Blue Cross Blue Shield of North Carolina Product Changes and FYIs

The NCMGMA BCBS Committee would like to draw your attention to recent changes, and likely more change in the future, to certain BCBS products. The links noted will provide more detail and the committee suggests you keep a close watch on http://www.bcbsnc.com.

State Health Plan Changes

• North Carolina State Health Plan Board of Trustees voted to end the provider designation program at the end of 2018
  • Between 10/1/18 and 12/31/18, SHP members will no longer see two designations: one for the current year and one for the next year on the Provider Directory, they will only see the current year’s designation.
  • Effective 1/1/19, there will not be any Provider Specialty or Facility Designations on the Provider Directory

   

• More information should come out this Fall regarding potential plan changes. To stay informed, check The Board of Trustees meeting materials page for full details: https://www.shpnc.org/about-us/board-trustees-meeting-materials
• Blue Cross and Blue Shield will send out notifications regarding any fee schedule, reimbursement, or contract changes per the State’s requirements after the Board approves any changes to the plan

Blue Local Changes

• Triangle market – Blue Local product eliminated for 2019. Members will be moved to Blue Value unless they opt for a different plan
• Charlotte market – a Blue Local product remains for 2019

Blue Value Changes

• Triangle market – UNC Health Alliance will be the exclusive in-network provider for Blue Cross ACA (Blue Value) plans in the Triangle in 2019

Question: What if my practice is in network for Blue Value, but NOT for UNC Health Alliance?

Answer from BCBS: We are not removing any providers from Blue Value in the Triangle. For 2019, Blue Value non-UNC Health Alliance providers can continue to see ACA members in the Triangle. Providers can always check their participation status by reviewing their current BCBSNC participation agreements or calling their local Provider Relations consultant.

https://www.bluecrossnc.com/sites/default/files/document/attachment/providers/public/pdfs/news-and-information/news/2019%20ACA%20Rate%20Release_FINAL.pdf

UNC Health Alliance: https://www.unchealthcare.org/health-alliance/for-providers/

As the NCMGMA BCBS Committee is made aware of changes we will keep you informed.