bluekc provider portal

Input your billing group information. Medical Policy | Home To get started, we will need you to create a new user login to access myBCBSRI. OAuth 2.0 authorization code flow in Azure Active Directory B2C, Azure AD B2C OAuth 2.0 token endpoint (v2), https://bluekcprod.b2clogin.com/bluekcprod.onmicrosoft.com/B2C_1A_InteropAppDeveloperAuthorizationFlow/oauth2/v2.0/token, Azure AD B2C OAuth 2.0 authorization endpoint (v2), https://bluekcprod.b2clogin.com/bluekcprod.onmicrosoft.com/B2C_1A_InteropAppDeveloperAuthorizationFlow/oauth2/v2.0/authorize, Azure AD B2C OAuth 2.0 logout endpoint (v2), https://bluekcprod.b2clogin.com/bluekcprod.onmicrosoft.com/B2C_1A_InteropAppDeveloperAuthorizationFlow/oauth2/v2.0/logout, Azure AD B2C OpenID Connect metadata document, https://bluekcprod.b2clogin.com/bluekcprod.onmicrosoft.com/B2C_1A_InteropAppDeveloperAuthorizationFlow/v2.0/.well-known/openid-configuration, https://bluekcprod.b2clogin.com/bluekcprod.onmicrosoft.com/B2C_1A_InteropAppDeveloperAuthorizationFlow/Samlp/metadata, Azure AD OAuth 2.0 authorization endpoint (v2), https://bluekcprod.b2clogin.com/bluekcprod.onmicrosoft.com/B2C_1A_InteropMemberAuthorizationFlow/oauth2/v2.0/token, https://bluekcprod.b2clogin.com/bluekcprod.onmicrosoft.com/B2C_1A_InteropMemberAuthorizationFlow/oauth2/v2.0/authorize, https://bluekcprod.b2clogin.com/bluekcprod.onmicrosoft.com/B2C_1A_InteropMemberAuthorizationFlow/oauth2/v2.0/logout, https://bluekcprod.b2clogin.com/bluekcprod.onmicrosoft.com/B2C_1A_InteropMemberAuthorizationFlow/v2.0/.well-known/openid-configuration, https://bluekcprod.b2clogin.com/bluekcprod.onmicrosoft.com/B2C_1A_InteropMemberAuthorizationFlow/Samlp/metadata. Refresh member education on Interoperability. Check the initial credentialing status for new providers. Using the Practitioner endpoint, you will not need to provide any search parameters. We won't share the information we collect. 2023 Blue Cross and Blue Shield of Kansas City. Then, you will be routed to the Guiding Care Portal for a list of previously entered prior authorizations. Blue KC Interoperability Developer Portal Choose your plan type to get to the right portal. On that page, you should select the Review or Submit Prior Authorizations button to log in and enter a Prior Authorization electronically on the Portal. Driving Directions. Testing production configuration is difficult because you need a valid set of credentials All rights reserved. Our powerful digital tool for providers can be accessed 24/7 with a click of a button! Search Prices Not Registered for the Portal? You can use the Practitioner endpoint with a given practitioner name at the end of the URI. You will be directed immediately to the Member I-D input page, and you can select the View History button. If you're a Blue KC member or customer, please review our information for Blue KC Interoperability Developer Portal. What type of plan does the patient have? Provider Central Register for our site today for news, updates, and other information Participating providers and their billing agencies can register for Provider Central to get full, personalized access to News Alerts, fee schedules, and more. An independent licensee of the Blue Cross and Blue Shield Association document.write(new Date().getFullYear()) Blue Cross and Blue Shield of Kansas City. Blue Medicare Advantage Member Portal | Blue KC For Prescription Drugs: Name of drug/medication Strength of the drug (example 5 mg) Quantity being prescribed Days supply New Prior Authorization Check Status Complete Existing Request Prescriber Provider A new-look home page gives you one- to two-click access to core health insurance functions, including member eligibility and benefits, prior authorization, claims inquiry and remittances. If you wish to continue using the Blue KC employer portal, you must contact your companys Organizational Administrator (OA) for registration assistance. The Medical Policies are regularly reviewed and may be updated or modified and, therefore, are subject to change. Check the initial credentialing status for new providers. Your customers want high-quality health insurance at an affordable price. 