Coverage profile

Work Blue Cross NC across every published route

Use the current payer record to choose the right claim-status, eligibility, portal, phone, or appeals workflow. Substrate only marks routes that are published for this payer.

Claim status

EDI 276/277

The Substrate Claim Status Agent can check clearinghouse claim status for your practice with Blue Cross NC.

Supported

Eligibility

EDI 270/271

The Substrate Eligibility Agent can verify patient benefits, identify TPAs and carve-outs, and more with Blue Cross NC.

Available

Coordination of benefits

Real-time check

The Substrate Eligibility Agent can check coordination of benefits for other active coverage and primary or secondary order with Blue Cross NC. Results can be partial. Enrollment is not required for this check.

Available

Portal claim status

Browser automation

The Substrate Claim Status Agent can check claim status via the payer portal for Blue Cross NC.

Supported

Substrate prior authorization catalog

1 source

Browse Blue Cross NC’s official prior authorization lists and lookups in Substrate’s catalog.

Plan scope
Original sources
Review dates

Open prior authorization catalog

Other aliases

Also known as

10383
12B23
1411
3562
560894904
61472
61473
BCSNC
NCBCBS
NCBLS
NCPNHP
SB810
SB810MA
BCBSNC
BCBSNC ASO
Blue Cross Blue Shield North Carolina
Blue Cross Blue Shield of North Carolina
Blue Cross NC - Medicare Advantage
Blue Cross NC – Dental Blue
Partners National Health Plans of North Carolina Inc
BCBSNC DENTAL BLUE - GROUP, INDIVIDUAL AND SENIOR
BCBS NORTH CAROLINA
HEALTHY BLUE NORTH CAROLINA

BlueCard home-plan routing

BCBS prefixes for Blue Cross NC

These 25 member ID prefixes resolve to Blue Cross NC as their terminal payer. Open a prefix to review its home plan, state, payer ID, and published routes.

Member ID prefixes

2027 maternity billing research

Review Blue Cross NC’s 2027 OB/GYN billing guidance, plan-specific updates and policy sources.

Awareness notice only

Policy Updated At: May 26, 2026

Open Blue Cross NC in the payer explorer →

View Payer Policy ↗Upstream page ↗

Changes to billing for global maternity services effective 1/1/27. Verify the payer source before claim submission.

Payer policies

Blue Cross NC policies

The first 25 of 1,022 public policies Substrate tracks for Blue Cross NC, by title. Links open the payer's own document; check its current version before relying on it.

2024 Affordable Care Act (ACA) Preventive Drug List (PDF)6756-A · CommercialView PDF ↗
2025 Affordable Care Act (ACA) Preventive Drug List (PDF)6756-A · CommercialView PDF ↗
2025 Health Savings Account (HSA) Preventive Drug List3160NR-F · Effective Jan 1, 2025 · CommercialView PDF ↗
2026 Affordable Care Act (ACA) Preventive Drug List (PDF)6756-A · CommercialView PDF ↗
A Quick Guide to Understanding JW and JZ Modifiers (PDF)NCBCBS-CR-086195-25-CPN85830 · MedicaidView PDF ↗
Abdominoplasty and PanniculectomyCommercialView policy ↗
Ablation and Neural Therapy Procedures for Headache and Pain ManagementCommercialView policy ↗
Ablative Techniques for the Myolysis of Uterine FibroidsCommercialView policy ↗
Abortion (Termination of Pregnancy)G-06057 · Effective Nov 4, 2024 · MedicaidView PDF ↗
Absorbable Nasal Implant for Treatment of Nasal Valve CollapseCommercialView policy ↗
ACCESS TO CARE STANDARDS FOR OFF-EXCHANGE MEMBERS IN ALL PRODUCTS IN ALL LINES OF BUSINESS - EXCLUDING MEDICARE AND MEDICAID DRIVING DISTANCE TO PROVIDERSBE 9 · CommercialView PDF ↗
Adaptive Behavioral Treatment for Autism Spectrum DisordersCommercialView policy ↗
Adaptive Behavioral Treatment for Autism Spectrum Disorders NotificationCommercialView policy ↗
Adaptive Behavioral Treatment for Autism Spectrum Disorders NotificationCommercialView policy ↗
Add-On CodesCommercialView policy ↗
Add-On CodesMedicaidView policy ↗
Add-on CodesView policy ↗
Addressing Medication Adherence Gaps (PDF)NCBCBS-CR-058767-24-CPN58567 · MedicaidView PDF ↗
Advanced Illness / Advance DirectivesCommercialView policy ↗
Allergen Testing AHS – G2031G2031 · CommercialView policy ↗
Allergen Testing AHS – G2031 NotificationG2031 · CommercialView policy ↗
Allergy Immunotherapy (Desensitization)CommercialView policy ↗
Allergy Skin and Challenge TestingCommercialView policy ↗
Ambulance and Medical Transport ServicesCommercialView policy ↗
Ambulance and Medical Transport ServicesMedicaidView policy ↗

