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Contact Information


Provider Administrative Policy

Section
Blue Cross of Idaho 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

 

Provider Contact Center for Commercial and Medicare Advantage
Hours: 8:00 a.m. - 5:00 p.m., MT (Monday, Tuesday, Thursday, Friday)
8:30 a.m. - 5:00 P.m., MT (Wednesday)
Interactive voice response (IVR) provides instant answers to 24/7 your questions about claim status, eligibility, deductible status and prior authorization. The IVR system does not provide FEP or BlueCard claim status information.

Type of Business Local Toll-Free
Pre-service benefits for Commercial, FEP, Dental
and Medicare Advantage lines of business
208-286-3656 866-482-2250
For the Hearing Impaired TTY: 800-223-3131
TDD: 800-377-1363

Medicare Medicaid Coordinated Plan True Blue Special Needs 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, www.bcidaho.com
  2. Select Eligibility and Claims
  3. Select Claims, then search for the claim in question and view your claim
  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 to a Customer Service Agent following HIPAA compliancy guidelines.

Option 2

  1. Log onto our secure website, www.bcidaho.com
  2. Select Contact Us
  3. Select General Information under the Email heading
  4. Select a Question Category for 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

With option 2, the form auto populates your contact information based on your user name and password. The system securely delivers your submission to a Customer Service Agent following HIPAA compliancy guidelines

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 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:  208-286-3563

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

Commercial and Dental

Debbie Gossage CPC

E: PR6987@bcidaho.com

P: 208-286-3602 Ext. 8311
P: 866-283-5723 Ext. 8311

F: 208-286-3559

Commercial and Dental

Kathy Root CPC

E: PR8315@bcidaho.com

P: 208-286-3602 Ext. 8315
P: 866-283-5723 Ext. 8315

F: 208-286-3581

Electronic Billing

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

Mailing Address

Blue Cross of Idaho
PO Box 7408
Boise, ID 83707


Prior Authorization Contacts:

  Local Toll-Free Fax
Behavioral Health Management 208-331-7535 800-743-1871 208-387-6840
Medical Management 208-331-7535 800-743-1871 208-331-7344
Inpatient/Home Health/Hospice 208-331-7535 800-743-1871 208-331-7326
Case Management 208-331-8872 800-627-1187 Ext. 8872  
Disease Management 208-387-6924 800-627-6655 Ext. 6924  
Pharmacy Management 208-387-6666 800-627-6655 Ext. 6666 208-387-6969
Quality Management 208-331-7327 800-274-4018 Ext. 7327  

 AIM - American Imaging Management (AIM) Specialty Health

Non-emergent MRI/MRA, CT, PET and nuclear cardiology scans require authorization by the ordering physicians prior to scheduling the appointment. You can obtain prior authorizations for these services through AIM located within the provider portal at bcidaho.com, or by calling AIM's toll-free number at 866-714-1105. Failure to obtain prior authorization could cause a claim denial or delay.

AMI - Alternative Medicine Integration

Phone: 855-432-2667
Email: mmarek@amibestmed.com
Hours: 9:00 a.m. - 5:00 p.m. MT, Monday - Friday                                     


Policy History

Date Action Reason
August 2014 Revised Removed free clearing house language. Added states to PR reps regions
February 2014 Revised Updated External Reps regional coverag
January 2014 Revised Updated Credentialing's Fax number
June 2013 Revised Update Relations Representatives Regions
May 2013 Revised Update process for post-service claims
January 2013 Revised Added note to Internal and External Reps, added pre-service and post-service
August 2012 Revised Removed phone number for EDI
June 2012 Revised Updated AMI's email address
January 2012 Revised Removed NIHN contact information
October 2011 Revised Updated Internal/External Reps Regional Areas
September 2011 Revised Updated email address for Provider Contact Center
June 2011 Revised Added new contact information
October 2010 Revised Added mailing address, updated Provider Relation positions
August 2010 Revised Phone number revisions
January 2010 Revised BPA, Home Health/Hospice, FEP 24-hour, and NIHN phone number revisions
October 2009 Revised Behavioral Health, Inpatient/Home Health/Hospice, AIM numbers added
July 2009 Revised FEP phone number removed, BPA number for all but NIHN removed, extensions updated
March 2009 Revised Customer Service hours changed, phone number added
November 2009 Revised Phone number revisions
August 2008 Revised Email inquiries and contact headings
May 2008 Revised Employee and phone number revisions

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