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.
- 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.
- 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. Please enter a valid email address to receive your reference number immediately after submission. For more information, please watch the Advanced Provider Inquiries eLearning module.
Narrow Networks Requests
Providers interested in joining any of the narrow networks listed below can submit their request through the Advanced Provider Inquiry form found on NaviNet.
- Premier Select BlueChoice
- BluePrint Health
- Medicare Advantage
Important Note: Premier Select BlueChoice is a closed network, with the exception of Behavioral Health and Substance Abuse providers.
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.
Phone: 402-390-1870 or 800-247-1103 option 5
Email: ProviderPortalAuthQuestions@NebraskaBlue.com
- 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: 402-548-4691
Email: SI@NebraskaBlue.com
Fax: 402-548-4660
Email: BAudit@NebraskaBlue.com