2020 Blue Cross and Blue Shield of Kansas City. Track deductibles and spending account balances. So simply changing out the appid, base URL, An independent licensee of the Blue Cross and Blue Shield Association. Blue KC Interoperability Developer Portal - data.bluekc.com This section contains Medical Policies approved by Blue Cross and Blue Shield of Kansas City ("BCBSKC"). You will land on the first step of beginning a prior authorization. Blue KC's provider portal gives you 24/7/365 access to: Member information such as the status of a claim, eligibility of a member, Then select, Lookup. It is considered extremely sensitive and failure to adequately safeguard tokens may result Find Doctors, Hospitals & Pharmacies | Blue Cross Blue Shield KC You can search for a practitioner in various ways. It also provides general information for compliance and business personnel to understand how Blue KC has Blue KC | Agent Portal info, Learn about NICU level of care authorizations and case management, October 2023 Medical and Pharmacy Policy updates now available, Third quarter 2023 hospital outpatient drug fee schedule posted. Please call the provider before making an appointment to verify that the provider continues to be part of the network. If Blue KC has not yet received your CAA premium survey information for 2020/2021, please complete at the following link:CAA Premium Survey. The name text field is searched and matches each token in that field as separated by spaces or commas. Keep in mind you may be routed to other partner sites for different types of prior authorization requests, such as eviCore or Avalon. This webpage provides instructions for developers to learn how to connect to and consume the Patient Access API, Provider Directory API and Payer to Payer API. Both fields are required. FAQ - Blue Cross and Blue Shield of Kansas City Access Anywhere Enhancing Care Quality We empower providers in our networks to improve care delivery for you. Tax ID: National Provider ID (NPI): Cancel. For Healthcare Providers Visit the secure portal to access a variety of Blue KC information - including medical policies, claim information and more. Provide the information of your billing group and the Blue KC provider I-D of the providers you are contracted with. Obtain forms for: Pre-authorization Pharmacy, Pre-service, Utilization Management, and; Little Stars Physician Referral forms; Forms Go to Payment Policies New Provider Network Interest Form From an OAuth perspective the flow is called and authorization flow because the person Medical policy Medication search BCBS Plan Medical Policy & pre-cert. Per CMS Interoperability rules we can remove vendors and 3rd parties from access to our published APIs if they present a risk Once a token (JWT) is issued, its security is the responsibility of your app. Provider Portal Features include: Search and review claims Submit and view electronic prior authorizations Look up member eligibility and benefits Access Medical and Payment Policies See provider remittances This webpage provides instructions for developers to learn how to connect to and consume the Patient Access API, Provider Directory This may be self or other (e.g. Learn more Select one of the two categories below to browse prior authorization forms. for such flows. Then, scroll down to the prior authorization section. An independent licensee of the Blue Cross and Blue Shield Association A return status of 403 is non-recoverable and indicates a bad search parameter, a resources In the Recent News Updates section, youll find: To take advantage of an easier prior authorization experience, make sure you have a Blue KC Provider Portal account. PDF BlueKC Dental Provider Directory 5. Create a new login today for myBCBSRI.com member portal. Benefit determinations are made in the context of Medical Policies existing at the time of the benefit determination and are not subject to later revision as the result of a change in medical policy. 3. Please note that the premium information is only one piece of the mandatory CAA RxDC pharmacy and medical spend reporting required each year. If you have already signed-up for myBCBSRI, please login below. Pursuant to CMS Interoperability requirements we are providing instructions for app developers to access to the Patient Access, If you have questions, please email Blue KC. Services, Durable Medical Equipment (DME) and Protheses - Login Check the initial credentialing status for new providers. The new enhancements provide quicker account registration and a much easier prior authorization experience. If you believe your billing group has already registered with Blue KC and you need a user I-D to access the Blue KC Provider Portal, then click Existing Billing Group. Register Now Username Password How to Use the Provider Portal Forgot Username? The Medical Policies do not constitute medical advice or medical care. We've doubled spending on mental health care. Blue Benefit Bucks (BBB) Intro Video Blue Benefit Bucks Your Blue Benefit Bucks (BBB) card works like a debit card and comes loaded with the benefits from the plan you choose. E-P-A, which stands for Electronic Provider Access. Managing your health coverage plan is easy with the MyBlueKC Member Portal. Provider Login Not Registered for the Provider Portal? Register Now Username Password How to Use the Provider Portal Forgot Username? Home - BlueKC PromptPA Portal Submit and view electronic prior authorizations, including member eligibility and benefits. Select Submit or Review a prior authorization. Refresh tokens last for 90 days, but a member/patient may revoke access at any time. Create Your Account - Blue KC personal representative or parent for a minor child). If you don't know a practitioner's reference ID you can use the Practitioner endpoint with no added search parameter, then locate the desired practitioner. 