N5K

BCBS Prefix N5K

Vermont • HMO, Traditional Indemnity, EPO

Billing reference for prefix N5K

Provider phone: (802) 223-8404
1 exception — check before you submit
Other cases
(877) 707-2583 — CustomerService for determining member eligibility/benefits
Electronic payer ID: 03036
Verified Aug 2026 · source
Claims mailing address: P.O. Box 2365, South Burlington, VT 05407-2365
Verified Aug 2026 · source
1 exception — check before you submit
Depends on the claim type
P.O. Box 9350, South Burlington, VT 05407-9350 — Dental claims and correspondence
Timely filing limit: 180 daysCompare all plans
Verified Aug 2026 · source
1 exception — check before you submit
Depends on the claim stage
365 days — corrected claims
Prior authorization phone: (802) 223-8404
Provider website: https://www.cbabluevt.com/providers

Billing CBA Blue (TPA) from outside Vermont?

Usually you do not send the claim to CBA Blue (TPA). Under the BlueCard program, a provider treating a member from another Blue plan submits the claim to their own local Blue Cross Blue Shield plan, which then routes it to CBA Blue (TPA) for processing.

The payer ID and claims address above are for filing within Vermont. Filing from elsewhere, use your local plan's details instead.
Prior authorizationis generally handled by the member's home plan — so CBA Blue (TPA), wherever you are.
Your timely filing limit is set by your own contract with your local Blue plan, not by the figure above. 365 days is customary but contracts vary.
To check eligibility and benefits for an out-of-area Blue member, call 1-800-676-BLUE (1-800-676-2583).

Arrangements vary by contract, and self-funded (ASO) accounts can differ — confirm with your local Blue plan before filing. See the BlueCard Program Provider Manual for the full rules.

Coverage under prefix N5K

HMO

HMO coverage means this member must use providers within the plan's network. A primary care physician serves as the care coordinator and must authorize specialist referrals. Emergency services are the primary exception to the network requirement. Always verify referral status before providing non-emergency specialty care.

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.

EPO

EPO coverage under this prefix means the member must use network providers but does not need referrals for specialist visits. This plan type is becoming more common as it offers lower premiums than PPO plans while providing more flexibility than HMOs. Verify network status before providing services.

About CBA Blue (TPA)

Third party administrator providing health insurance administration services in Vermont.

Look up another BCBS prefix · All prefixes for CBA Blue (TPA) · All prefixes starting with N

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