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Telephone Directory

BlueCare® Service Representatives (Customer Service) - for Providers

  • BlueCare HMO – 1-800-822-8752
  • BlueCare Traditional (Blue Cross & Blue Shield) – 1-888-827-7117
  • BlueCare PPO – 1-866-262-5635
  • BlueCare Comprehensive – 1-866-262-5635
  • BlueCare EPO – 1-888-345-2353

BlueCare® Service Representatives (Customer Service) - for Members

  • BlueCare HMO – 1-800-822-8753
  • BlueCare Traditional (Blue Cross & Blue Shield) – 1-800-829-8599
  • BlueCare PPO – 1-888-338-2211
  • BlueCare Comprehensive – 1-888-338-2211
  • BlueCare EPO – 1-888-345-2346

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

First Priority Health Non-Participating Referrals - 1-800-962-5353 & fax# (570) 200-6840 and fax # for Pediatric (570) 200-6822

First Priority Health Precertification - 1-800-962-5353

Blue Cross of Northeastern Pennsylvania Precertification (FPLIC Traditional, Special Care and FEP) – 1-800-638-0505

FPLIC PPO Precertification – 1-866-262-5623

FPLIC EPO Precertification – 1-888-345-2360

Community Behavioral Healthcare Network of PA (CBHNP) – FPH – 1-800-599-2428
FPLIC – 1-800-577-3742


FAX NUMBERS

DEPARTMENT

FAX NUMBER

BlueCare Traditional Claims Department
(for Claims adjustments, Reconsideration forms, BlueCare Senior, FEP)

(570) 200-6790

Blue Cross Precertification Department

(570) 200-6788

BlueCare PPO Claims Department
(for Claims adjustments and Reconsideration forms)

(570) 200-6790

BlueCard ITS Claims Department
(for Claims adjustments and Reconsideration forms)

(570) 200-6790

FPH Claims Department
(for Adjustments, Claims Research Request Forms, etc.)

(570) 200-6790

Provider Relations Department

(570) 200-6880

BlueCare Service Representative (Customer Service)

(570) 200-6710

First Priority Health Complaint/Grievance Department

(570) 200-6770

First Priority Health Non-Par Referral Requests

(570) 200-6840
(570) 200-6822 (Pediatric)

BCNEPA/FPH Pharmacy Department

(570) 200-6870

First Priority Health Precertification Department

(570) 200-6799

Other Party Liability (OPL)

(570) 200-6790

Behavioral Health (CBHNP)

1-888-548-8013 FPH & FPLIC



PROVIDER RELATIONS PHONE NUMBERS AND EMAIL ADDRESSES

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
Health System Analyst Karen.Elmy@bcnepa.com
Hashagen, Cheryl
(570) 200-4670
Health System Consultant Cheryl.Hashagen@bcnepa.com
Jenkins, Jill
(570) 200-4647
Provider Relations Consultant Jill.Jenkins@bcnepa.com
Klimchak, Karen
(570-200-4672)
Provider Relations Project Specialist Karen.Klimchak@bcnepa.com
Ladd, Jim
(570) 200-4664
Provider System Support Analyst Jim.Ladd@bcnepa.com
Laskoski, Lori
(570) 200-4663
Provider System Support Analyst Lori.Laskoski@bcnepa.com
Levenoskie, David
(570) 200-4673
Regional Manager, Provider Relations Dave.Levenoskie@bcnepa.com
Lewis, MaryJo
(570) 200-4668
Health System Analyst MaryJo.Lewis@bcnepa.com
LoPresto, Louise
(570) 200-4674
Provider Relations Consultant Louise.LoPresto@bcnepa.com
Quaglia, Kevin
(570) 200-4676
Provider Relations Project Manager Kevin.Quaglia@bcnepa.com
Rivera, Jeanine
(570) 200-4669
Provider Relations Consultant Jeanine.Rivera@bcnepa.com
Starnes, Paula
(570) 200-4656
Provider Operations Manager Paula.Starnes@bcnepa.com
Wisnewski, Jeanne
(570) 200-4679
Director of Provider Relations Jeanne.Wisnewski@bcnepa.com



PRODUCT INFORMATION

First Priority Health

Product

Prefix

Claim Address

Telephone #

(for providers only)

BlueCare HMO;
BlueCare HMO PLUS;
BlueChip

YZH

First Priority Health
PO Box 69699
Harrisburg, PA 17109-9699

1-800-822-8752


Blue Cross of Northeastern Pennsylvania

Product

Prefix

Claim Address

Telephone #
(for providers only)

BlueCare Assure PPO & QHD

YZP

Claims
PO Box 890179
Camp Hill, PA 17089-0179

1-866-262-5635

BlueCare Cooperative (Non-Group);
BlueCare Student;
Special Care

YZR (institutional)
ZAT (professional)

