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.

Member Services: 844-594-5070
Provider Services: 844-594-5072
Behavioral Health Crisis Line: 844-594-5076

Healthy Blue Training Academy

Don’t forget to enroll in electronic fund transfer (EFT): If you are not registered with CAQH EnrollHub, you will need to register and create a username and password. Once registered, you can submit an EFT enrollment with your financial information. At the payer selection step, select Blue Cross NC - Healthy Blue. Registration and enrollment are available via https://www.caqh.org/solutions/enrollhub. Click here to learn more.

Provider news

Please review the requirements for the maternity notification process and additional resources available.

Maternity and Newborn Notification Process

We encourage you to use the DHHS COVID-19 Communications Toolkit to assist with sharing information about the COVID-19 vaccine. See this link and the flier for more information: https://covid19.ncdhhs.gov/vaccines/covid-19-vaccine-communications-toolkit.

COVID-19 Vaccine Update August 24, 2021

This guide provides a process to assist with entering a large number of past visits to aid in brining payments up to date.

PCS Update

To provide clarity and education on the similarities and differences between Healthy Blue Medicaid and Healthy Blue Medicare DSNP, please view flier.

Healthy Blue Medicaid and Medicare Comparison Flier

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.

View pharmacy information

Maternal Child Program

When it comes to our pregnant members, we are committed to keeping both mom and baby healthy. That’s why we encourage all our moms-to-be to take part in our New Baby, New Life^SM program, a comprehensive, proactive care management and care coordination program for all expectant mothers and their newborns. We also support the state’s Care Management for High Risk Pregnancy (CMHRP) program.

Learn about the maternal child program

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.

Learn more about Behavioral health resources

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.