RPN

BCBS Prefix RPN

Blue Cross and Blue Shield of North Carolina

North Carolina • Traditional Indemnity, EPO, Medicaid

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 RPN

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

This is an Exclusive Provider Organization (EPO) prefix. EPO plans do not cover out-of-network care except in genuine emergencies. Members can see any in-network specialist without a referral from their primary care physician. Claims for out-of-network non-emergency services will be denied.

Medicaid

This prefix is associated with Medicaid managed care. When a BCBS plan administers Medicaid, the claims process may differ from commercial coverage: different payer ID, different claims address, different prior authorization rules, and different timely filing limits. Always verify Medicaid-specific details before submitting.

About Blue Cross and Blue Shield of North Carolina

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