TELEPHONE DIRECTORY (Addresses & Telephone Numbers)
| Name | Title | E-Mail Address |
|
Ashby, Odette (570) 200-4658 |
Provider Relations Consultant | Odette.Ashby@bcnepa.com |
|
Donnelly, Pat (570) 200-4687 |
Provider System Support Analyst | Patricia.Donnelly@bcnepa.com |
|
Elmy, Karen (570) 200-4665 |
Provider Relations Analyst | Karen.Elmy@bcnepa.com |
|
Fasciana, Jackie (570) 200-4667 |
Provider Relations Analyst | Jackie.Fasciana@bcnepa.com |
|
Haduck, Lorraine (570) 200-4669 |
Provider Relations Consultant | Lorraine.Haduck@bcnepa.com |
|
Hashagen, Cheryl (570) 200-4670 |
Provider Relations Consultant | Cheryl.Hashagen@bcnepa.com |
|
Klimchak, Karen (570) 200-4672 |
Provider Relations Analyst | Karen.Klimchak@bcnepa.com |
|
Ladd, Jim (570) 200-4664 |
Provider System Support Analyst | Jim.Ladd@bcnepa.com |
|
Laskoski, Lori (570) 200-4663 |
Provider Systems Support Analyst | Lori.Laskoski@bcnepa.com |
|
Levenoskie, David (570) 200-4673 |
Regional Manager, Provider Relations | Dave.Levenoskie@bcnepa.com |
|
Lewis, MaryJo (570) 200-4668 |
Provider Relations Analyst | MaryJo.Lewis@bcnepa.com |
|
LoPresto, Louise (570) 200-4674 |
Provider Relations Consultant | Louise.LoPresto@bcnepa.com |
|
Malahowski, Joe (570) 200-4656 |
Provider Relations Consultant | Joe.Malahowski@bcnepa.com |
|
Podcasy, Carrie (570) 200-4675 |
Provider Relations Analyst | Carrie.Podcasy@bcnepa.com |
|
Quaglia, Kevin (570) 200-4676 |
Provider Relations Consultant | Kevin.Quaglia@bcnepa.com |
|
Smatko, Donna (570) 200-4677 |
Provider System Support Analyst | Donna.Smatko@bcnepa.com |
|
West, Rosanne (570) 200-4678 |
Regional Manager, Provider Relations | Rosanne.West@bcnepa.com |
|
Wisnewski, Jeanne (570) 200-4679 |
Director of Provider Relations | Jeanne.Wisnewski@bcnepa.com |
|
Yager, Deborah (570) 200-4681 |
Provider Relations Consultant | Debbie.Yager@bcnepa.com |
|
Zingaretti, Rebecca (570) 200-4682 |
Provider Relations Consultant | Rebecca.J.M.Zingaretti@bcnepa.com |
| BlueCareฎ Service Representatives
(Customer Service) - for Providers
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| BlueCareฎ Service Representatives
(Customer Service) - for Members
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| Provider Relations Department - 1-800-451-4447 | ||
| Health & Disease Management Programs - 1-866-262-4764 | ||
| Managed Pharmacy Program- 1-800-722-4062 & fax# (570) 200-6870 | ||
| Medical Directors - 1-800-462-0900 | ||
| NaviMedix Customer Service (for system issues)- 1-888-482-8057 | ||
| Non-Participating Referrals - 1-800-962-5353 & fax# (570) 200-6840 | ||
| First Priority Health Precertification - 1-800-962-5353 | ||
| Blue Cross of Northeastern Pennsylvania Precertification 1-800-638-0505 | ||
| PRODUCTS | PREFIX | CLAIM ADDRESS | PHONE # (for providers) |
| BLUE CROSS | |||
| BlueCare PPO (formally Access Care II) |
QEE QEC AUV BVD EBU NNU NTQ NTJ SNQ SVQ |
Blue Cross NEPA/Access Care II PO Box 890179 Camp Hill, PA 17089-0179 |
1-866-262-5635 |
| Blue Care Traditional (formally Blue Cross Traditional) |
YZA Trad. BC ZAD BS YZA BC Special Care ZAP BS QAB Wrap-around (BC and BS) |
Blue Cross of NEPA Blue Cross Claims Dept. 19 N. Main St. Wilkes-Barre, PA 18711-0302 |
1-888-827-7117 |
| BlueCare Major Medical (formally Major Medical) |
Major Medical Claims Po Box 3100 Wilkes-Barre, PA 18711 |
1-888-827-7117 | |
| BlueCare Security (formally Security 65) |
YZS BlueCare Security Non-Grp ZAS Highmark Blue Shield 65 Medigap YZS BlueCare Senior Grp ZAT Highmark Blue Shield 65 Special |
For ZAS & ZAT claims, mail to: Medigap ClaimsFor YZS claims, mail to: Blue Cross of NEPA Blue Cross Claims Dept. 19 N. Main St. Wilkes-Barre, PA 18711-0302 |
1-888-827-7117 |
| BlueCare Senior (Medigap) formally 65 Special |
|||
