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An Insurance Representative, also called a Provider Representative or Provider Network Consultant, serves as the liaison between Blue Cross and Blue Shield and the contracted provider community.
A ?precertification review? is conducted before the treatment has been provided and allows the health plan to decide if the requested treatment satisfies the plan's requirements for medical necessity.
Providers who want to contract with Blue Cross NC Once you have become credentialed and enrolled with your registered NPI number and tax ID, you can begin the contracting process. To begin the process, call 800-777-1643 (option 6). Please allow at least 60 days for Blue Cross NC to process your application.
Visit BlueCrossNC.com/Claims for prescription drug, dental and international claim forms, or call the toll-free number on your ID card. SECTION 1: Patient Information Please enter the subscriber number from your ID card. Please complete the information below if the patient is covered by another health insurance policy.
To make a one-time payment by phone, call 844-395-4535. Available payment methods by phone include debit cards, credit cards or bank draft. You can make a one-time payment online and by phone. To pay online, log into your Blue Connect account.
Review and Quiz QuestionAnswerWhich concept applies when BCBS directly reimburses participating providers for health care services rendered to subscribers?Assignment of benefitsA third-party administrator is a company thatprovides administrative services to health care plans208 more rows
-In return, BCBS corporations agree to: -Make direct payments to PARs. -Conduct regular training sessions for PAR billing staff. Provide free billing manuals and PAR newsletters.
Health Insurance today Chapter 11, QuestionAnswerWhich is a program that requires providers to adhere to managed care provisionspreferred provider networkOne of the expectations that nonparticipating provider has is to_____for services rendered:obtain payment for the full fee charged33 more rows