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Blue Medicare HMO Blue Medicare PPO

Provider resources and information

We are pleased to offer the Blue Medicare HMOSM and Blue Medicare PPOSM providers a variety of online information and resources. If there are questions, please contact us.

Resources and forms includes:
  • Online provider manual
  • Information about drugs requiring prior approval or quantity limitations
  • Formulary information
  • Request forms for prior approval for drugs or nonformulary drugs
  • Referral forms
  • Medicare payer sheets
  • Provider newsletters
  • Provider field office contact information
  • And more
Policies and responsibilities includes information about:
  • Prior authorization
  • Credentialing and contracting
  • Policies
  • Responsibilities of primary care physicians
  • Specialty networks
Medical management programs and services includes information about:
  • Programs and services
  • Review processes for health care services
  • Quality Improvement Program
Electronic commerce includes:
  • Resources for electronic batch processing
Contact information

Blue Medicare HMO and Blue Medicare PPO plans are offered by PARTNERS National Health Plans of North Carolina, Inc., a subsidiary of Blue Cross and Blue Shield of North Carolina (BCBSNC). PARTNERS is a Medicare Advantage organization with a Medicare contract to provide HMO and PPO plans. Plans are administered by BCBSNC. BCBSNC and PARTNERS do 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 and PARTNERS are independent licensees of the Blue Cross and Blue Shield Association.

National Provider Identifier