| FPLIC | |||
| Blue Care PPO |
QFG QFC AUV EBU NNU NTQ NTJ SNQ SVQ QFM |
FPLIC/BlueCare PPO PO Box 890179 Camp Hill, PA 17089-0179 |
1-866-262-5635 |
| BlueCare Comprehensive | |||
| BlueCare Traditional | QFT QFD |
FPLIC/BlueCare PO Box 890179 Camp Hill, PA 17089-0179 |
1-888-827-7117 |
| BlueCare Direct | |||
| FIRST PRIORITY HEALTH | |||
| BlueCare HMO & POS - (formally First Priority Health) | YZH FPH & FPH PLUS |
First Priority Health PO Box 69699 Harrisburg, PA 17106-9699 |
1-800-822-8752 |
| MISCELLANEOUS | |||
| BlueCard | CMS 1500 providers mail claims to
Highmark BS & contact the phone # on the side for claims questions. NUCC 1450 providers mail claims to your local Blue Cross & contact your local Blue Cross for claims questions. |
Blue Card Claims Highmark Blue Shield PO Box 890062 Camp Hill, PA 17089-0062 |
Claims: 1-800-637-3493 Benefits & Eligibility: 1-800-676- Blue (2583) |
| FEP | Federal Employee Program |
FEP Claims Highmark Blue Shield PO Box 898854 Camp Hill, PA 17089-8854 *This is for providers who bill on a CMS 1500 form. |
1-866-763-3608 (Blue Shield # for claims and eligibility) |
|
Blue Cross of Northeastern Pennsylvania FEP Claims 19 N. Main St. Wilkes-Barre, PA 18711 *This is for providers who bill on a NUCC 1450 form. |
1-800-618-3337 (Blue Cross # for claims and eligibility) |
||
| Personal Choice (IBC product) |
ADQ AEK AEV AEW AHJ BME BYN CDJ CDQ CDZ CQA CQX DAZ DGR DPX DVU EEN EGD ETF GCY GEA GMA HAJ HXT INW MGL NFY NLR PCX QCA QCB WCM SDA SEZ SFU SHQ SKH SQT WYK TFE TLG TRX UBF UFN UFP UFT UTR |
Personal Choice Claims PO Box 890016 Camp Hill, PA 17089-0016 |
IBC Provider Service: 1-800-332-2566 |
| FreedomBlue | FER 378 | Facility: FreedomBlue PO Box 358 Pittsburgh, PA 15230 Professional: FreedomBlue PO Box 890170 Camp Hill, PA 17089-0170 |
Claims/Benefits/Eligibility 1-866-588-6967 Member Services: 1-866-306-1061 |
| Highmark Blue Shield | Predeterminations |
Pre-Authorization PO Box 890041 Camp Hill, PA 17089-0041 |
|
| Physician Precertification Inquires | Precerts for providers who are calling for a member to be seen at a facility in the BCNEPA service area | 1-800-638-0505 | |
| Highmark EDI department |
Electronic billing | 1-800-992-0246 | |
| Highmark Fee Schedule |
To obtain a copy of PremierBlue Shield allowances for the most frequently
reported codes for your specialty, or a copy of your Highmark Blue Shield UCR
profile, send in a letter of request to the address listed on the side. Include your full name, address and Highmark Blue Shield provider number, and indicate whether you are requesting your UCR profile, PremierBlue Shield allowances, or both. |
Professional Pricing and Analysis Highmark Blue Shield PO Box 890089 Camp Hill, PA 17089-0089 |
|
| OASIS | For eligibility, benefits and status of claims. | 1-800-462-7474 |
IMPORTANT FAX NUMBERS
| DEPARTMENT | FAX NUMBER |
| Blue Cross Claims Department (for Claims adjustments, Reconsideration forms, BlueCare Senior, FEP) |
(570) 200-6790 |
| Blue Cross Precertification Department | (570) 200-6788 |
| BlueCare PPO (formally Access Care II) (for Claims adjustments and Reconsideration forms) |
(570) 200-6790 |
| BlueCard ITS Claims | (570) 200-6790 |
| FPH Claims Department (for Maternity Precertification Forms, Adjustments, Claims Research Request Forms, etc.) |
(570) 200-6790 |
| Provider Relations Department | (570) 200-6880 |
| BlueCare Representative Service (Customer Service) | (570) 200-6733 |
| First Priority Health Complaint/Grievance Department | (570) 200-6770 |
| First Priority Health Non-Par Referral Requests | (570) 200-6840 |
| BCNEPA/FPH Pharmacy Department | (570) 200-6870 |
| First Priority Health Precertification Department | (570) 200-6799 |
| Other Party Liability (OPL) | (570) 200-6790 |
10/07