CONTACT INFORMATION FOR PROVIDERS DEPARTMENT PHONE

CONTACT INFORMATION FOR PROVIDERS
DEPARTMENT
CUSTOMER/PROVIDER SERVICE
PHONE
NUMBER
E-MAIL
CONTACT FOR ISSUES
RELATED TO:
BlueCard Claim Inquiries including New England
Health Plan (complete listing of NEHP prefixes
available on our provider website at
www.bcbsvt.com under the provider manual &
reference guidelines link then general documents)
BlueCard Eligibility/Benefits
(800) 395-3389
(800) 676-2583
[email protected]
(802) 225-7698
CBA Blue (complete listing of CBA Blue prefixes
available on our provider website at
www.bcbsvt.com under the provider manual &
reference guidelines link then general documents)
Federal Employee Program (alpha prefix R)
(888) 222-9206
Not Available
(802) 846-2755
(800) 328-0365
[email protected]
(802) 225-7700
Blue Cross and Blue Shield of Vermont products
(complete listing available on our provider
website at www.bcbsvt.com under the provider
manual & reference guidelines link then
general documents)
(800) 924-3494
[email protected]
(802) 371-3658
FRAUD HOTLINE
(800) 337-8440
N/A
N/A
To report suspected fraudulent
activity
INTEGRATED HEALTH MANAGEMENT
(800) 922-8778
[email protected]
(802) 371-3491
Physician to Physician calls
Prior Approval submission
Referral Authorization submission
Pre-Certification/Pre-Admission
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(Formerly Medical Services)
Contact information for providers
Updated: November 2014
[email protected]
FAX
(802) 225-7698
Benefits
Claim status/adjustment/denial
Check traces
Coordination of benefits
Eligibility
Negative balance issues
Prior Approval status
Referral Authorization(NEHP only)
Remittance Advice issues
MANAGED MENTAL HEALTH
Vermont Collaborative Care (VCC)
(800) 922-8778
[email protected]
Prior Approval
(PA) Forms
(802) 371-3491
Prior Approval of Managed Mental
Health Services
(888) 620-1746
http://groups.rxmedicareplans.co
m/pdfs/CoverageDeterminationPh
ysician.pdf
(855) 633-7673
All pharmacy related
questions/issues including prior
approval submission and prior
approval status.
(877) 493-1947
https://expressPA.pahub.com
(888) 255-1006
(877) 727-3784
Not Available
(877) 378-4727
All pharmacy related
questions/issues including prior
approval submission and prior
approval status
(800) 701-0080
www.aimspecialtyhealth.com
Not Available
NOTE: Alpha prefixes FAH and FAO do not use VCC.
Benefits are through CIGNA. Prefix FAC and R (FEP)
only requires VCC approval for inpatient services.
PHARMACY BENEFIT MANAGERS
Employer Group Wrap (EGWP)Plan
Medicare Part D coverage administered by BCBSVT via
the New England Joint Enterprise product, Blue
Medicare RX. This is used by some large group
retirees, such as Vermont Education Health Initiative
(VEHI).
Express Scripts, Inc. (ESI)
NOTE:
Alpha prefixes CWS, FAC, FAH and FAO do not use ESI.
Benefits are through CIGNA.
Federal Employee Program (alpha prefix of “R”)
pharmacy benefits are managed by Caremark.
State of Vermont members, alpha prefix DVT, EVT and
FVT have pharmacy benefits directly through ESI.
They have their own ID cards and ID numbers for the
benefit.
RADIOLOGY
AIM Specialty Health
NOTE: FEP (prefix R) does not require prior approval.
Contact information for providers
Updated: November 2014
Submission, status of prior
approval for radiology services
TECHNICAL HELP DESK
Electronic Data Interchange - EDI
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Website
Technical Support/Enrollment
PROVIDER ENROLLMENT OR
CREDENTIALING
PROVIDER RELATIONS
Contact information for providers
Updated: November 2014
(800) 334-3441
option 1
[email protected]
(802) 371-3659
All website issues including
password/user name
(800) 334-3441
option 2
[email protected]
(802) 225-7696
835/837 set up or information
New clearinghouse information
(888) 449-0443
Option 2
[email protected]
(802) 371-3489
Enrollment. credentialing or
demographic changes
(888) 449-0443
Option 1
[email protected]
(802) 371-3489
Contractual or educational issues.
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