GFJ

BCBS Prefix GFJ

Blue Cross and Blue Shield of North Carolina

North Carolina • POS, PPO, Traditional Indemnity

Billing essentials

Provider phone
(800) 214-4844
Electronic payer ID
SB865
Claims mailing address
P.O. Box 35, Durham, NC 27702
Timely filing limit
365 daysCompare all plans
Prior authorization phone
(800) 214-4844

Coverage under prefix GFJ

POS

POS coverage under this prefix operates on a tiered system. Tier 1 (in-network with referral) provides the highest coverage. Tier 2 (in-network without referral) provides moderate coverage. Tier 3 (out-of-network) provides the lowest coverage. Verify which tier applies before submitting the claim.

PPO

Under this PPO prefix, members are covered for both in-network and out-of-network care. The plan pays a higher percentage of allowed charges when members use participating providers. No gatekeeper or primary care referral is required. Verify the member's specific benefits for cost-sharing details.

Traditional Indemnity

This prefix includes traditional indemnity coverage. Indemnity plans are the oldest form of health insurance and offer maximum provider choice with no network restrictions. Members pay a percentage of charges after meeting their deductible. Reimbursement is based on reasonable and customary rates for the service area.

About Blue Cross and Blue Shield of North Carolina

Independent licensee providing commercial, Medicare and Medicaid plans to North Carolina members.