TOK

BCBS Prefix TOK

Blue Cross and Blue Shield of North Carolina

North Carolina • High-Deductible Health Plan (HDHP), 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 TOK

HDHP

This is a High-Deductible Health Plan (HDHP) prefix. These plans have minimum deductible thresholds set by the IRS. Members often use HSA funds to cover out-of-pocket costs. The plan's claims processing and payer ID are the same as the standard plan, but expect higher patient responsibility amounts on remittance.

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

Traditional indemnity coverage under this prefix is a fee-for-service plan. Members can see any provider without network restrictions or referral requirements. The plan reimburses a set percentage of usual and customary charges. Claims are submitted directly to the payer listed above.

About Blue Cross and Blue Shield of North Carolina

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