Healthy Blue + Medicare

D-SNP Resources

The Model of Care Training

Annually, a representative from each provider’s practice and/or facility must attest to completing the Special Needs Plans (SNPs) and Model of Care overview.  At the end of the training, an attestation form must be completed by the representative attesting that training has been completed.

Model of Care Training  Model of Care Attestation Form

Should you encounter an issue with completing the attestation form online after reviewing the Model of Care training, you may print a copy of the form (pdf), complete all required information and fax to 919-765-7109 or you may return the attestation via e-mail to DSNP_providerattestations@bcbsnc.com


Availity Training

All claims for Healthy Blue + Medicare members are required to be filed through Availity.  We have provided a claims filing tutorial for Availity should you need assistance. Please do not file any claims through Blue e, the Blue Cross and Blue Shield of North Carolina claims filing portal.

Go to Availity

 


Forms

Below are the essential forms that are required to be completed prior to rendering services such as general pre-certification forms, behavioral health treatment and refund requests.

 


Resources


Reimbursement Policies


Sample ID cards

 


 

Contact Information

We have provided you with a list of useful contacts.

Healthy Blue + Medicare Customer Service

Healthy Blue + Medicare Customer Service
P.O. Box 62947
Virginia Beach, VA 23466-2947

1-833-713-1078 (telephone)
1-855-358-1226 (fax)

Medicare Complaints, Appeals & Grievances (Medical and Drugs Part C)

Attention: Medical Necessity Provider Appeals
Mailstop: OH0205-A537
4361 Irwin Simpson Rd.
Mason, OH 45040

1-833-713-1078 (telephone)
1-888-458-1406 (fax)

For coverage decisions and appeals for Part D Drugs

Prime Therapeutics
Medicare Appeals Department

10802 Farnam Dr.
Omaha, NE 68154

1-800-725-7710 (telephone)
For difficulties with hearing or speaking, please call 1-800-693-6703

1-888-285-2242 (fax)

Website: www.primetherapeutics.com

Provider Services (Medical & Drug)

1-844-895-8160 (telephone)
1-877-799-4129 (fax)

Healthy Blue + Medicare
P.O. Box 60007
Los Angeles, CA 90060-0008

Case Management (Medical & Drug)      

1-866-611-4287 (telephone)
1-855-443-7821 (fax)

Healthy Blue + Medicare
3350 Peachtree Rd NE
Atlanta, GA 30326