Claims
PO Box 890179
Camp Hill, PA 17089-0179

1-888-827-7117

BlueCare Senior (group);
BlueCare Security (non-group)

YZM (institutional)
ZAS (professional)

Claims
PO Box 890179
Camp Hill, PA 17089-0179

1-888-827-7117


First Priority Life Insurance Company (FPLIC)

Product

Prefix

Claim Address

Telephone #
(for providers only)

BlueCare PPO and BlueCare PPO Qualified High Deductible (QHD)

BlueCare PPO Special Groups

QFG

AUV EBU NNU NTJ NTQ SNQ SVQ

Claims
PO Box 890179
Camp Hill, PA 17089-0179

1-866-262-5635

BlueCare Comprehensive

QFM

Claims
PO Box 890179
Camp Hill, PA 17089-0179

1-866-262-5635

BlueCare PPO Individual Conversion

QFC

Claims
PO Box 890179
Camp Hill, PA 17089-0179

1-866-262-5635

BlueCare Direct
BlueCare Direct Advantage
BlueCare Direct Select
BlueCare Direct Essentials

QFD

Claims
PO Box 890179
Camp Hill, PA 17089-0179

1-866-262-5635

BlueCare Traditional

QFT

Claims
PO Box 890179
Camp Hill, PA 17089-0179

1-888-827-7117

BlueCare EPO

QFI (member resides in area)
QFO (member resides out of area)

Claims
PO Box 890179
Camp Hill, PA 17089-0179

1-888-345-2353


NaviNet

NaviNet Customer Care

NaviNet Customer Care is available Monday – Friday, 8:00 a.m. to 11:00 p.m., Saturday 8:00 a.m. – 3:00 pm.

1-888-482-8057


Highmark Blue Shield

Product

Prefix

Claim Address

Telephone #
(for providers only)

ClassicBlue
PPOBlue
EPOBlue
DirectBlue
SelectBlue

Highmark Blue Shield
PO Box 890173
Camp Hill, PA 17089-0173

1-866-731-8080

MedigapBlue

Signature 65

 

Highmark Blue Shield
PO Box 890052
Camp Hill, PA 17089-0052

1-866-763-6695

FreedomBlue PPO

FER FEM

Medical & Surgical (UB &1500):

FreedomBlue
PO Box 890062
Camp Hill, PA 17089-0062

Claims/Benefits/Eligibility
1-866-588-6967

Member Services:
1-866-306-1061

DME/P&O/Respiratory

 

DME/P&O/Respiratory
Highmark BlueShield
PO Box 890173
Camp Hill PA 17089-8819

1-866-588-6967

BlueCard

NUCC 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.

BlueCard Claims
Highmark Blue Shield
PO Box 890062
Camp Hill, PA 17089-0062

BlueCard Claims
PO Box 890179
Camp Hill, PA 17089-0179

Claims:
1-800-637-3493

Benefits & Eligibility:
1-800-676- Blue (2583)

1-888-827-7117

Federal Employee Program   (FEP)

 

FEP Claims
Highmark Blue Shield
PO Box 890062
Camp Hill, PA 17089-0062

*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
PO Box 890179
Camp Hill, PA 17089-0179

*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, AGE, AHJ, BRD, BWW, CDJ, CDQ, CDZ, CHC, COS, CQA, CQX, DAZ, DBO, DFB, DGR, DKV, DVU, DWU, EEN, EGD, EIZ, FFI, FQU, FSC, GCY, GEA, GEU, HAJ, HFO, HKZ, HXT, IGN, INW, IUR, IYC, KPY, LFS, LJB, LLH, LRC, LYW, MGL, MNF, NPP, NZK, OCR, OCZ, PAH, PCX, PDA, PSM, PXF, QCB, QCM, RAE, RJG, RLA, ROQ, SDA, SEZ, SFU, SHQ, SKH, SQT, SYK, TFE, TMB, TMW, TQJ, TWS, UBF, UBL, UDS, UFN, UFP, UFT, UHF, ULB, UPB, UTR, WHV, WQB

Personal Choice Claims
PO Box 69352
Harrisburg, PA 17106-9352

IBC Provider Service:
1-800-275-2583


Highmark Blue Shield -
Miscellaneous

FreedomBlue Authorizations

   

1-866-731-8080

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 claims billing

 Payor ID # 4210

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.

Fee Based pricing and Analysis
Highmark Blue Shield
PO Box 890089
Camp Hill, PA 17089-0089

 

Behavioral Health Authorizations

FreedomBlue PPO

Other plans

 

1-800-628-0816 Option 3

1-866-731-8080

Radiology Management Program -Authorizations

Outpatient, non-emergency advanced imaging for selected CT scans, selected MRI and MRA scans and PET scans. If NaviNet-enabled, use the authorization function on NaviNet.

If not NaviNet enabled, call National Imaging Associates, Inc.

 

1-866-731-2045 Option 4