Provider Contacts

All claim questions (30 days from submission) should be submitted through NaviNet®. Begin by using the Claim Investigation Inquiry feature, and if further assistance is needed, proceed with the Advanced Provider Inquiry feature.

BCBSNE Provider Executive Support Team

We are committed to supporting our providers with the following:

  • Escalated Claims Inquiries
  • NaviNet System Support
  • Provider Education Opportunities
  • Medicare Advantage Rate Letters
  • Medicare Advantage Bad Debt Settlement Requests
  • Open Negotiation Requests

Claims Investigation Process

To ensure efficient processing of claim questions, please begin by using the NaviNet Claims Investigations inquiry feature before escalating through the Advanced Provider inquiry option.

  1. Start your Claims Investigations inquiry online using the link above. Once submitted, you’ll receive a reference number.
    • For more information, please watch the Claims Investigations eLearning module.
  2. If the online claims investigation isn’t viable, please contact our Customer Support Center at 800-635-0579.

Note: For Coordination of Benefits or Workers Compensation review submit as a Reconsideration via NaviNet.

Advanced Provider Inquiries

If the NaviNet Claim Investigation inquiry did not resolve your claim questions or concerns, please use the Advanced Provider Inquiry form for further assistance. Important: The Claim Investigation process must be completed first, as the resulting reference number is required when using this form.

In the Advanced Provider Inquiry form select the appropriate subject from the “Nature of Inquiry” dropdown menu. This ensures your inquiry is routed to the correct team for resolution. For more information, please watch the Advanced Provider Inquiries eLearning module. 

Narrow Networks Requests

Premier Select Blue Choice is a closed network with the exception of Behavioral Health & Substance Abuse providers. If you are a Behavioral Health & Substance Abuse provider, please email your provider executive directly. If you are interested in BluePrint, please contact CHI via their Provider - Network Participation Request page. 

Mailing Address:

PO Box 3248, Omaha, NE 68180-0001

IVR:

800-635-0579

 

Additional contacts:

BCBSNE subscribers
(Commercial, Federal Employee Program Service Benefit Plan (FEP SBP) for both Federal Health Plan (FEHB) and Postal Service Health Benefits (PSHB))

Eligibility and Benefits:
Online: Visit NaviNet.net. Log in, select “Health Plans,” then “BCBSNE.” Under “Workflows for this Plan,” select “Eligibility and Benefits.”
Phone: 800-635-0579

Dental Benefits:
Phone: 800-635-0579

Medical Claim Status:
Online: Visit NaviNet.net. Log in, select “Health Plans,” then “BCBSNE.” Under “Workflows for this Plan,” select “Claims Status.”
Automated: 800-635-0579
Phone: 800-635-0579 (M – F, 7:30 a.m. – 5 p.m. CT)

BCBSNE subscribers outside of Nebraska

National BlueCard® 800# Network:
Phone: 800-676-BLUE (2583)

Medicare Advantage subscribers

Eligibility and Benefits:
Phone: 888-505-2022
Online: Visit NaviNet.net. Log in, select “Health Plans,” then “BCBSNE.” Under “Workflows for this Plan,” select “Eligibility and Benefits.”

Medical Claim Status:
Phone: 888-505-2022
Online: Visit NaviNet.net. Log in, select “Health Plans,” then “BCBSNE.” Under “Workflows for this Plan,” select “Claims Status.”

Inpatient admission (behavioral health)
Health Service Programs Department:
Phone: 402-390-1870 or 800-247-1103

Inpatient admission (medical/surgical)
Health Service Programs Department:
Phone: 402-390-1870 or 800-247-1103 option 2
Online: Visit NaviNet.net. Log in, select “Health Plans,” then “BCBSNE.” Under “Workflows for this Plan,” select the preauthorization link needed.

Skilled nursing facility or rehab admission
Health Service Programs Department:
Phone: 402-390-1870 or 800-247-1103 option 2

Urgent radiology preauthorization requests
Health Service Programs Department:
Online: Visit NaviNet.net. Log in, select “Health Plans,” then “BCBSNE.” Under “Workflows for this Plan,” select the preauthorization link needed.

FEP – Intensive outpatient, partial care or inpatient admissions (behavioral health)
Health Service Programs Department:
Phone: 402-390-1870 or 800-247-1103 option 2

FEP – Submit an outpatient treatment plan form for behavioral health visits
Health Service Programs Department:
Fax: 402-343-3444

 

Preauthorization request
Health Service Program Department:
Fax: 800-255-2838
Online: Visit NaviNet.net. Log in, select “Health Plans,” then “BCBSNE.” Under “Workflows for this Plan,” select the preauthorization link needed.

Pharmacy preauthorization
Commercial, FEP SBP - FEHB and PSHB
Phone: 877-999-2374
Online: Visit NaviNet.net. Log in, select “Health Plans,” then “BCBSNE.” Under “Workflows for this Plan,” select the pharmacy preauthorization link needed. If you are unable to submit a pharmacy preauthorization online through NaviNet, you can print the form. See all pharmacy preauthorization forms.

Medicare Advantage Pharmacy Preauthorization
We contract with PrimeMRx Part B drugs/medications. Please submit preauthorization requests directly to PrimeMRx.
Hours of operation: 24 hours a day
Phone: 800-424-1709
Fax: 888-656-6671
Online: MRxGateway.com

Medicare Advantage inpatient and SNF notifications
Phone: 877-399-1671
Online: Visit NaviNet.net. Log in, select “Health Plans,” then “BCBSNE.” Under “Workflows for this Plan,” select the preauthorization link needed.

To access the preauthorization request form, use this link.

  • Escalated Claims Inquiries
  • NaviNet System Support
  • Provider Education Opportunities
  • Medicare Advantage Rate Letters
  • Medicare Advantage Bad Debt Settlement Requests
  • Open Negotiation Requests

Online: Advanced Provider Inquiry Form 
Note: For Medicare Advantage questions, please call 888-505-2022.

COB Department:
Phone: 402-390-1840 or 800-462-2924

Refunds Department:
Phone: 402-398-3653 or 877-435-7258
Mailing Address: BCBSNE
                               P.O. Box 30112
                               Omaha NE 68103

Subrogation Department:
Phone: 402-390-1847 or 800-662-3554

Workers’ Compensation Department:
Phone: 402-398-3615 or 800-821-4786

Medical Support Department:
Fax: 402-392-4111 or 800-991-7389

Electronic Data Interchange (EDI) technical submission issues
Phone: 888-233-8351
(For issues regarding EDI connectivity, EDI enrollment, questions about remits, EFT and PC-ACE software setup and questions, select option 3) 
Fax: 402-343-3457
Email: ProviderServicesOperationsSupport@NebraskaBlue.com

Phone: 402-398-3615 or 800-821-4786

Fax: 402-548-4660
Email: BAudit@NebraskaBlue.com