Search all 1,022 Blue Cross NC policies by CPT code, keyword or policy number →

Routing reference

Blue Cross NC payer IDs and operating states

Use the payer ID listed for the transaction you are submitting. Verify current routing and enrollment requirements with your clearinghouse.

Blue Cross NC payer name, operating states, and transaction-specific payer IDs
Payer name	Blue Cross NCSource: Substrate payer directory · data last changed Nov 10, 2026
Operating states	NCSource: Substrate payer directory · data last changed Nov 10, 2026
837P professional claims payer IDStedi	`BCSNC`Source: Stedi payer catalog · catalog dated Aug 8, 2026 · matched by payer ID
837I institutional claims payer IDStedi	`BCSNC`Source: Stedi payer catalog · catalog dated Aug 8, 2026 · matched by payer ID
835 ERA payer IDStedi	`BCSNC`Enrollment requiredSource: Stedi payer catalog · catalog dated Aug 8, 2026 · matched by payer ID
270 eligibility payer IDStedi	`BCSNC`Source: Stedi payer catalog · catalog dated Aug 8, 2026 · matched by payer ID
270 eligibility payer IDAvaility	`BCSNC`Source: Availity payer catalog · catalog dated Feb 2025 · matched by payer ID
276 claim status payer IDStedi	`BCSNC`Source: Stedi payer catalog · catalog dated Aug 8, 2026 · matched by payer ID
276 claim status payer IDAvaility	`BCSNC`Source: Availity payer catalog · catalog dated Feb 2025 · matched by payer ID

Routing sources and verification

Substrate payer directoryPayer identity, aliases, operating states, and vendor IDs. Data last changed Nov 10, 2026; checked Nov 13, 2026.Open payer website ↗
Stedi payer catalogMatched by payer ID; matched record: Blue Cross NC. Source dated Aug 8, 2026.PrimaryPayerId is used as the transaction payer ID when the corresponding Stedi support flag is true.Open current Stedi reference ↗
Availity payer catalogMatched by payer ID; matched record: BCBS NORTH CAROLINA. Source dated Feb 2025.The attached API workbook supplies 270 and 276 payer IDs only. It does not supply 837P, 837I, or 835 IDs.Open current Availity reference ↗
United Clearinghouse payer catalogMatched by payer name; matched record: Blue Cross NC. The source did not provide a publication date.The attachment supplies payer names and states only; it does not contain transaction-specific payer IDs.Open current United Clearinghouse reference ↗

Clearinghouse payer IDs are transaction-specific and can change. Confirm the current payer list and the member’s ID card before submission.

Phone and fax contacts

Numbers vary by plan, service, and department. Check the member’s ID card before calling or sending a fax.

Phone lines2

(800) 214-4844Blue Cross and Blue Shield of North CarolinaBlue Cross and Blue Shield of North Carolina line with options for certifications, appeals, and automated ID card, benefit and claim self-service.Answered by: Automated phone menu
(888) 296-9790Blue Cross and Blue Shield of North Carolina Provider LineBlue Cross and Blue Shield of North Carolina provider line for claims, oncology drug review, skilled nursing authorization, drug coverage determinations, medical prior authorization and Prime Therapeutics pharmacy help.Answered by: Automated phone menu → Voicemail → Hold queue

