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New BCBSNC Provider Service Model Effective November 1, 2011


Key Messages

  • Blue Cross and Blue Shield of North Carolina (BCBSNC) is introducing a new provider service model effective November 1, 2011, which will lead to better alignment of provider service functions and a more consistent service experience for providers and their staff.
  • Beginning November 1, 2011, day-to-day provider service and operational functions, including phone and field support, will be handled by BCBSNC's Provider Service Delivery team, which consists of customer service professionals, provider service associates, and provider service consultants.
  • With this transition of service and claims-related provider support to the Provider Service Delivery team, BCBSNC's Network Management will be able to focus on the more strategic aspects of provider relations, such as communications, education and provider advocacy efforts.

Questions and Answers

What will these changes mean for the provider community?
These changes will better align provider service and operational functions, which will now be handled by BCBSNC's Provider Service Delivery team, which includes customer service professionals, provider service associates and provider service consultants. By moving all day-to-day service functions to Provider Service Delivery, BCBSNC Network Management staff will be able to focus more on strategic provider relations and other provider-centric initiatives, such as communications, education, and provider advocacy efforts.

Who do I call with any service or claims-related questions?
As of November 1, provider service and operational functions, including phone and field support, will be handled by BCBSNC's Provider Service Delivery team. Whenever you call us via the Provider Blue LineSM at 1-800-214-4844, you will be assisted by someone on this team with your service or claims-related questions, as well as when you need specific member benefits or eligibility information.

Who do I call with any contract or credentialing-related questions?
You will continue to call BCBSNC Network Management at 1-800-777-1643 when you need assistance with contracting, network participation, credentialing status, or NPI configuration questions.

What happens if I call the wrong department on or after November 1?
Be assured that we will make sure your call is handled by the appropriate department or staff member. Refer to this chart for helpful information regarding which number you should call based on your type of question or after November 1:

Type of Call Responsible Dept. as of Nov. 1, 2011 Transfer Ext. or Toll-Free Number
Questions about claims, payments, refunds, benefits, eligibility, etc.) BCBSNC Provider Service Delivery Provider Blue Line at 1-800-214-4844
Credentialing status, Contracting questions, Demographic Changes, NPI Issues, etc. BCBSNC Network Management BCBSNC Network Management at 1-800-777-1643