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Contact Information


Provider Administrative Policy

Section
Information
Policy Date
November 2007
Status/Date
Revised/August 2014
Provider Type(s)
All Providers  

Disclaimer

Our provider administrative policies contain information regarding claims submission, reimbursement, and other information in order to achieve an efficient relationship with our providers. These policies are not an authorization or explanation of benefits. Blue Cross of Idaho retains the right to add to, delete from and otherwise modify this policy in accordance with our provider contracts


Policy

Contact Information

Medicare Advantage Customer Service Hours
Hours: 8 a.m. - 8 p.m., MT seven days a week

Member Contact Center
Local Toll-Free Hearing Impaired
208-395-8200 888-494-2583 1-800-377-1363
Non-English speaking members can call the numbers listed above.
 

Provider Contact Center
Hours: 8:00 a.m. - 5:00 p.m., MT (Monday, Tuesday, Friday)
8:30 a.m. - 5:00 p.m., MT (Wednesday)
Interactive voice response (IVR) provides instant answers 24/7 to your questions about claim status, eligibility and prior authorizations.

Type of Business Local Toll-Free Fax
Medicare Advantage Pre-service benefits 208-286-3656 866-482-2250 208-387-6811

Medicare Medicaid Coordinated Plan True Blue Dual Special Need Plan
Hours: 8:00 a.m. - 9:00 p.m., MT seven days a week

Member Line Dual Special Needs Plan: 888-495-2583                                           
Waiver Providers Support Line: 866-588-6174

Post Service Claims

Submit secure on-line inquiries for post-service claims on the secure provider portal on our website bcidaho.com, using one of the two options below:

Option 1

  1. Log onto our secure website, bcidaho.com
  2. Select Eligibility and Claims
  3. Select Claims, search for the claim in question then select the claim to view the details
  4. If you have a question, select Provider Contact Center
  5. After typing your question, select Continue

With option 1, the form auto populates the appropriate member, provider and claim information. Simply type your question in the notes field. The system will securely deliver your submission following HIPAA compliancy guidelines.

Option 2

  1. Log onto our secure website, bcidaho.com
  2. Select Contact Us
  3. Select General Information under the Email heading
  4. Select a Question Category from the drop-down list. Select I have a different question, when unable to locate the claim on the website
  5. Complete the required fields marked with a red asterisk
  6. Select Submit Question


 

Automated System

Blue Cross of Idaho has an automated system that allows you to enter the extension of a provider relations representative or access a department directory by calling:  208-286-3602 or 866-283-5723.

When the automated system asks for a specific extension, use the following contact information based on your geographic area:

Internal Provider Relations Representatives

If you have questions regarding coding or contracting, you may contact one of the following provider relations representatives:

Counties:  Benewah, Bonner, Boundary, Clearwater,
Idaho, Kootenai, Latah, Lewis, Nez Perce and
Shoshone


States:  AK, CO, DE, IN, KY, MN, MT, NJ, OH, SD, TX,
and WA

Leah Hulse CPC

E:  PR8326@bcidaho.com

P:  208-286-3602 Ext. 8326
P:  866-283-5723 Ext. 8326

F:  208-286-3575

Counties:  Adams, Boise, Canyon, Elmore, Gem, Owyhee
Payette, Valley and Washington


St. Alphonsus Health Systems statewide

States:  AZ, FL, IL, LA, MA, NE, NY, OR, RI, TN, VT, and WI

Pam Roach CPC

E:  PR7541@bcidaho.com

P:  208-286-3602 Ext. 8306
P:  866-283-5723 Ext. 8306

F:  208-286-3556

Counties:  Ada

St. Luke's Health System Statewide

States:  AR, CT, HI, IA, MD, MS, MO, NH, NM, ND, OK,
and VA

Heidi Lowman

E:  PR7560@bcidaho.com

P:  208-286-3602 Ext. 8304
P:  866-283-5723 Ext. 8304

F:  208-286-3558

Counties:  Bannock, Bear Lake, Bingham, Blaine,
Bonneville, Butte, Camas, Caribou, Cassia, Clark,
Custer, Franklin, Freemont, Gooding, Jefferson,
Jerome, Lemhi, Lincoln, Madison, Minidoka, Oneida,
Power, Teton and Twin Falls

HCA

States:  AL, CA, GA, KS, ME, MI, NV, NC, PA, SC, UT,
WV, and  WY

Jenn Lucy

E:  PR7205@bcidaho.com

P:  208-286-3602 Ext. 8310
P:  866-283-5723 Ext. 8310

F:  208-286-3560

External Provider Relations Representatives

For questions about EDI Plus, Direct Claims Entry and secure provider portal website training you may contact one of the following:

