Blue cross blue shield customer service for providers

In-State Eligibility, Benefits and Claim Status Information


Out-of-State (BlueCard®) Eligibility and Claim Status Information


Chiropractic Services

Health Network Solutions, Inc.

(Blue Cross NC HMO & Blue Cross NC PPO)


Contractual Updates

Updates to Notice Contract Address


Credentialing and Enrollment

Credentialing

Enrollment

(to obtain billing numbers)


Demographic Updates


Disease Management

Healthy Outcomes

Tools for managing specific health conditions such as asthma, diabetes, or cardiovascular disease


Electronic Claim Submissions

Electronic claims submission

Tools for managing specific health conditions such as asthma, diabetes, or cardiovascular disease


Federal Employee Program (FEP)

  • Benefits

  • Claims

  • Eligibility

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 Network

Member-specific, dose-specific drugs delivered directly to your practice.


Diagnostic Imaging Management Program

CT/CTA scans

MRI/MRA scans

PET scans

Nuclear cardiology studies


Spanish Speaking Patients

Blue Cross NC offers a Spanish speaking customer service line for your patients


State Health Plan (SHP)


 Strategic Provider Relationships

Questions 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 Michigan

Behavioral health

Behavioral 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
Hospitals or facilities: 1-800-249-5103

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 Michigan

1-800-762-2382
8:30 a.m. to 6 p.m.
Monday through Friday

New Directions

Use New Directions' WebPass tool.

Federal Employees Program

1- 800-342-5891

UAW Trust Retiree Medical Benefits Trust 

1-877-228-3912

Medicare Plus BlueSM PPO

You'll need to use e-referral for Medicare Plus Blue authorization requests.

1-888-803-4960
8 a.m. to noon and 1 to 5 p.m.
Monday through Friday

Fax: 1-866-315-0442

Mailing address for medical records for authorizations

Care Management--Mail Code C355
Blue Care Network
20500 Civic Center Drive
Southfield, MI 48075

Claims

Log in to secured provider portal

Get 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:


Medicare Plus BlueSM PPO claims
Blue Cross Blue Shield of Michigan
P.O. Box 32593
Detroit, MI 48232-0593

UB-04 claims
Blue Cross Blue Shield of Michigan
P.O. Box 310166
Detroit, MI 48231-0166

Federal Employee Program claims
Blue Cross Blue Shield of Michigan
P.O. Box 312599
Detroit, MI 48231-2599

Blue Cross Complete claims
P.O. Box 7355
London, KY 40742

Log in to secured provider portal

Get 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
Hospitals or facilities: 1-800-249-5103
Vision and hearing providers: 1-800-482-4047

When you call:

  1. Step 1: Say "claims" when the system asks why you're calling.
  2. Step 2: Answer the system's prompts about your patient and whether you provided care in Michigan.
  3. Step 3: Enter the following information:
    • Your 10-digit national provider identifier, BCBSM PIN or facility code
    • The member’s contract number, date of birth, the spelling of their first name and their ZIP code
  4. Step 4: Say "no" when asked if you have additional questions about the determination of a claim.
  5. Step 5: Tell the system the date of service provided.
  6. Step 6: Tell the system the total amount charged.
  7. Step 7: Listen to your claim's status, which includes the following information:
    • Claim number
    • Payment date and amount
    • Check number and post date
    • Member liability, including deductible, coinsurance and copays
  8. Step 8: After listening to the claim's status, you'll have the following choices:
    • Say "representative" to reach someone who can help.
    • Say "date of service" to learn about a different claim.
    • Say "another member" to inquire on another member.
    • Say "another contract" to inquire on another contract.
    • Say "fax or email" to receive a copy of your claim's status.

Federal Employee Program providers and facilities: 1-800-482-3600
    Note: The FEP phone system has a different set of prompts than the others.

Log in to secured provider portal

Get 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
Hospitals or facilities: 1-800-249-5103
Vision and hearing providers: 1-800-482-4047

When you call:

  • Step 1: Say "claims" when the system asks why you're calling.
  • Step 2: Answer the prompts about your patient and whether you provided care in Michigan.
  • Step 3: Enter the following information:
    • Your 10-digit national provider identifier, BCBSM PIN or facility code
    • The member’s contract number, date of birth, the spelling of their first name and their ZIP code
  • Step 4: Say "yes" when asked if you have additional questions about the determination of the claim.
  • Step 5: Tell the system the date of service.
  • Step 6: You will then be transferred to the servicing center for assistance.

