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Providers Serving Out-Of-State Blue Cross and/or Blue Shield Medicare Advantage Members

The information below relates to provider terms and conditions for non-affiliated, out-of-state Blue Plans offering Medicare Advantage PFFS plans.

Blue Cross and Blue Shield companies (Blue Plans) are independent, non-affiliated entities that offer a variety of health care products; some offer Medicare Advantage PFFS plans in their area. BCBSNC does not offer a Medicare Advantage PFFS product. Through the Blue Cross and Blue Shield Association, however, BCBSNC provides an on-line search tool for providers who accept Medicare and who are serving patients who have a Medicare Advantage PFFS policy with another Blue plan. This search tool allows providers to review the Terms and Conditions of participation that a provider must accept to see a patient with an out-of-state PFFS policy as offered by another Blue plan.

Please enter the first three letters of the member’s identification number on the Blue Cross Blue Shield Medicare Advantage PFFS card and click “GO” to view the BCBS Medicare Advantage PFFS Plan’s Terms & Conditions for providers.

If the first three letters of the member’s identification number are “XDV”, please select the appropriate plan name in the drop down box before clicking “GO”. Otherwise, it is not necessary to select a plan name.


Alpha Prefix:

Plan:

If you experience any difficulties, please call 1-800-676-BLUE.



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Blue Cross and Blue Shield of North Carolina (BCBSNC) is not responsible for and does not maintain the information contained in the search tool. BCBSNC cannot vouch for the accuracy of the information contained therein.

Blue Cross and Blue Shield of North Carolina (BCBSNC) is a Medicare Advantage organization with a Medicare contract to provide HMO and PPO plans. BCBSNC does not discriminate based on color, gender, religion, national origin, age, race, disability, handicap, sexual orientation, genetic information, source of payment or health status as defined by the Centers for Medicare & Medicaid Services (CMS). All qualified Medicare beneficiaries may apply. You must be entitled to Medicare Part A and enrolled in Medicare Part B and must reside in the CMS-approved service area. You must continue to pay your Medicare Part B premium, if not otherwise paid for under Medicaid or another third party. BCBSNC is an independent licensee of the Blue Cross and Blue Shield Association.