Skip to main content
Shop Plans Learn more about our coverage options including health, Medicare, dental and vision options for you, your family or your employees. Get Started Individual & Family Medicare Employer Vision Dental International Travel Find Care FAQ Blog Members Stay on top of your health care with helpful member resources. Members Home Medicare Health Dental Vision Find Care Member Knowledge Center Member Forms Medicare Forms Library Make a Payment Federal Employees Student Blue Healthy Blue Providers Access tools, policies and the latest information to help you care for our members. Providers Home Network Participation Networks & Programs Claims, Appeals & Inquiries Prior Authorization Services & CPT codes Prescription Drug Search Forms and Documents Policies, Guidelines & Codes Provider News Provider FAQ Contact Us Employers Learn about our coverage options for small and large employers, and access tools and resources for your group. Employers Home Shop Employer Plans Employer Portal Support Member Forms & Resources Find Care Blog Agents Access the tools you need: rate quotes, applications, forms, the latest industry news, marketing materials and more. Agents Home Agent Services Check Eligibility Find Care Member Forms & Resources Medicare Forms Library
Contact Us
Log In
I am ... Please select A member A provider An employer An agent
Log in to Agent Services
Log in to Employer Services Register for Employer Services I'm registered but need portal access
Username Forgot username? Continue to Log In Register for the member portal Need help? Learn how to log in.
Log in to Blue e Register for Blue e Log in to Dental Blue
Blue Cross NC Home Providers Networks & programs Quality-based programs Top performing providers Top performing providers

Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is introducing a designation that recognizes high-performing providers who consistently meet established performance criteria. 

Eligible providers will receive a “Top Performing Provider” designation in Find Care to help members identify providers who meet Blue Cross NC’s performance criteria when searching for care.

How the designation is determined

Blue Cross NC uses available claims, administrative and specialty data to evaluate provider performance. Defined performance measures and established methodologies determine how results are calculated, compared, and used in designation decisions.

Step 1: Collect data from sources

  • Claims
  • Member eligibility
  • Enrollment
  • Specialty information
  • Data from our analytics partners Motive Medical Intelligence and Blue Health Intelligence
Step 2: Measure performance

  • Quality of care
  • Appropriateness of care
  • Cost of care
Step 3: Determine designation with methodology

  • Measure selection
  • Attribution
  • Benchmarking
  • Scoring
Provider Performance Analytics Core Methodology Guide (PDF) Top Performing Provider Quality Designation (PDF)
Provider designation eligibility and review process

A provider may not receive the Quality Designation if the applicable performance evaluation does not meet designation criteria based on the available claims-based methodology, specialty-specific measures, data availability, minimum thresholds, or composite performance results. The evaluation may include factors such as adherence to evidence-based clinical guidelines, quality of care, clinical appropriateness of care, and cost of care, depending on the specialty and available data. 

Providers who have questions about how the designation was determined, how the methodology was applied, or why a designation does or does not appear in Find Care may contact us through the Provider Analytics Inquiry process.

Contact

If you have questions, please contact the Provider Performance Analytics Team at provideranalyticsinquiry@bcbsnc.com.

Blue Cross NC Provider Performance Analytics is intended to support provider education, transparency, and continuous improvement. Methodologies are reviewed periodically and may evolve based on updated clinical evidence, data availability, stakeholder feedback, regulatory considerations, and operational improvements.

About Us Newsroom Blog Member Forms Transparency in Coverage Find Care Rights & Responsibilities Policies & Best Practices Privacy Policy Website User Agreement Fraud & Abuse Technical Information Contact Us Locations Careers Developers

Blue Cross and Blue Shield of North Carolina does not discriminate on the basis of race, color, national origin, sex, age or disability in its health programs and activities. Learn more about our non-discrimination policy and no-cost services available to you.

Information in other languages: Español   中文   Tiếng Việt   한국어   Français   العَرَبِيَّة   Hmoob   ру́сский   Tagalog   ગુજરાતી   ភាសាខ្មែរ   Deutsch   हिन्दी   ລາວ   日本語

Technical Information   Privacy Policy   Terms of Use   Fraud & Abuse   Linked Apps

© 2026 Blue Cross and Blue Shield of North Carolina. ®, SM Marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans. All other marks and names are property of their respective owners. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association.