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Making Cost and Quality Information Available to BCBSNC Customers

Blue Cross and Blue Shield of North Carolina (BCBSNC) will be introducing a new cost and quality tool designed to help the customers we serve better leverage their health care coverage and make decisions impacting their health, well-being, and financial security. The new tool is being offered on line to our customers at and will provide data on cost ranges, quality, and out-of-pocket expenses, based on medical treatment categories and customer selected provider choices.

BCBSNC is offering this cost and quality tool to make it possible for our customers to make better informed health care decisions in those instances when members have choices they can make about the health care services they receive. The tool will be made available to our customers beginning late July 2011, at which time cost range information for 59 specific treatment categories will be available for BCBSNC customers who log on at and use the provider search tool or access the health care cost estimator tool.

Additional tool enhancements will be released in phased intervals throughout the remainder of 2011. Additionally, 40 treatment categories will be added later this fall, to be followed by member's out-of-pocket estimator, and provider quality and accreditation information becoming available by the end of the year for 11 select radiology services.

Phase 1: Cost - Becoming available late July 2011. BCBSNC will begin offering our customers cost data for 59 treatment categories from the Blue Cross and Blue Shield Association's (BCBSA) National Consumer Cost Tool (NCCT), which provides estimated costs for certain common, high-volume elective services (including 40 + additional treatment categories to be added this coming Fall). The estimates come exclusively from data reported on health insurance claims. Treatment costs reflect a range of allowed amounts for the most common elective services at network hospitals, ambulatory surgery centers, imaging centers and doctors- offices across the country.

Phase 2: Out of Pocket Expense - Coming late 2011. BCBSNC will begin offering to our members their estimated out-of-pocket expenses (most recent deductible and co-insurance data) for the 59+ treatment categories. The out of pocket information will be calculated via HIPAA 270-271 transactions and feeds.

Phase 3: Quality and Accreditation - Coming late 2011. BCBSNC will provide our members access to quality information for 11 radiology services when performed at imaging facilities based on accreditations achieved by the following national accrediting bodies:

  • American College of Radiology
  • Intersocietal Accreditation Commission
  • Joint Commission on Accreditation of Healthcare Organizations

Please look for additional announcements and information from BCBSNC as additional functionality is added to the tool. If you have any additional questions, please feel free to contact your dedicated Network Management Provider Relations team member.