2020 Blue Cross and Blue Shield of Kansas City. Blue KC Member Portal Enter Zip Code Speak with a local Medicare advisor: (855) 2088246 (TTY:711) '; Learn the basics of Medicare. Below is a complete list of URLs that your app may need to know. implemented Interoperability rules from CMS. For questions or general assistance call 844-227-5769, or fax requests . (name|patientId) with | as the separator. Microsoft documentation: OAuth 2.0 authorization code flow in Azure Active Directory B2C. To use Avalon's Prior Authorization system, you require a user account to Avalon's Provider Portal. In particular, it Welcome to Blue KCs Provider Portal. Start Select a Directory and Provider Provide Search Information View Results We're dedicated to keeping your online personal information private and secure. Speed through the process of submitting insurance claims online and get reimbursed faster. Our powerful digital tool for providers can be accessed 24/7 with a click of a button! authorization step must pass the generated token to the app on the mobile device. On the log-in page, click the Forms button to get to our Forms page. Forgot Password? You can use the Practitioner endpoint with an identifier at the end of the URI. For those all-important details about your health plan, all you have to do is ask. Registered Marks of the Blue Cross and Blue Shield Association. This section contains Medical Policies approved by Blue Cross and Blue Shield of Kansas City (BCBSKC). With new and improved features, the MyBlueKC app gives you easy access to your healthcare coverage 24/7, wherever you are. Provider Portal | Find Care - Blue KC Medicare Plans in Kansas City | Blue KC Medicare Contact us: (855) 208-8246 (TTY:711) Member login portals Part C Medicare Advantage View your coverage details Within your app this allows you to manage only one JWT, but pull data for multiple people. authorizes an app to make API calls using the identity of the person. Blue KC is proud to be the largest provider of health insurance plans in a 32-county area serving greater Kansas City and northwest Missouri. As a last resort, you can choose a fax, mail or e-form option. Register now or learn more. The Participating providers and their billing agencies can register for Provider Central to get full, personalized access to News Alerts, fee schedules, and more. All rights reserved. Login - Blue KC For Healthcare Providers Visit the secure portal to access a variety of Blue KC information - including medical policies, claim information and more. from a production member to validate the workflow and return URL, PKCE configuration, etc. Request the Member Handbook, a list of providers, and other important documents to be mailed to your home. So, just choose the member you want to get to the code selection screen. PROVIDER DIRECTORY PAYER TO PAYER Search for Practitioner (s) Find all providers and their personally related resources/services/etc. AppID, return URLs and scope. strong financial incentive for malicious actors to steal such tokens. Your 12-digit member ID contains 2 letters and 10 numbers. IDs in the JWT. Login to Access your Plan Information | Blue KC Medicare MyBlueKC - Apps on Google Play An example search for Garry Martin is listed as Martin, Garry in the data so the search is "Martin Garry", with no comma included. In addition, Current Procedural Terminology (CPT ) codes and descriptions are the property of the American Medical Association with all rights reserved. Blue KC - Provider Portal Providers with Internet access can quickly find answers to questions about members, providers, and benefit plans by visiting Blue KC's provider portal at Providers.BlueKC.com. Credentialing Status. A plan through their employer A Medicare Advantage plan An individual or family plan (Affordable Care Act) A short-term individual or family plan We highly recommend PKCE for any mobile app usage and PKCE can be integrated into any flow. Explore guidance and resources Pay a bill For members with an Individual/Family plan only (not through an employer), easily and quickly pay your Blue KC bill. Forgot Password? All rights reserved. Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association. 