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Medicaid Providers

Welcome!

Healthy Blue is the Medicaid plan offered by Blue Cross and Blue Shield of North Carolina (Blue Cross NC) to serve North Carolinians who participate in the state Medicaid program.

Focused on the health of each member

Blue 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 what they do best — care for our members.

Notice about NC Medicaid Managed Care Suspension

North Carolina has suspended the transition of Medicaid and NC Health Choice to managed care. Nothing will change for Medicaid and NC Health Choice beneficiaries; they will get health services as they do today. All health providers enrolled in Medicaid will continue to submit claims through NCTracks as they do today. Health providers should continue contracting with health plans during the suspension as broad provider participation in health plan networks will help beneficiaries understand which providers are available to them before open enrollment restarts.

Beginning April 1, 2020, the Healthy Blue provider support line is no longer in service due to the Managed Care suspension. If you would like to speak with a Blue Cross and Blue Shield of North Carolina representative about contracting, please contact our Healthy Blue Network Development team at 1-844-415-2045 or email NCProviderQuestions@NCHealthyBlue.com. For more information on the suspension, please visit Medicaid Managed Care Questions and Answers for Providers.

Provider news

The latest articles and announcements can be found here on claims filings, products, benefits, administrative updates, new and revised procedures and guidelines, prescription information, and more.

Updates on the status of COVID-19 in North Carolina

On March 10, 2020, Governor Cooper declared a State of Emergency in response to COVID-19. For current updates on the status of COVID-19 in North Carolina, please see the North Carolina Department of Health & Human Services (NCDHHS) COVID-19 website .

EFT Enrollment Notification

CAQH EnrollHub, which has been temporarily offline, will be operational on January 27, 2020.

Legislators Adjourn Without Taking Actions Required for Medicaid Managed Care

DHHS Suspends Implementation of Managed Care

Provider Credentialing and re-credentialing process

Policy outlining the Centralized Provider Enrollment and Credentialing process.

Availity access

The Availity Portal offers health care professionals free access to real-time information and instant responses in a consistent format regardless of the payer.

At Availity you can:

Request Authorizations
Submit Claims
Confirm Eligibility

Don't have an Availity account? Register free now!

Featured resources


Pharmacy information

Search for up-to-date drug information, including hundreds of brand-name and generic medications.

Maternal Child Program

We offer a proactive care management program for expectant mothers and their newborns. The My Advocate™ program provides pregnant women with proactive outreach and education through interactive voice response (IVR), text or smartphone application.

Behavioral health providers

We work collaboratively with hospitals, group practices and independent behavioral health care providers, community and government agencies, human service districts, and other resources to successfully meet the needs of members with mental health, substance use, and intellectual and developmental disabilities.

Provider tools & resources

Interested in becoming a provider in the Healthy Blue network?

We look forward to working with you to provide quality services to our members.