Federal Employee Program providers and facilities: 1-800-482-3600
    Note: The FEP phone system has a different set of prompts than the others.

Electronic Data Interchange

Fraud

To report fraud, waste or abuse, call our hotline:

1-844-786-7392

Medicare fraud hotline

1-888-650-8136

Blue Cross Complete of Michigan fraud hotline

1-855-232-7640

Hospital Pay for Performance

Pharmacy services

Clinical pharmacy help desk

1-800-437-3803
8 a.m. to 6 p.m.
Monday through Friday


Express Scripts technical help desk

1-800-922-1557


Submit prior authorization requests electronically through Express Scripts' CoverMyMeds.

Physician Group Incentive Program

If you're interested in joining the Physician Group Incentive Program, also known as PGIP, or want more information, email . 

You can also talk to your provider consultant.

Prior authorization

Provider enrollment

Have your NPI, Tax ID or Social Security number ready before calling.

1-800-822-2761
8 a.m. to 4 p.m.
Monday through Friday

Fax: 1-866-900-0250

Provider consultants

Provider inquiry

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.

Michigan providers

1-800-344-8525
8:30 a.m. to noon and 1 to 5 p.m.
Monday through Friday
The automated system is available anytime.

Vision and hearing

1-800-482-4047
8:30 a.m. to noon and 1 to 5 p.m.
Monday through Friday
The automated system is available anytime.

Providers outside of Michigan

1-800-676-2583

Inquiries for Blue Cross employees only

1-877-258-0167
8:30 a.m. to noon and 1 to 5 p.m.
Monday through Friday

You can write to us by finding your area code with the relevant mailing address.

Area codes: 248, 313, 517, 734, 810, 947, 989 or outside Michigan

Facility and Special Programs
Provider Inquiry — Mail Code 0301
Blue Cross Blue Shield of Michigan
P.O. Box 33248
Detroit, MI 48232-4248

Area codes: 734, 810, 947, 989 or outside Michigan

Provider Inquiry
Blue Cross Blue Shield of Michigan
P.O. Box 2227
Detroit, MI 48321-2227

Area codes: 231, 269, 616

Blue Cross Blue Shield of Michigan
P.O. Box 230589
Grand Rapids, MI 49523-0589

Area code: 906

Provider Inquiry
Blue Cross Blue Shield of Michigan
415 S. McClellan Ave.
Marquette, MI 49855

For questions about Blue Cross employees only

Employee Inquiry
232 S Capitol Ave
L07B
Lansing, MI 48933

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.

Michigan hospitals and facilities

1-800-249-5103
8:30 a.m. to noon and 1 to 5 p.m.
Monday through Friday
The automated system is available anytime.

Outside-of-Michigan hospitals and facilities

1-800-676-2583

Inquiries for Blue Cross employees only

1-877-258-0167
8:30 a.m. to noon and 1 to 5 p.m.
Monday through Friday

You can write to us by matching your area code with the relevant mailing address.

Area codes: 248, 313, 517, 734, 810, 947, 989 or outside Michigan

Facility and Special Programs
Provider Inquiry — Mail Code 0301
Blue Cross Blue Shield of Michigan
P.O. Box 33248
Detroit, MI 48232-4248

Area codes: 734, 810, 947, 989 or outside Michigan

Provider Inquiry
Blue Cross Blue Shield of Michigan
P.O. Box 2227
Detroit, MI 48321-2227

Area codes: 231, 269, 616

Blue Cross Blue Shield of Michigan
P.O. Box 230589
Grand Rapids, MI 49523-0589

Area code: 906

Provider Inquiry
Blue Cross Blue Shield of Michigan
415 S. McClellan Ave.
Marquette, MI 49855

For questions about Blue Cross employees only

Employee Inquiry
232 S Capitol Ave
L07B
Lansing, MI 48933

Blue Care Network

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
Hospitals or facilities: 1-800-249-5103

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.

Use e-referral for authorizations for Blue Care Network and BCN AdvantageSM members.

BCN

1-800-482-5982
8 a.m. to noon and 1 to 5 p.m.
Monday through Friday

Fax: 1-877-706-1993

BCN Advantage

1-800-431-1059
8 a.m. to noon and 1 to 5 p.m.
Monday through Friday

Fax: 1-877-706-1993

Mailing address for medical records for authorizations

Care Management--Mail Code C355
Blue Care Network
20500 Civic Center Drive
Southfield, MI 48075

Physician determination review line

1-877-293-2788
8 a.m. to 5 p.m.
Monday through Friday

Claims

Log in to secured provider portal

Get fast, easy access to everything you need when you log in to the secured provider portal.

