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
Note: All fee schedules are available in NaviNet and will no longer be available via CSC, email or inquiry. If you are affiliated with a PHO, you must obtain the fee schedule from the PHO.
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.
Please note: The NaviNet NPS number is not considered a valid CSC reference number. If a request requires a reference number, it must include one from a phone call or a completed Claims Investigation. Requests submitted without a valid reference number will be returned without review.
In the Advanced Provider Inquiry form, select the appropriate subject from the “Nature of Inquiry” dropdown menu to ensure your inquiry is routed to the correct team. Be sure to 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.”
Participating providers are expected to use NaviNet, our provider portal, for all preauthorization and precertification submissions for Commercial, FEP and Medicare Advantage members, unless otherwise noted.
Online Submission Instructions:
- Visit NaviNet.net
- Log in
- Select “Health Plans”
- Choose “BCBSNE”
- Under “Workflows for this Plan,” select the appropriate preauthorization link
Exceptions to Online Submission
While most requests must be submitted online, there are three key exceptions where participating providers should use the Universal Prior Authorization Request Form:
- Hospice services
- Newborns requiring services who have not yet been added as a permanent member of the benefit plan
- Member lookup exception: If a member’s information is not found in NaviNet
The form is available on our Preauthorization page.
For Out-of-Network and Out-of-State Providers
- Preferred Method: If you have access to the provider portal, please use it to submit your request.
- Alternative Method: If you do not have portal access, you may use the Universal Prior Authorization Request Form, available on the Provider Preauthorization page. Clear navigation buttons will guide you to the appropriate option for these exceptions.
Types of Requests to Submit Online via NaviNet
- Inpatient Admission (Behavioral Health)
- Inpatient Admission (Medical/Surgical)
- Skilled Nursing Facility or Rehab Admission
- Urgent Radiology Preauthorization Requests
- FEP – Behavioral Health Outpatient Treatment Plan Submission
- General Preauthorization Requests
Be sure to check the Medical Policy tool to verify whether a service requires preauthorization before submitting your request.
Pharmacy Preauthorization
Commercial, FEP SBP - FEHB and PSHB:
- Online: NaviNet.net → Select the pharmacy preauthorization link
- Phone (if needed): 877-999-2374
Medical Pharmacy Preauthorization
Refer to the Medical Pharmacy Prior Authorization FAQs for additional information:
- Online: NaviNet.net → Select the Medical Pharmacy Prior Auths (Prime) link
- Submit directly to PrimeMRx
- Phone: 800-424-1709
- Fax: 888-656-6671
- Online: GatewayPA.com
Phone: 402-390-1870 or 800-247-1103 option 5
Please see our eLearning video, NaviNet Preauthorization, for guidance in submitting and viewing preauthorization and precertification requests. For additional tips and resources, please see our Preauthorization page.
- 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
All fee schedules are available in NaviNet and will no longer be available via CSC, email or inquiry.
If you are affiliated with a PHO, you must obtain the fee schedule from the PHO.