Phone numbers76

Blue Cross NC phone numbers
Channel and number	Payer Notes	Department	Specialties
phone(800) 335-8289	Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information	DELTA DENTAL OF VA	Dental Care
phone(800) 441-9188	Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information	Customer Service	Hospital, Hospital - Inpatient
phone(800) 451-0287	Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information	CUSTOMER SERVICE	Hospital, Hospital - Inpatient
phone(800) 521-3605	Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information	EYEMED	Vision (Optometry)
phone(800) 523-4702	Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information	National Elevator Industry Health Benefit Plan	Physician Visit - Office: Well
phone(800) 524-0149	Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information	DELTA DENTAL	Dental Care
phone(800) 610-0201	Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information	DELTA DENTAL	Dental Care
phone(800) 634-4832	Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information	KEPRO	Hospital - Emergency Accident, Hospital - Emergency Medical, Emergency Services
phone(800) 635-1928	Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information	BCBSIL	Hospital, Hospital - Inpatient
phone(800) 676-2583	Eligibility / benefits, Other stated contextBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Active Coverage	560894904 BCBSIL Blue Cross NC Blue Cross and Blue Shield of NC CAPITAL BLUE CROSS CUSTOMER SERVICE Customer Service	Health Benefit Plan Coverage, Hospital, Hospital - Inpatient, Vision (Optometry)
phone(800) 723-4337	Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information	NORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES	Dental Care
phone(800) 877-7195	Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information	VSP	Vision (Optometry)
phone(800) 972-8088	Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information	CUSTOMER SERVICE	Hospital, Hospital - Inpatient, Hospital, Hospital - Inpatient, Hospital - Emergency Accident, Urgent Care, Hospital - Emergency Medical, Emergency Services, Chiropractic, Professional (Physician) Visit - Office, Physician Visit - Office: Well, Hospital - Outpatient, Vision (Optometry)
phone(833) 870-0272	Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information	CVS CAREMARK	Pharmacy
phone(844) 354-3241	Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information	CVS/CAREMARK	Pharmacy
phone(844) 594-5084	Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information	CARELONRX	Pharmacy
phone(844) 714-5678	Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information	EyeMed	Vision (Optometry)
phone(855) 811-2218	Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information	OPTUMRX	Pharmacy
phone(866) 335-1392	Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information	Tyler Technologies Inc	Vision (Optometry)
phone(866) 723-0514	Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information	EyeMed	Vision (Optometry)
phone(866) 797-9884	Eligibility / benefits, Utilization managementBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Co-Insurance; Benefit context: Co-Payment	CARELONRX UTILIZATION MANAGEMENT	Chiropractic, Pharmacy
phone(866) 827-9866	Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information	BLUE VIEW VISION	Vision (Optometry)
phone(866) 840-2655	Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information	PBA	Hospital, Hospital - Inpatient
phone(866) 846-9350	Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information	CAREMARK	Pharmacy
phone(877) 769-7447	Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information	CVS CAREMARK	Pharmacy
phone(877) 799-5783	Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information	ESI	Pharmacy
phone(888) 265-7790	Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information	CVS Specialty RX	Professional (Physician) Visit - Office
phone(888) 335-8296	Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information	DELTA DENTAL	Dental Care
phone(888) 352-7924	Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information	LIBERTY DENTAL	Dental Care
phone(800) 274-7767	Utilization managementBenefit context: Co-Insurance	UTILIZATION MANAGEMENT	Hospital, Hospital, Hospital - Inpatient, Hospital - Outpatient
phone(800) 832-7850	Utilization managementBenefit context: Co-Insurance	UTILIZATION MANAGEMENT	Hospital
phone(844) 594-5072	Utilization managementBenefit context: Co-Payment	UTILIZATION MANAGEMENT	Chiropractic
phone(855) 343-4851	Utilization managementBenefit context: Co-Insurance; Benefit context: Co-Payment	UTILIZATION MANAGEMENT	Hospital
phone(855) 984-2583	Utilization managementBenefit context: Co-Insurance	UTILIZATION MANAGEMENT	Hospital
phone(866) 470-6244	Utilization managementBenefit context: Co-Insurance	UTILIZATION MANAGEMENT	Hospital
