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Frequently Asked Questions

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Answers to Some of the Most Commonly Asked Questions for Self-Service

Accessing the System

Why can't I log on to the system?
Before logging on for the first time, you must register your account. You will be asked to pick a unique username and a password, along with an e-mail address, challenge question and answer. Once completed, you can log on to the system with the username and password you just registered.

I have entered all my information. Why won't the system allow me to register?
There are two possible reasons. 1) The username you have chosen is already being used by another member. To resolve this, please choose another username. 2) You are not authorized to enter the system. This means that you do not have coverage with BCNEPA and cannot register. If this is not correct, please call us at the number on the back of your ID card to verify.

Authorized User Accounts

I am the contract/policy holder. Whose information will I be allowed to view if I register as myself?
When registering as yourself, you will be able to view your information along with your MINOR dependents' information.

I am the contract/policy holder and I have an authorization form on file to view my spouse's claims. Why can I not see their information?
In order to view your ADULT dependent's information, you will have to register as their authorized user.

I am the spouse on the contract/policy and I should be able to receive my minor children's information. But, when I register on the system, I am only able to view my information.
Only the contract/policy holder can view the minor dependents' information when registering as himself/herself. Since the contract/policy holder is the individual with whom Blue Cross of Northeastern Pennsylvania (BCNEPA) has a contract/policy, they are able to view the information.

What is the authorized/personal representative ID number and how do I obtain it?
In order to register as an individual's authorized representative, you will be asked to enter an Authorized/Personal Representative ID. If you have an authorization form or a personal representative document on file with BCNEPA you will be able to get this number. You can get this number by calling us at the phone number on the back of your ID card and asking for an Authorized/Personal Representative ID letter.

What if I want to view a family member's information and I do not have an authorization form or personal representative document on file with BCNEPA?
You can complete an authorization form or call us using the number on the back of your ID card. Personal Representative documents are Power of Attorneys Court Orders, Guardianship documents, etc. All documents can be sent to:

Attention: Privacy & Security Office
Blue Cross of NEPA
19 N. Main St.
Wilkes-Barre, PA 18711

Benefits

Why can't I view my dental or vision care coverage?
Blue Cross of Northeastern Pennsylvania does not administer the benefits for these plans; therefore, we do not have the information to supply to you. If you have questions on this coverage, please call the number on the back of your dental or vision ID cards.

I have three children, why do I only see my policy in the dropdown list?
If you are an adult dependent on the contract and not the contract policy holder, you will only be able to view information on yourself. The only way you will be able to view others on your contract is if there is a valid authorization on file with our Privacy and Security Office. (Please refer to "Authorized Users.”)

Why can't I see my spouse's and/or my adult dependent's claims or referrals?
As a contract policy holder you will be able to see benefits for everyone on your contract. You will not be able to view claims or referrals for family members on your account that are over the age of 18. The only way to view this information is to file a valid authorization form with our Privacy and Security Office. (Please refer to the question "Authorized Users.")

How far back can I look for benefits? referrals? claims?
You can view benefits and referrals up to one year prior to today's date. Claims can be viewed 2 years prior to today's date.

PCPs

Why can I only change my PCP effective date to a future date?
Changes to your PCP can only be made for a future date. Call the number on the back of your ID card if you need additional help.

Care Comparison Tools

Our online directory, “Doctor & Hospital Finder,” provides you with cost and quality of care ratings.

Where can I find cost and quality ratings for my doctor?

  • Login to Self-Service
  • Choose the "Doctors & Hospitals' tab
  • Click on the "Doctor/Hospital Finder" link
  • Click on the "Doctor" button and search for your doctor

The “cost” and "quality" ratings appear to the right of the doctor’s name.

How do I rate my doctor?

  • Login to Self-Service
  • Choose the "Doctors & Hospitals' tab
  • Click on the "Doctor/Hospital Finder" link and search for your doctor
  • Click on the doctor’s name
  • Select the "Patient Ratings" tab
  • Click on the "Rate This Provider" button

Where can I find my hospital’s quality ratings?

  • Login to Self-Service
  • Choose the "Doctors & Hospitals' tab
  • Click on the "Doctor/Hospital Finder" link
  • Click on the "Facility" button and search for your hospital

The "overall quality" rating appears to the right of the facility name, indicated by star symbols.*

How can I tell how much a hospital charges for a specific treatment?

  • Login to Self-Service
  • Choose the "Doctors & Hospitals' tab
  • Click on the "Doctor/Hospital Finder" link
  • Click on the "Facility" button and search for your hospital
  • Select a treatment from the menu provided

The price range appears to the right of the facility name, under the "Est Cost" header.

ID Cards

Why can I request ID cards only for my entire family?
With some plans, you can request only one card if you have individual coverage and two cards if you have family coverage. BlueCare HMO members can request cards for an individual family member.

Claim Inquiries

I have BlueCare Traditional coverage. Why can't I see the claims from my doctors' appointments?
BlueCare PPO and BlueCare Traditional professional (doctor) claims are processed for us by Highmark Blue Shield. These claims are not stored in our electronic system. If you need information on these claims, please call the number on the back of your ID card.

Why can't I see claims for prescription drugs?
These claims are processed by Express Scripts, Inc. These claims are not stored in our electronic system. If you need information on these claims, just click on Rx Drug Benefits or call the number on the back or your ID card.