Our Provider Network Consultants serve as the liaison between Blue Cross and Blue Shield of Illinois and our independently contracted provider community, developing and maintaining working relationships with their assigned providers. Among other services, your assigned PNC can:
- Help keep you up to date on our products, programs, and initiatives.
- Alert you of training opportunities.
- Help ensure adherence to financial requirements and contractual compliance.
- Provide education on administration and delivery of managed health care, such as quality improvement and utilization management programs, the implementation of legislative requirements, and preventive care and wellness initiatives.
Note: For claims issues or inquiries, please contact Customer Service or verify claim status online.
Dedicated PNCs
Certain providers may be assigned to a dedicated PNC. These PNCs are available to help address any special needs or concerns you’ve been unable to resolve. To find your designated point of contact, refer to the Field PNC Assignment List.
Dedicated Group PNCs
Other providers may be assigned to a dedicated group of PNCs. These PNCs are available to help address any special needs or concerns you’ve been unable to resolve.
Contact information:
- Cook, DuPage, Kane, Lake, McHenry, and Will counties
- All other IL counties
Note: Independently contracted providers who work with members of Blue Cross Community Health PlansSM and Blue Cross Community MMAI (Medicare-Medicaid) PlanSM may contact the Government Programs Provider Relations Team.
Ancillary
This includes ancillary providers (durable medical equipment, home infusion therapy, skilled nursing facility, home health, hospice, orthotics/prosthetics, dialysis, and private duty nursing.) These PNCs are available to help address any special needs or concerns you’ve been unable to resolve. Please contact Ancillary PNCs.
HMO Medical Groups/Independent Practice Association PNCs
HMO Medical Groups in the HMO Illinois, Blue Advantage HMO, BlueCare Direct, Blue Precision HMO, and Blue FocusCare networks may refer to the HMO MG/IPA PNC List.