"The Largest Insurer in North Carolina with 3.6 million insured."
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Experienced insurance agents who can assist you with making the right choice for yourself and your family. |
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Plans with convenient copayments for doctor visits, emergency room services, urgent care, physicals, and more. |
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Blue Advantage offers the largest network of doctors and hospitals in North Carolina. |
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You are covered throughout the United States and in more than 200 countries and territories worldwide.
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FAQs
Physicians & Other Providers
How do I find a network provider?
What is a primary care physician?
What are the advantages of
using network providers?
What happens if my current
physician is not a network provider?
How do I change my primary
care provider?
Can I change my primary care
provider any time I want?
What if a primary care physician
cannot see me right away?
What if a network provider
isn't available to treat my condition?
Can I go to a non-network provider?
Q: How do I find
a network provider?
A: Access the most up-to-date provider
information with our online Provider Search. Here, you
can locate providers by name, specialty, county or zip
code The Provider Search information is updated weekly.
You can also contact Customer Service at 1-800-914-4220
for assistance locating a provider or to obtain a paper
copy of a directory. Additionally, many employers stock
directories in their Benefits Department.
Q: What is a primary
care physician?
A: BCBSNC believes in the value of maintaining
a relationship with a primary care provider. These providers
are general practice, family practice, internal medicine
and pediatric doctors who deal with a broad range of health
care issues. They also help members manage their health
and make decisions about their health care needs.
In addition, participating primary care providers participate
in cost-saving quality assurance and utilization management
programs. They also coordinate patient care, allowing
the patient to easily navigate the health care system.
These activities serve to enhance the physician-patient
relationship, as well as increase the practice of cost-effective,
high-quality medicine.
Q: What are the
advantages of using network providers?
A: Network providers agree to:
Provide medical care at cost saving rates File claims
for you Coordinate prior plan approvals, order records,
verify benefits Require no out-of-pocket payment for covered
services provided to you, except where copayments or coinsurance
may apply Adhere to proven, cost-saving medical management
practices such as certification for hospital admissions,
concurrent review, case management and discharge planning
Accept BCBSNC's reimbursement as payment in full Participate
in BCBSNC's quality assurance program
Q: What happens
if my current physician is not a network provider?
A: If your current physician is not a
BCBSNC network provider and you are just joining a BCBSNC
health plan or changing health plans, we will assist you
in finding a new provider. The continuity of care process
will apply to Blue Care, Blue Choice and Blue Options
plans if you are being seen regularly for an ongoing special
condition or if you are in the second or third trimester
of pregnancy or completing post-partum care.
If you are changing health plans, you can obtain information
on how to request continuity of care from your employer
or benefit administrator or by contacting BCBSNC Customer
Service at 1-800-914-4220.
Continuity of care requests will be reviewed by a medical
professional based on the information provided about specific
medical conditions. Notification about eligibility for
continuity of care will be sent after a decision is made.
If a continuity of care request is approved, you may continue
to see your current specialist for up to 90 days. BCBSNC
will assist you in finding a network provider for any
future services before the 90-day period expires.
Q: How do I change
my primary care provider?
A: To change your primary care provider,
you can either call Customer Service at 1-800-914-4220
or visit eMemberServices at bluechipins.com.
Q: Can I change
my primary care provider any time I want?
A: Yes. You may designate a new primary care
provider at any time.
Q: What if a primary
care physician cannot see me right away?
A: Answers vary according to plan. For
more information, please visit the FAQs on your plan's
Member page.
Q: What if a network
provider isn't available to treat my condition?
A: Answers vary according to plan. For more information,
please visit the FAQs on your plan's Member page.
Q: Can I go to a
non-network provider?
A: Answers vary according to plan. For
more information, please visit the FAQs on your plan's
Member page.
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