directory. It allows you to quickly and easily identify your insurance home plan, saving you time and hassle. Blue Cross NC provides the telehealth program for your convenience and is not liable in any way for the goods or services received. Whether you are searching by a provider’s name, a particular specialty, a specific treatment, or your condition, you’ll be able to get accurate results that will help you make more informed care decisions. 6 days ago · Find doctors, hospitals, and more in your plan's network. At the January 25, 2024, State Health Plan Board of Trustees, the board voted to remove GLP-1 and GIP-GLP-1 agonist medications from State Health Plan coverage for the purpose of weight loss effective April 1, 2024. , an Independent Licensee of the Blue Cross Blue Shield Association. Our Company About Us Search Search. bcbsnc. The preferred method for submitting authorizations is through the Secure Provider Portal at Learn about Experience Health, a new and innovative insurance company owned by Blue Cross NC. You can search by specialty, location or network to find the healthcare provider that meets your needs. Healthy Blue’s provider manual provides key administrative information including the quality improvement program, the UM program, quality standards for participation, claims appeals, and reimbursement and administration policies. 800-777-1643. Use the Find Care tool above or the BCBSTX mobile app to search for in-network doctors who specialize in your diagnosis. C. BCBS prefix lookup directory is a valuable resource for anyone who is looking for right Blue Cross Blue Shield home plan. 20930 Allograft, morselized, or placement of osteopromotive material, for spine surgery only (List separately in addition to code for primary procedure) MSK 7/1/2023 10/1/2023 National Provider Search As a BCBS member, your coverage travels with you. To find a provider in the Healthy Blue network, click the search for a provider button below or contact Member Services at 844-594-5070 or TTY 711. Your health insurance provider may require your health care provider to submit a prior review and authorization before your plan will cover costs. Members are still expected to select a primary care physician (PCP). Getting a referral from your primary care provider is important if you have an HMO plan and want to save money. Ask your doctor for a recommendation or referral. Blue Cross NC 1/1/2005 0552 PRIVATE DUTY NURSING – RN; Blue Cross NC 1/1/2005 0559 PRIVATE DUTY NURSING – LPN Blue Cross NC 1/1/2005 0570 HOME HEALTH AIDE – HH Get in touch with your local Blue Cross and Blue Shield company. . 2024 Program Highlights Close 2024 Program Highlights Open 2024 Program Highlights; Why BCBS FEP Vision? ©2024 Blue Cross and Blue Shield of North Carolina. Type a Current Procedural Terminology (CPT) code or a Healthcare Common Procedure Coding System (HCPCS) code in the space below to get started. Medicaid. This feature provides the capability to validate provider information for billing, attending, referring, rendering, ordering, and prescribing providers. To access provider online reporting for all users once registration is completed: From the Availity homepage, select Payer Spaces from the top navigation. Your doctor can also find pre-approval forms on our provider prior authorization page . Mail: Blue Cross NC P. Better care starts here. Use the Find Care tool above or the BCBSIL mobile app to search for in-network doctors who specialize in your diagnosis. com . Use the Eye Doc Locator from Eye Med Vision Care to search for an eye care professional in your Blue 20/20℠ plan. Error code: 440 440 Search for specialized care local to Illinois. Claims/Customer Service. Blue Cross Blue Shield of North Carolina P. Precertification. Welcome to the Blue Connect and Blue Cross of North Carolina Member Self-Service Portal. Providers can submit claims for members with Blue Medicare HMO and PPO plans electronically through Blue e or EDI. If the drug is listed in the Drug Search, these requirements may still apply. We skipped a beat. Virgin Islands. In-network D/HME providers should participate in the Blue Plan in the state the equipment is shipped to, or the location of the store if it is purchased at a retail location. Health plans have a provider network (group). Providers joined the CPP at the practice level, so members should be able to see any provider in that listed CPP practice. Go to Report Search, select the program, complete the required fields and select Search. View or download the provider manual. Blue Cross NC has robust search tools to help you find in-network doctors, hospitals, specialty pharmacies and urgent care in your state or across the country. Use the Prior Authorization Lookup Tool within Availity or; Call Provider Services at 1-844-594-5072. Network Development Representatives are available to assist providers Monday through Friday, 8 am to 5pm ET. Our large provider network gives them access to care across all 50 states and nearly 200 countries and territories around the world. Through this search tool, you can also search for health care facilities, including hospitals, urgent care and labs. Search nationwide for physicians, specialists or hospitals. Member Portal. Mail completed appeal form and any supporting documents to: Blue Cross NC Provider Appeal Department PO Box 2291 Durham, NC 27702 Or fax the completed form and supporting documents to: Billing/coding denials: 919-287-8708 Back to Top 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. Search for specialized care local to Texas. Find results using these care categories. In addition, you'll find directories for mental health clinicians and facilities. That CPP designation DOES need to be noted in the Find a Doctor tool for the provider to be a CPP Primary Care Provider (PCP). Specialty Pharmacy Services include injectables and infusion therapies, and high-cost and complex care therapies. Find resources for Blue Cross NC Providers in- and out-of-network to manage patient claims and appeals, eligibility, prior authorization and more. (844) 594-5072 Toll Free or NC_Provider@healthybluenc. Licensee Search Request Verification; Roster; Search Tips; Glossary of Terms To locate a provider within your plan’s network, you will need to know the name of your plan. BCBS members can search for doctors, hospitals and dentists. Get the Blue Cross NC forms and documents for providers that you need all in one place. Only providers with a Blue Cross NC contract can receive direct payment. The full text or spelling is not required for the city and dentist name fields. Provider Manual. Quality Blue Directory. Get information on your policy using the state website found on your membership ID card. 1 The provider tool includes information on all physicians, hospitals, and specialty service providers who participate in our managed care plans. 