September 2018

Meet Your New PPO Provider Network Consultant (PNC) Team

Blue Cross and Blue Shield of Illinois (BCBSIL) continues to expand its products and networks to better serve our members. New products and networks also affect how our independently contracted providers do business with us. We have been working to help ensure we continue to deliver the service and support our contracted providers need.

To help meet those needs, we have aligned our PPO Provider Network Consultants (PNCs) into teams of subject matter experts. Instead of just one PPO PNC, our regional support teams will be equipped to research and respond to your inquiries in a more timely and comprehensive manner. Additionally, our teams will be offering more training and education aimed at helping improve providers’ experience with BCBSIL.

Each PPO PNC team continues to serve as liaisons between BCBSIL and our independently contracted professional provider community. Your PPO PNC team is available to provide education on BCBSIL procedures, support provider contract compliance and work with each practice to help resolve any operational concerns. In addition, PNCs specialize in investigating issues, producing data and developing solutions. This dedicated staff has a thorough knowledge of all BCBSIL PPO products, programs and initiatives.

Join Us for a Virtual Provider Workshop
Virtual provider workshops will be hosted throughout the year. Look to the Workshops/Webinars section of our Provider website and the Provider Learning Opportunities section of the Blue Review for upcoming dates and registration links.

How to Contact Your PNC Team
You can contact your assigned PPO PNC team by using the Professional Provider Network Consultant List. Each demographic region has an assigned email address managed by the PNC team dedicated to that area. Inquiries are monitored daily and responses are provided within five business days. 

As a general reminder, please ensure all necessary information is provided. This includes call reference number or Claim Inquiry Resolution (CIR) Tracking ID. For inquiries related to credentialing, include the Tax ID, billing National Provider Identifier (NPI), rendering provider name, license number, rendering provider NPI and Council for Affordable Quality Healthcare (CAQH^®) number.

If you need help identifying your designated PNC team, email ProviderRelations@bcbsil.com along with your provider name, NPI, Tax ID, city and county.

CAQH is an independent third party not-for-profit collaborative alliance of the nation’s leading health plans and networks. The mission of CAQH is to improve health care access and quality for patients and reduce administrative requirements for physicians and other health care providers and their office staffs. CAQH is solely responsible for its products and services, including the ProView database.