Providers who don't have an account yet can mail a claim to one of the following:

Blue Care Network Claims
P.O. Box 68710
Grand Rapids, MI 49516-8710

BCN Advantage Claims
P.O. Box 68753
Grand Rapids, MI 49516-8753

Blue Cross Complete Claims
P.O. Box 7355
London, KY 40742

Log in to secured provider portal

Get 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 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
Hospitals or facilities: 1-800-249-5103
Vision and hearing providers: 1-800-482-4047
Federal Employee Program providers and facilities: 1-800-840-4505

When you call:

  • Step 1: Say "claims" when the system asks why you're calling.
  • Step 2: Answer the system's prompts about your patient and whether you provided care in Michigan.
  • Step 3: Enter the following information:
    • Your 10-digit national provider identifier, BCBSM PIN or facility code
    • The member’s contract number, date of birth, the spelling of their first name and their ZIP code
  • Step 4: Say "no" when asked if you have additional questions about the determination of a claim.
  • Step 5: Tell the system the date of service provided.
  • Step 6: Tell the system the total amount charged.
  • Step 7: Listen to your claim's status, which includes the following information:
    • Claim number
    • Payment date and amount
    • Check number and post date
    • Member liability, including deductible, coinsurance and copays
  • Step 8: After listening to the claim's status, you'll have the following choices:
    • Say "representative" to reach someone who can help.
    • Say "date of service" to learn about a different claim.
    • Say "same member" to inquire on another member.
    • Say "another contract" to inquire on another contract.
    • Say "fax or email" to receive a copy of your claim's status.

Log in to secured provider portal

Get 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
Hospitals or facilities: 1-800-249-5103
Vision and hearing providers: 1-800-482-4047
Federal Employee Program providers and facilities: 1-800-840-4505

When you call:

  • Step 1: Say "claims" when the system asks why you're calling.
  • Step 2: Answer the prompts about your patient and whether you provided care in Michigan.
  • Step 3: Enter the following information:
    • Your 10-digit national provider identifier, BCBSM PIN or facility code
    • The member’s contract number, date of birth, the spelling of their first name and their ZIP code
  • Step 4: Say "yes" when asked if you have additional questions about the determination of the claim.
  • Step 5: Tell the system the date of service.
  • Step 6: You will then be transferred to the servicing center for assistance.

Electronic Data Interchange

Fraud

To report fraud, waste or abuse, call our hotline:

1-844-786-7392

Medicare fraud hotline

1-888-650-8136

Blue Cross Complete of Michigan fraud hotline

1-855-232-7640

Pharmacy services

Clinical pharmacy help desk

1-800-437-3803
8 a.m. to 6 p.m.
Monday through Friday


Express Scripts technical help desk

1-800-922-1557


Submit prior authorization requests electronically through Express Scripts' CoverMyMeds.

Prior authorization

Provider enrollment

1-800-822-2761
8 a.m. to 4 p.m.
Monday through Friday

Fax: 1-866-900-0250

Provider consultants

Provider inquiry

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.

Michigan providers

1-800-344-8525
8:30 a.m. to noon and 1 to 5 p.m.
Monday through Friday
The automated system is available anytime.

Vision and hearing

1-800-482-4047
8:30 a.m. to noon and 1 to 5 p.m.
Monday through Friday
The automated system is available anytime.

Providers outside of Michigan

1-800-676-2583

Inquiries for Blue Cross employees only

1-877-258-0167
8:30 a.m. to noon and 1 to 5 p.m.
Monday through Friday

You can write to us by finding your ZIP code with the relevant mailing address.

Area codes: 248, 313, 517, 734, 810, 947, 989 or outside Michigan

Facility and Special Programs
Provider Inquiry — Mail Code 0301
Blue Cross Blue Shield of Michigan
P.O. Box 33248
Detroit, MI 48232-4248

Area codes: 734, 810, 947, 989 or outside Michigan

Provider Inquiry
Blue Cross Blue Shield of Michigan
P.O. Box 2227
Detroit, MI 48321-2227

Area codes: 231, 269, 616

Blue Cross Blue Shield of Michigan
P.O. Box 230589
Grand Rapids, MI 49523-0589

Area code: 906

Provider Inquiry
Blue Cross Blue Shield of Michigan
415 S. McClellan Ave.
Marquette, MI 49855

For questions about Blue Cross employees only

Employee Inquiry
232 S Capitol Ave
L07B
Lansing, MI 48933

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.