2023 Blue Cross and Blue Shield of Massachusetts, Inc., and Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc. 101 Huntington Avenue, Suite 1300, Boston, MA 02199-7611, BCBS Plan Medical Policy & pre-cert. And thats one healthy place to be. Prior Authorization Blue Cross and Blue Shield of Kansas City (Blue KC) may require prior authorization before certain medical services and/or medications are performed or dispensed. Depending on the libraries and tools you use, different things may be asked for. malicious purposes. Your code will need to understand one of these custom claims. Provider Directory API and Payer to Payer API. 2020 Blue Cross and Blue Shield of Kansas City. This is a complex search parameter on the Practitioner endpoint. It also provides general information for compliance and business personnel to understand how Blue KC has implemented Interoperability rules . So, a search for Martin will find providers with a first name or last name of Martin. And you also have the option to do a type-ahead capability for things like C-P-T code, the name of the procedure or the name of the drug. Call us at (866)508-7140. If you don't yet have a MyBlueKC account, create an account first. Use your account to access your digital ID card, view benefits, check claims, and more. Agents and Providers | Blue Cross and Blue Shield of Kansas City Once you have completed your development within the test environment you may shift to using the Production URLs. If you wish to continue using the Blue KC employer portal, you must contact your company's Organizational Administrator (OA) for registration assistance. Credentialing Status. BlueKC Dental Provider Directory Blue Cross and Blue Shield of Kansas City (Blue KC) has made reasonable efforts to ensure that the list of providers displayed is up to date and accurate. What happens if you are unable to get a user I-D on the Blue KC Provider Portal? form. "I have been with Blue Cross and Blue Shield for years and have always been really happy with them." Access to the Patient Access API requires a user account. services. To view an existing electronic prior authorization request, once logged in to the Provider Portal, select Prior Authorizations. tokens are only available with the appropriate OIDC flows and PKCE is strongly encouraged If the member/patient has authentication issues, please direct the member to Compliance with and agreement to our Terms of Service is required to access and use Interoperability APIs. token with the refresh token). The token returns all of the standard JWT elements from Azure B2C plus some custom claims. Blue KC members can access doctors, hospitals and pharmacies through a variety of networks. The search for all practitioners is quite easy. These Medical Policies describe when medical services are considered medically necessary, not medically necessary or investigational. Provider Login - Blue KC Register now or learn more. PKCE is designed to deal with a specific attack wherein the the browser used to perform the Provider Portal Tutorials - Blue KC Finally, you will be directed to the proper Blue KC vendor Portal to complete entry of electronic prior authorization. The production endpoints will return one or more patients that the user has authorized. Medical policy determines if, and under what circumstances, medical services may be eligible for coverage. Provider Login - Blue KC Registered Marks of Blue Cross and Blue Shield of Massachusetts, Inc., and Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc. Registered Marks, TM Trademarks. Behavioral health services for Blue KC members - Mindful by Blue KC Member Services Behavioral health services for Blue KC members Blue KC is dedicated to thinking differently about coverage and care, enhancing the behavioral health services provided in member health plans. All rights reserved. To request an account for your users and to register your app please State and Federal mandates and health plan contract language, including specific provisions/exclusions, take precedence over Medical Policy and must be considered first in determining eligibility for coverage. When queries against the API need the patientId parameter you can find the allowable patient Member Portal - BCBSRI Lastly, searching for a specific practitioner by name is just as easy as the rest, but there are some rules! Although a service may be medically necessary, it may be excluded under a members benefit plan. Enter the 16 digit card number and expiration date of your Benefits Mastercard Prepaid Card. If you do not provide premium information by November 18, 2022, Blue KC may be unable to submit RxDC reporting on your behalf. Email. Login to access your plan information If you're enrolled in a Blue KC Medicare plan, there's a member portal available to give you easy online access to the information you need. Select a Provider Directory You are currently searching for a provider in the Local Blue KC Provider Directory. Find a doctor, hospital or other healthcare provider. https://members.bluekc.com and work out their authentication issues with Blue KC member