In-State Eligibility, Benefits and Claim Status InformationOut-of-State (BlueCard®) Eligibility and Claim Status InformationChiropractic ServicesHealth Network Solutions, Inc. Show
(Blue Cross NC HMO & Blue Cross NC PPO) Contractual UpdatesUpdates to Notice Contract Address Credentialing and EnrollmentCredentialing Enrollment (to obtain billing numbers) Demographic UpdatesDisease ManagementHealthy Outcomes Tools for managing specific health conditions such as asthma, diabetes, or cardiovascular disease Electronic Claim SubmissionsElectronic claims submission Tools for managing specific health conditions such as asthma, diabetes, or cardiovascular disease Federal Employee Program (FEP)
Health Management (case management) Healthy Endeavors (disease management) Behavioral Health (mental health and substance use disorder) Precertification and Prior Approval Retail Pharmacy Fraud and Abuse
If you suspect healthcare fraud and abuse, please report the problem immediately to Blue Cross NC Healthcare Management and Operations (HM&O)Prospective review Prior review Admission certification Discharge planning Case management Continuity of care Submitting Precertification/Admission Notification or Continued Stay Review Blue e https://providers.bcbsnc.com/providers/login.faces 800.672.7897 Monday-Thursday 8 a.m. - 7 p.m. Friday 8 a.m. - 5 p.m. Voice Messaging System is available outside of regular business hours. Blue e https://providers.bcbsnc.com/providers/login.faces 800.672.7897 Behavioral Health (Mental Health and Substance Use Disorder)Behavioral Health Value Options (for members enrolled in SHP) 800.359.2422 800.367.6143 Office-Administered Specialty Drug NetworkMember-specific, dose-specific drugs delivered directly to your practice. Diagnostic Imaging Management ProgramCT/CTA scans MRI/MRA scans PET scans Nuclear cardiology studies Spanish Speaking PatientsBlue Cross NC offers a Spanish speaking customer service line for your patients State Health Plan (SHP)Strategic Provider RelationshipsQuestions regarding policies, procedures or guidelines (non-claims related) 800-777.1643 919.765.4349 Web Self Service Tools
If you're a provider who needs to contact us about one of our Blue Cross Blue Shield of Michigan, Blue Care Network or our Medicare products, start here. Find the right contact I need to contact about TTY users: To reach any number listed here, dial 711. Blue Cross Blue Shield of MichiganBehavioral healthBehavioral health services for Blue Cross Blue Shield of Michigan are managed by New Directions.® Medicare Plus BlueSM PPO services are managed by Medicare Plus Blue Behavioral Health. Our automated interactive voice response system provides claims, benefit and cost-share information. If you need more information, you can transfer to a customer service representative during business hours. Physicians and professionals: 1-800-344-8525 Customer service is available 8 a.m. to noon and 1 p.m. to 5 p.m. Monday through Friday. The automated system is available anytime. Blue Cross Blue Shield of Michigan1-800-762-2382 New DirectionsUse New Directions' WebPass tool. Federal Employees Program1- 800-342-5891 UAW Trust Retiree Medical Benefits Trust1-877-228-3912 Medicare Plus BlueSM PPOYou'll need to use e-referral for Medicare Plus Blue authorization requests. 1-888-803-4960 Fax: 1-866-315-0442 Mailing address for medical records for authorizationsCare Management--Mail Code C355 ClaimsLog in to secured provider portalGet fast, easy access to everything you need when you log in to the secured provider portal. Don't have a secured provider portal account yet? Providers who don't have an account can mail a claim to one of the
following:
UB-04 claims Federal Employee Program claims Blue Cross Complete claims Log in to secured provider portalGet fast, easy access to everything you need when you log in to the secured provider portal. If you don't have an account yet, you can check claims for BCBSM patients with our automated system. It can also send you a copy of your claim's status. Just keep in mind you'll need to go through the prompts before you're
connected to someone. Note: It can take up to 30 days for a claim to be processed. If you call before 30 days, we may not be able to check your claim through our automated phone system. Physicians and professionals: 1-800-344-8525 When you call:
Federal Employee Program providers and facilities: 1-800-482-3600 Log in to secured provider portalGet fast, easy access to everything you need when you log in to the secured provider portal. You can use our automated system to reach a representative to discuss your claim's outcome. Just keep in mind you'll need to go through the prompts before you're connected to someone. Physicians and professionals: 1-800-344-8525 When you call:
Federal Employee Program providers and facilities: 1-800-482-3600 Electronic Data InterchangeFraudTo report fraud, waste or abuse, call our hotline: 1-844-786-7392 Medicare fraud hotline1-888-650-8136 Blue Cross Complete of Michigan fraud hotline1-855-232-7640 Hospital Pay for PerformancePharmacy servicesClinical pharmacy help desk1-800-437-3803
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