NWO

BCBS Prefix NWO

Blue Cross and Blue Shield of North Carolina

North Carolina • EPO, Medicare Advantage, 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 NWO

EPO

Under this EPO prefix, the member has no out-of-network coverage for routine care. However, unlike HMO plans, no referral is needed to see a specialist within the network. When billing, confirm the provider's network participation status with the plan before submitting the claim.

Medicare Advantage

This prefix is associated with Medicare Advantage. MA plans combine hospital (Part A) and medical (Part B) coverage, and many include prescription drug coverage (Part D). When billing, confirm whether the plan uses the same payer ID for MA claims as for commercial claims, as many BCBS companies use separate IDs.

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.