Michigan hospitals and facilities

1-800-249-5103
8:30 a.m. to noon and 1 to 5 p.m.
Monday through Friday
The automated system is available anytime.

Outside-of-Michigan hospitals and facilities

1-800-676-2583

Inquiries for Blue Cross employees only

1-877-258-0167
8:30 a.m. to noon and 1 to 5 p.m.
Monday through Friday

You can write to us by matching your area code with the relevant mailing address.

Area codes: 248, 313, 517, 734, 810, 947, 989 or outside Michigan

Facility and Special Programs
Provider Inquiry — Mail Code 0301
Blue Cross Blue Shield of Michigan
P.O. Box 33248
Detroit, MI 48232-4248

Area codes: 734, 810, 947, 989 or outside Michigan

Provider Inquiry
Blue Cross Blue Shield of Michigan
P.O. Box 2227
Detroit, MI 48321-2227

Area codes: 231, 269, 616

Blue Cross Blue Shield of Michigan
P.O. Box 230589
Grand Rapids, MI 49523-0589

Area code: 906

Provider Inquiry
Blue Cross Blue Shield of Michigan
415 S. McClellan Ave.
Marquette, MI 49855

For questions about Blue Cross employees only

Employee Inquiry
232 S Capitol Ave
L07B
Lansing, MI 48933

Vision provider

Claims

VSP Provider service: 1-800-615-1883

In-network providers

Blue Vision providers submit claims electronically directly to VSP.

Out-of-network providers

If you're not a Blue Vision provider, send claims to:

VSP 
PO Box 385018
Birmingham, AL 35238-0518

Vision providers who can't access their account or need more information can read the Blue Vision Provider Summary Guide (PDF) to learn how to:

• Submit claims, appeals and attachments
• Verify patient eligibility and benefits
• Contact customer service

Heritage Provider service: 1-800-252-2053

In-network providers

Essential Vision providers submit claims through Heritage Vision Plan.

Out-of-network

If you're not an Essential Vision provider, send claims to:

Heritage Vision Plans, Inc.
Attention: Claim Processing
One Woodward Avenue, Suite 2020
Detroit, MI 48226

Dental provider

Care, payment and claims

Dental providers should log in to their secured portal to contact someone for questions about care, payment and claims.

Dental providers who can't able to access their account can read the  Dental Summary Guide (PDF) to learn how to:

  • Submit claims, appeals and attachments
  • Verify patient eligibility and benefits
  • Contact customer service

To use the document, you'll need to know if your patient has a Medicare Advantage plan, Federal Employee Program plan or a commercial plan.

If you need additional guidance, read the Dentaquest Dental Manual (PDF).

Inquiry

Group and Medicare Supplement plans

1-888-826-8152
8 a.m. to 7 p.m.
Monday through Friday
Automated information is available anytime.

Medicare Advantage: Medicare Plus BlueSM and BCN Advantage plans

1-844-876-7917
8 a.m. to 7 p.m.
Monday through Friday
Automated information is available anytime.

Federal Employee Program plans

1-855-504-2583
8:30 a.m. to 4:30 p.m.
Monday through Friday
Automated information is available anytime.

How do I speak to a representative at BCBS Il?

Contact Us.
Member Services. 1-877-860-2837 (TTY/TDD: 711) Call to ask about your plan benefits, help finding a provider, to change your PCP, and much more. ... .
24/7 Nurseline. 1-888-343-2697 (TTY/TDD: 711) Our 24/7 Nurseline lets you talk in private with a nurse about your health. ... .
By Mail. Blue Cross Community Health Plans..

How do I verify BCBS of Illinois?

Patient eligibility and benefits should be verified prior to every scheduled appointment..
Blue Cross Community Health PlansSM (BCCHP) – 877-860-2837..
Blue Cross Community MMAI (Medicare-Medicaid Plan)SM – 877-723-7702..
Blue Cross Medicare AdvantageSM – 877-774-8592..

Is BCBS the same as BCBS of Texas?

BCBSTX is a Division of Health Care Service Corporation (which operates Blue Cross and Blue Shield plans in Texas, Illinois, Montana, Oklahoma and New Mexico), the country's largest customer-owned health insurer and fourth largest health insurer overall.

How do I contact BCBS Texas?

Call us toll-free at 1-888-657-6061 (TTY 711).