YPR

BCBS Prefix YPR

Blue Cross and Blue Shield of North Carolina

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

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 YPR

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.

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.

HDHP

This prefix is associated with a High-Deductible Health Plan. HDHP members pay more out-of-pocket before insurance coverage begins. These plans are commonly paired with HSA or HRA accounts. When billing, be aware that the member may have significant cost-sharing responsibility until their annual deductible is satisfied.

About Blue Cross and Blue Shield of North Carolina

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