phone(866) 773-2884	Other stated context, Utilization managementBenefit context: Co-Insurance; Benefit context: Contact Following Entity for Eligibility or Benefit Information	Pre Service Review UTILIZATION MANAGEMENT	Chiropractic, Hospital - Inpatient
phone(877) 867-7610	Utilization managementBenefit context: Co-Insurance	UTILIZATION MANAGEMENT	Hospital
phone(800) 924-7141	Other stated context, PharmacyBenefit context: Co-Insurance; Benefit context: Benefit Description	BLUECROSS AND BLUESHIELD OF TENNESSEE MAGELLANRX	Hospital - Outpatient, Pharmacy
phone(866) 325-1794	PharmacyBenefit context: Benefit Description	OPTUM RX	Pharmacy
phone(866) 688-2242	PharmacyBenefit context: Active Coverage	PRIME THERAPEUTICS	Pharmacy
phone(855) 339-8558	Behavioral health, Other stated contextBenefit context: Active Coverage; Benefit context: Coverage Basis	LUCET	Mental Health
phone(866) 322-1657	Behavioral healthBenefit context: Active Coverage	BEHAVIORAL HEALTH MANAGER	Mental Health
phone(602) 864-4320	Other stated contextBenefit context: Benefit Description	BLUE CROSS BLUE SHIELD OF AZ	Hospital - Inpatient, Professional (Physician) Visit - Office, Hospital, Hospital - Outpatient
phone(800) 232-2345	Other stated contextBenefit context: Benefit Description	BLUE CROSS BLUE SHIELD OF AZ	Hospital - Inpatient, Professional (Physician) Visit - Office, Hospital, Hospital - Outpatient
phone(800) 248-2342	Other stated contextBenefit context: Deductible	BCBS OF ALABAMA	Hospital
phone(800) 344-5245	Other stated contextBenefit context: Active Coverage	HIGHMARK WV MEDICAL MANAGEMENT & POLICY	Hospital
phone(800) 351-2370	Other stated contextBenefit context: Co-Insurance; Benefit context: Co-Payment	CLINICAL INTAKE OPERATIONS	Hospital
phone(800) 424-8270	Other stated contextBenefit context: Coverage Basis	PRIME THERAPEUTICS
phone(800) 452-8507	Other stated contextBenefit context: Active Coverage	HIGHMARK MEDICAL MANAGEMENT & POLICY	Hospital
phone(800) 523-6435	Other stated contextBenefit context: Co-Payment	LABLUE Clinical Inquiry	Chiropractic, Hospital - Emergency Accident, Hospital - Emergency Medical, Emergency Services
phone(800) 541-6652	Other stated contextBenefit context: Co-Insurance; Benefit context: Co-Payment	BLUE SHIELD OF CALIFORNIA	Hospital
phone(800) 572-2872	Other stated contextBenefit context: Active Coverage	BCBSDE MANAGED CARE	Hospital
phone(800) 664-2583	Other stated contextBenefit context: Active Coverage	HORIZON BCBSNJ	Health Benefit Plan Coverage
phone(800) 678-9133	Other stated contextBenefit context: Benefit Description	ASH - AMERICAN SPECIALTY HEALTH NETWORK	Chiropractic
phone(800) 780-7881	Other stated contextBenefit context: Co-Insurance; Benefit context: Co-Payment	CLINICAL INTAKE OPERATIONS	Hospital
phone(800) 827-4814	Other stated contextBenefit context: Limitations	MEDICAL AUDIT AND REVIEW	Hospital - Inpatient
phone(800) 841-9659	Other stated contextBenefit context: Co-Insurance	BCBS OF MISSISSIPPI	Hospital
phone(800) 869-7093	Other stated contextBenefit context: Co-Insurance	HMA HEALTH SERVICES DEPARTMENT	Hospital - Inpatient
phone(800) 905-4102	Other stated contextBenefit context: Active Coverage	BLUECROSS VISION	Vision (Optometry)
phone(800) 972-4226	Other stated contextBenefit context: Benefit Description	ASH - AMERICAN SPECIALTY HEALTH NETWORK	Chiropractic
phone(833) 447-4397	Other stated contextBenefit context: Coverage Basis	REACH KIDNEY CARE
phone(833) 462-0104	Other stated contextBenefit context: Limitations	AMERICAN HEALTH HOLDING	Hospital, Hospital, Hospital - Inpatient
phone(833) 592-9956	Other stated contextBenefit context: Co-Insurance	ANTHEM BLUE CROSS AND BLUE SHIELD	Chiropractic, Hospital, Hospital, Hospital - Inpatient
phone(833) 663-8703	Other stated contextBenefit context: Co-Insurance; Benefit context: Deductible; Benefit context: Coverage Basis	CREDENCE BCBS PA LOGIC SOLUTIONS	Hospital
phone(844) 241-7087	Other stated contextBenefit context: Co-Insurance	ANTHEM BLUE CROSS	Hospital, Hospital - Inpatient
phone(855) 798-2627	Other stated contextBenefit context: Other or Additional Payor	MEDICARE PART A ONLY
phone(866) 205-5107	Other stated contextBenefit context: Coverage Basis	PA LOGIC SOLUTIONS
phone(866) 803-8002	Other stated contextBenefit context: Coverage Basis	CARELON MEDICAL BENEFITS MANAGEMENT EVICORE HEALTHCARE
phone(866) 918-1595	Other stated contextBenefit context: Other or Additional Payor	UPMC HLTH PLAN INC	Health Benefit Plan Coverage
phone(877) 324-2990	Other stated contextBenefit context: Co-Insurance	QUANTUM HEALTH	Hospital
phone(800) 214-4844		Blue Cross NC Blue Cross and Blue Shield of NC
phone(800) 327-6716		560894904 Blue Cross NC
phone(800) 727-2227		Blue Cross NC
phone(844) 465-5227		Blue Cross NC
phone(877) 444-2374		Blue Cross NC
phone(888) 233-8351		Blue Cross NC