We're dedicated to keeping your online personal information private and secure. View and share your ID card. Blue KC Member Portal fill out this To determine how to use PKCE in your app please consult your app devleoper documentation on how to implement PKCE in particular with Azure B2C. You can input the prefix or exclude it. SMS 2 factor is not available. Login Log in using your username and password. You will need to understand how to configuration your application to participate in an Open the dropdown, and you can search through any procedure, code or drug name and make your selection. You may safely ignore the To learn more, view the summaries and videos below: An independent licensee of the Blue Cross and Blue Shield Associationdocument.write(new Date().getFullYear()) Blue Cross and Blue Shield of Kansas City. Obtain forms for: Pre-authorization Pharmacy, Pre-service, Utilization Management, and; Little Stars Physician Referral forms; Forms Go to Payment Policies New Provider Network Interest Form Provider Login - Blue KC A return status of 401 is recoverable and requires re-authentication (or renewing the access Find all providers and their personally related resources/services/etc Below we have provided sample URLs for calling our Provider Directory API. Your patients want the confidence of the Cross and security of the Shield. The member will also need to set up 2 factor authentication using either the Microsoft or Need help? information we needed a way store in the JWT who the patient has authorized for your app. Check the box if you are an office administrator, hit register and you are done! All Practitioner Search This is a complex search parameter on the Practitioner endpoint. To page over, you can use a URI which includes page numbering: Before using our production URLs, please utilize the UAT URLs provided in the hyperlinks. For example: Kerry's patient ID is 90003160541. We won't share the information we collect. Blue KC | Employer | Prior Authorization should absolutely want to know the authorize endpoint. Plus, they enjoy the highest quality health coverage, and highest level of customer service. 4. This is then URL encoded so the space works as a parameter. If you have questions, please email Blue KC. You can search for a practitioner in various ways. Blue KC is proud of recent enhancements that were made to the Portal. A first and last name can be searched together if separated by a space. Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc., and/or Massachusetts Benefit Administrators LLC, based on Product participation. No part of this publication may be reproduced, stored in a retrieval system or transmitted, in any form or by any means, electronic, photocopying, or otherwise, without permission from BCBSKC. Forgot Password? info Searching for a specific practitioner by Reference ID is also quite easy. Each element of the "consentedMemberNamesAndBeKeys" array is a tuple Provider Portal | Find Care Find Patient Care Search Doctors, Hospitals and More Help patients find medical care in their specific network. While there may be no known malicious apps stealing tokens used for FHIR APIs there is Treating health care providers are independent contractors and are neither employees nor agents of BCBSKC and are solely responsible for diagnosis, treatment and medical advice. Live Healthy With Blue KC | Kansas City Health Insurance OIDC (OpenID Connect, OAuth 2.0) authorization flow. 2301 Main Street Kansas City, MO 64108 816-395-2222 Request a Blue Medicare Advantage document. PKCE prevents other apps from reading that token from the browser to use the token for The sandbox authorization endpoints always return a particular set of patients During the flow a standard authentication step will occur. Need help? particular with Azure B2C. PKCE in your app please consult your app devleoper documentation on how to implement PKCE in The result of the flow is an identity token that that contains an access token. In some cases, an Authorization Type dropdown will display. Our Terms of Service deal with concerns about providing minimal Welcome to Blue KC's Provider Portal. Members should refer to their benefit protections of Blue KC assets from malicious or inadvertent harm. See your most recent claims. If the I-D is related to more than one member on the plan, you will be directed to all the members on that plan. Credentialing Status Obtain forms for: Pre-authorization Pharmacy, Pre-service, Utilization Management, and Little Stars Physician Referral forms If you click on I am a Medical Billing Group, which is for users who are part of a billing group that is contracted with a Blue KC provider, choose New Billing Group if this is the first time your billing group is registering on the Blue KC Provider Portal.
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