BCBSNC Disclosures

This web page contains important information and links regarding BCBSNC compliance with the Thomas/Love Settlement.

• Prompt Payment / Late Payment Interest NEW!
• External Level II Provider Appeals Process NEW!
  • Effective November 21, 2008, Physicians, Physician Groups, and Physician Organizations may file a Level II Post-Service Provider Appeal for medical necessity or billing disputes. Level II Provider Appeals are conducted by an Independent Review Organization, and there is a filing fee associated with all requests for a Level II Post-Service Provider Appeal.
• Explanation of Benefits (EOB) form updates NEW!
• Explanation of Payment (EOP) form updates NEW!

Additional Information

• Information about Your Fee Schedule
• Provider Fee Schedules in Blue e FAQ
• Information About Claims Submission
• Information About Overpayments
• Joint Advisory Group (JAG)
• List of physicians, including participating psychiatrists
• Medical Policies
  • Definition of Medical Necessity
  • Administrative Guidelines, including Limited Code Combinations/Modifiers
• Member Consent for Release of Clinical Information (for use with Magellan)
• Prior Review/Prior Plan Approval Information
• Routine Review of Clinical Information
• Update Your Information
  • Changes to provider directory information

BCBSNC Disclosures Requiring Secure Logon

Certain disclosures, such as significant claims edits, Clear Claims Connection or Joint Advisory Group information require secure log-on through Blue e. Once logged in, click on "BCBSNC Disclosures" on the left side of the page, under "Administrator." If you do not have access to Blue e, please register here.

Recent Communications

• Provider Update Q2 2008
• Provider Update Q1 2008