Providers
Commercial claims, appeals, and inquiries
Find out when and how to file.
Submit a claim
Submit a commercial claim to Blue Cross and Blue Shield of North Carolina (Blue Cross NC).
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Once you select the form, you'll be prompted to log in to Blue e where you can complete and submit it.
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CMS 1500 Digital Form
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UB04 Digital Form
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EDI
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You can submit commercial claims electronically as a trading partner or with a third-party clearinghouse. In either case, you or your clearinghouse will need to complete the required forms before we can accept and process any claims.
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Become a Trading Partner
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Mail
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Print, complete, and mail paper claim form to:
Blue Cross NC
PO Box 35
Durham, NC 27702
Make sure all claims and attachments have member’s Blue Cross NC ID.
Use black ink when printing and completing the forms.
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CMS 1500 Digital Form (PDF)
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UB04 Digital Form (PDF)
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Need help submitting a claim?
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For assistance with digital forms:
eSolutions Help Desk
888-333-8594, Option 1
Monday through Thursday, 8 AM to 5 PM ET, and Friday, 8 AM to 4 PM ET
For assistance with mailing paper forms:
Provider Blue Line
800-214-4844
Monday through Thursday, 8 AM to 5 PM ET, and Friday, 8 AM to 4 PM ET
File an appeal
File an appeal when you are disputing the billing, coding, or medical necessity of a claim.
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Use the Blue e and Care Affiliate provider portal for a streamlined and efficient process to file your appeal along with supporting documentation.
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Log In to Blue e
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Mail or fax
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Complete and file the Provider Coding Dispute Form or the Provider Commercial Appeal Form along with supporting documentation.
Mail:
Blue Cross NC
Provider Appeals Department
PO Box 2291
Durham, NC 27702-2291
Fax:
- Billing and coding denials: 919-287-8708
- Medical necessity and administrative denials: 919-287-8709
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Provider Coding Dispute Form (PDF)
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Provider Commercial Appeal Form (PDF)
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Need help filing an appeal?
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Reach out to our appeals department for support.
800-214-4844 (toll-free)
File an inquiry
File an inquiry when you have a contractual dispute that is not related to billing, coding, or medical necessity.
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Mail or fax
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Mail:
Blue Cross NC
Provider Inquiry Department
PO Box 2291
Durham, NC 27702-2291
Fax:
866-987-4167
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General Inquiry Form (PDF)
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Need help filing an inquiry?
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Reach out to our inquiry department for support.
800-214-4844 (toll-free)