Provider.healthybluenc.com

Healthy Blue North Carolina Providers

WEBBlue Cross NC embraces the mission to improve the health and well-being of members and communities. On this site, you will find resources that help health care professionals do …

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URL: https://provider.healthybluenc.com/north-carolina-provider/home

Behavioral Health

WEBBehavioral health. Member Services: 844-594-5070 Provider Services: 844-594-5072 Behavioral Health Crisis Line: 844-594-5076. Integrated health care. Blue Cross and …

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Provider Resources

WEBThe behavioral health provider network for Healthy Blue members includes psychiatrists, psychologists, social workers, psychiatric nurses, and other mental health and …

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Prior authorization requirements

WEBBehavioral health. Services billed with the following revenue codes always require prior authorization:. 0240–0249 — All-inclusive ancillary psychiatric; 0513 — Psychiatric clinic …

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Provider Manuals and Guides

WEBProvider Manual. Healthy Blue’s provider manual provides key administrative information including the quality improvement program, the UM program, quality standards for …

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Eligibility & Provider Report

WEBSelect the health plan. From the Payer Spaces homepage, select the Resources tab. From the Resources tab, select Provider Online Reporting. If you don't see it in the list, select …

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Guide to drug coverage under medical benefit Healthy Blue

WEBGuide to drug coverage under medical benefit. Prescription drugs are covered in two ways—through the Healthy Blue pharmacy benefit or via medical benefit. The method of …

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Healthcare Effectiveness Data and Information Set (HEDIS)

WEBThe Healthcare Effectiveness Data and Information Set (HEDIS) The Healthcare Effectiveness Data and Information Set (HEDIS®) is a tool used by more than 90% of …

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Behavioral Health Overview

WEBMembers have access to the Behavioral Health Crisis Line 24/7, 365 days a year through a confidential, toll-free number with immediate access to trained, skilled, licensed …

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Full list of Medical Policies and Clinical Guidelines

WEBMedical Policy. Administrative. ADMIN.00006 Review of Services for Benefit Determinations in the Absence of a Company Applicable Medical Policy or Clinical …

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Search Medical Policies and Clinical Guidelines

WEBThere are several factors that impact whether a service or procedure is covered under a member’s beneﬁt plan. Medical policies and clinical utilization management (UM) …

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Join Our Network

WEBFor contracting questions, call Healthy Blue Provider Services at 1-844-594-5072 or via email at [email protected]. Blue Cross and Blue Shield of North Carolina …

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Fact Sheet Telehealth Program

WEBNC Medicaid 3. of . 4 20210614. WHAT IS THE DIFFERENCE BETWEEN TELEHEALTH THROUGH MEDICAID DIRECT, VERSUS TELEHEALTH IN MANAGED CARE? …

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Maternal Child Services

WEBHealthy Blue is here to support providers, pregnant members, and their little ones on the way. If you would like more information about the OB Care Management program or …

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Learn about Availity

WEBLearning opportunities. Find learning opportunities to assist with administering your patient’s health plan using Availity Essentials multi-payer features and payer spaces applications. …

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Telehealth Quick Reference Guide

WEBto improve access to health care in rural communities. CRHI’s Health-e-Schools program is designed to improve access to health care for students through telemedicine. •To learn …

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Frequently Asked Questions

WEBone of several prepaid health plans (PHPs) selected by the North Carolina Department of Health and Human Services (NC DHHS) to manage the care of Medicaid members. …

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