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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.

Category:  Health Go Health

Search Medical Policies and Clinical Guidelines

WebMedical Policies. Medical Policies are used by all plans and lines of business unless Federal or State law — as well as contract language, including definitions and specific contract …

Category:  Medical Go Health

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 …

Category:  Health Go Health

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 …

Category:  Health Go Health

Behavioral Health Overview

Web• Ensure service accessibility, including a comprehensive array of quality and evidence-based supports and services for eligible members. • Integrate the management and …

Category:  Health Go Health

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 …

Category:  Medical Go Health

EPSDT Provider Toolkit

WebEarly Periodic Screening Diagnosis Treatment (EPSDT) is Medicaid’s federally mandated comprehensive and preventive child health program for individuals under the age of 21. …

Category:  Health Go Health

Requesting a Prior Authorization for Outpatient Specialized …

WebHealthy Blue Requesting a Prior Authorization for Outpatient Specialized Therapy Services 2 Note: A beneficiary can receive a maximum of 27 therapy treatment visits per calendar …

Category:  Health Go Health

New Carelon Rehabilitation Program Effective May 1, 2023

WebJanuary 2023 Notes: • Carelon Medical Benefits Management, Inc. is an independent company providing utilization management services for Healthy Blue providers on behalf …

Category:  Medical Go Health

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. …

Category:  Health Go Health

Healthy Blue Provider Billing Guide

WebNCHB-CD-005766-22. Healthy Blue Provider Billing Guide. Provider Services: 844-594-5072 https://provider.healthybluenc.com. Notes: • Availity, LLC is an independent …

Category:  Health Go Health

Telehealth Quick Reference Guide

WebTo learn more about NC-STeP, visit NC Step Program and Resources or call 252-744-0454. Convenient and easy way to get care anytime, anywhere via smartphone, tablet or …

Category:  Health Go Health

Fact Sheet Telehealth Program

WebNC Medicaid 4. of . 4 20210614 • Assist providers with Health Information Exchange (HIE) inquires related to NC HealthConnex connectivity compliance and the HIE Hardship …

Category:  Health Go Health

Utilization Management Clinical Criteria

WebHealthy Blue Utilization Management Clinical Criteria 6 Criteria number Criteria title New and Revised Item CG-SURG-01 Colonoscopy CG-SURG-03 Blepharoplasty, Blepharoptosis …

Category:  Health Go Health

Using CareBridge Electronic Visit Verification

WebNote: CareBridge is an independent company providing electronic visit verification services for Healthy Blue providers on behalf of Blue Cross and Blue Shield of North Carolina.

Category:  Health Go Health

Frequently Asked Questions

WebHealthy Blue Frequently Asked Questions 4 Is a contracted Healthy Blue specialist provider able to act as a PCP? A specialist can act as a PCP; however, NCTracks enrollment will …

Category:  Health Go Health

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