1-800-222-4739. Blue Cross NC makes health insurance easy. Once you have selected your practice or provider name that meets your search, click on the provider name to find more details on the profile, and verify BlueHPN par status under the plans accepted section. 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. Shop plans for Medicare, Medical, Dental, Vision & Employers. Blue Cross and Blue Shield Licensees have made reasonable efforts to validate that the information displayed is up to date and accurate. 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. CAQH Provider Data Portal eliminates duplicative paperwork with organizations that require your professional and practice information for claims administration, credentialing, directory services, and more. Find out if your doctor, drug, or pharmacy is in-network, or explore other care options. Provider data last updated: Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association. Find Providers. Here you will find frequently used forms, PDFs, provider manuals and guides, prior authorization information, practice policies, and support for delivering benefits to Healthy Blue members. 1 Support for agencies of all sizes Our team is ready to support yours. Search. Many of the health care providers in our network join quality programs. Provider News Get the latest articles and announcements on claims filings, products, benefits, administrative updates, new and revised procedures and guidelines, prescription 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. If not using the search field, the steps below outline Some prescriptions may require prior authorization or prior plan approval. These programs also help direct members to participating providers who embrace quality improvement. View or download the Quick Reference Guide. Learn more about our coverage options including health, Medicare, dental and vision options for you, your family or your employees. Important notice. Participating physicians who wish to view a special or supplemental fee schedule can contact their Network Management service representative to request a hard copy of the fee schedule. If the member’s group is not enrolled in the Carelon program indicated, PPA is not required for that procedure/drug in the specified place of service. This tool provides general information for outpatient services performed by a participating provider. Here, you can locate providers by name, specialty, county or zip code The Provider Search information is updated weekly. Fax: 919-765-4349. Within 90 days of claim adjudication date, complete and submit the level I provider commercial appeal form. S. The Enrolled Practitioner Search feature allows NCTracks providers to inquire about other providers enrolled in N. If you don't have an account, register now. Payments for services from a non-participating provider are generally sent to the member, except where federal or state mandates apply, or negotiated agreements are in place. Box 35 Durham, NC 27702 Customer Service. For example, to search for all dentists in cities starting with "C," enter "C" for the city. Claims information and online EOBs; Up-to-date information about your deductible and coinsurance; Estimated out-of-pocket costs for specific providers and services Ready to become a provider in the Anthem network? We look forward to working with you to provide quality service for our members. The organization does not use quality measures, member experience measures, or cost related measures to select any of our practitioners or hospitals for participation in the network, this includes those treating our Marketplace members. Dr. Local Provider Directory Find a doctor near you or search for other doctors in Louisiana and more. O. Within the United States, to search for a dentist by location, supply your city (optional) and state. However, a lot of providers practice at multiple locations and different practices. com Federal Employee Program Jan 25, 2021 · With over 90,000 providers participating in NC Medicaid, the available search options offer instructions about fields required to conduct a search and are designed to narrow search results to a level manageable to find the desired provider. You will need to contact Blue Cross NC Provider Service at 800-777-1643. Inquiries about our medical policies can be made by mail to the addresses listed below or you can call our Customer Service Department at 877-258-3334. We are committed to supporting you in providing quality care and services to Healthy Blue members. You can search by name, specialty, location and more. About Mental Health (cdc. Provider information contained in this directory is refreshed nightly with the exception of Pharmacy (refreshed monthly). They care for your health, coordinate your needs and refer you to specialists when you need them. BCBS FEP – It’s indicated with letter R followed by the id number. Blue Vision Directory Blue Cross and Blue Shield of North Carolina (Blue Cross NC) offers several decision-support tools to aid you in making decisions around your health care experience. These tools are offered for your convenience and should be used only as reference tools. pfmirz zbmh fayj nad augbvu xlm varklcj xmxn jzynqzwtn hypcc