Numbers stated in payer eligibility responses; scope may depend on benefits, products, or departments.

Fax numbers14

Blue Cross NC fax numbers
Channel and number	Payer Notes	Department	Specialties
fax(866) 411-2573	Prior authorizationBenefit context: Co-Insurance	ACUTE INPATIENT REHABILITATION ADMISSION PRECERTIFICATION SKILLED NURSING FACILITY ADMISSION PRECERTIFICATION	Hospital
fax(866) 411-2585	Prior authorizationBenefit context: Co-Insurance	ACUTE INPATIENT HOSPITAL ADMISSION PRECERTIFICATION	Hospital
fax(410) 781-7661	Utilization managementBenefit context: Contact Following Entity for Eligibility or Benefit Information	UTILIZATION MANAGEMENT
fax(800) 348-3804	Other stated contextBenefit context: Co-Insurance	BCBS OF MISSISSIPPI	Hospital
fax(800) 453-4341	Other stated contextBenefit context: Co-Insurance; Benefit context: Co-Payment	CLINICAL INTAKE OPERATIONS	Hospital
fax(833) 453-0101	Other stated contextBenefit context: Coverage Basis	REACH KIDNEY CARE
fax(833) 938-9934	Other stated contextBenefit context: Co-Insurance; Benefit context: Deductible	CREDENCE BCBS	Hospital
fax(844) 295-4637	Other stated contextBenefit context: Co-Insurance; Benefit context: Co-Payment	BLUE SHIELD OF CALIFORNIA	Hospital
fax(866) 606-6021	Other stated contextBenefit context: Coverage Basis	PA LOGIC SOLUTIONS
fax(877) 665-5542	Other stated contextBenefit context: Limitations	AMERICAN HEALTH HOLDING	Hospital, Hospital, Hospital - Inpatient
fax(501) 212-8518		Blue Cross NC
fax(501) 378-2965		Blue Cross NC
fax(501) 379-1200		Blue Cross NC
fax(888) 282-1321		560894904 Blue Cross NC

Numbers stated in payer eligibility responses; scope may depend on benefits, products, or departments.

Retired numbers3

These numbers played a not-in-service recording when called. Do not use them; call the replacement or the number on the member’s ID card.

(800) 397-7337Not in service when called; re-check pending
(800) 832-3211Out of serviceUse (800) 244-6224
(844) 775-7419Out of serviceUse (877) 842-3210