Counties:  Adams, Benewah, Bonner, Boundary,
Clearwater, Idaho, Kootenai, Latah, Lewis,                          
Nez Perce, Shoshone, Valley and Washington

States:  AK, CO, DE, IN, KY, MN, MT, NJ, OR, SD,
TX, and WA

Kathy Brock CPC-P

E:  PR7329@bcidaho.com

P:  208-286-3602 Ext. 8307
P:  866-283-5723 Ext. 8307

F:  208-286-3561

Cities:  Eagle, Garden City, Kuna, Meridian, Star

Counties:  Blaine, Butte, Camas, Cassia, Custer,
Elmore, Gooding, Jerome, Lemhi, Lincoln, Minidoka,
Owyhee and Twin Falls

States:  AZ, FL, IL, LA, MA, NE, NV, NY, PA, TN, VT,
and WI

Diane Mortensen CPC

E:  PR7450@bcidaho.com

P:  208-286-3602 Ext. 8308
P:  866-283-5723 Ext. 8308

F:  208-286-3562


Cities:  Boise

Counties:  Boise, Canyon, Gem and Payette

St. Lukes Health Systems statewide

States:  AR, CT, HI, IA, MD, MS, MO, NH, NM,
ND, OK, VA, and WV

Jamie Hunihan

E:  PR6668@bcidaho.com

P:  208-286-3602 Ext. 8309
P:  866-283-5723 Ext. 8309

F:  286-3563

Counties:  Bannock, Bear Lake, Bingham, Bonneville,
Caribou, Clark, Franklin, Fremont, Jefferson, Madison,
Oneida, Power and Teton

States:  AL, CA, GA, KS, ME, MI, NC, OH, RI, SC, UT,
and WY

Angie McCormick

E:  PR7032@bcidaho.com

P:  208-286-3602 Ext. 7032
P:  866-283-5723 Ext. 7032

F:  208-331-7502

Credentialing/Re-credentialing
Hours: 9:00 a.m. - 5:00 p.m., MT, Monday - Friday

Local Toll-Free Fax
208-387-6860 800-627-6655 Ext. 6860 208-286-3584

 

Provider Communications

One to One for Healthcare Provider Newsletters, Administrative Policies for Commercial, Dental and Medicare Advantage, Provider Alerts and Provider website communications.

Provider Communications Representative                                 

Melissa Johnston

E:  PR8317@bcidaho.com

P:  208-286-3602 Ext. 8317
P:  866-283-5723 Ext. 8317

F:  208-286-3592

 

Provider Appeals

Medicare Advantage                                                             

Natalie Cook CPC, CPC-H

E:  PR6650@bcidaho.com

P:  208-286-3602 Ext. 8312
P:  866-283-5723 Ext. 8312

F:  208-286-3559

 

Electronic Billing

For questions about electronic billing errors and your Error and Acceptance Report, contact the help desk at:  edihelpdesk@bcidaho.com

Mailing Address

Blue Cross of Idaho
PO Box 8406
Boise, ID 83707

Care Coordination Customer Service
Hours: 8:00 a.m. - 8:00 p.m., MT seven days a week

Care Coordination                          800-682-9329

Prior Authorization Contacts:

Changes to Existing Authorizations                                         
Prior Authorizations
Utilization Management
208-331-7535
800-743-1871
Professional Medical Records Fax:  208-395-8204
Facility Medical Records Fax:  208-286-3553
Quality Management 208-331-7327
800-274-4018 Ext. 7327
CVS Caremark 855-344-0930
American Imaging Management (AIM) bcidaho.com (AIM Portal)
866-714-1105


Policy History

Date Action Reason
August 2014 Revised Removed free clearinghouse language, added states to PR reps regions.
July 2014 Revised Removed NIHN information added Care Coordination hours
June 2014 Revised Added MMPC numbers, Added Care Coordination toll free number
February 2014 Revised Updated External Reps Regional Coverage
December 2013 Revised Updated PO Box from 7408 to 8406
June 2013 Revised Updated Relations Representatives Regions
May 2013 Revised Updated post-service process
January 2013 Revised Removed PBM contact information and added CVS and phone number, updated for email contacts vs phone
August 2012 Revised Removed EDI contact phone numbers replaced with email address
April 2012 Revised Administrative Updates
January 2012 Revised Removed reference to Flexi Blue
October 2011 Revised Updated Regional Coverage for Internal/External Reps
January 2011 Revised Phone numbers updated
August 2010 Revised Phone numbers updated
July 2009 Revised Phone extensions updated
March 2009 Revised Phone numbers added and reformatted
November 2008 Revised Phone numbers added
August 2008 Revised Flexi Blue phone number added
May 2008 Revised Contact information added

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