Who is responsible for getting prior plan approval from BCBSNC?
Your doctor. If your doctor is part of the BCBSNC network, he or she should contact BCBSNC and request prior plan approval for your scans. If your doctor is not part of the BCBSNC network or is located outside of North Carolina, you must tell your doctor to get prior plan approval for you. An out-of-network or out-of-state provider will not be familiar with BCBSNC’s prior plan approval requirements. If prior plan approval is not obtained, BCBSNC will not pay for the scan and you will be responsible for the bill (this does not apply if you see an in-network provider). Tell your doctor to visit our Web site, www.bcbsnc.com/providers/ppa, for more information about how to get prior plan approval for your scan.
