Insurance Verification Phone Numbers for Providers

This centralized guide provides easy access to up-to-date phone numbers, specific contact hours, and helpful calling tips for all major providers. This one-stop resource empowers your staff to quickly connect with the right insurance representative, streamlining verification processes and boosting overall workflow efficiency.

Information for Eligibility Checks, Benefits Coverage, and Prior-Authorization:

Company NameToll Free NumberOperational HoursAdditional InformationWebsite
1Blue Cross Blue ShieldCheck the table belowVaries state-wise (Find table below).For specific state-wise provider helpline desk, you can go through the table given below.  blueshieldca.comaetna.com
2Aetna+1 888-632-38628.00AM - 6.00 PM (EST)Select option 1 for coverage and benefits OR option 3 for prior-auth requirements. Share the member's details and ask for the representative for assistance.https://apps.availity.co...uhc.com
3United Health Care+1 877-842-32108.00 AM - 5.00 PM (EST)Ask for an agent through IVR to directly connect for assistance. uhcprovider.com
4United Health Care - UMR+1 ‪877 233-1800‬8.00 AM - 8.00 PM (EST)Ask for an agent through IVR to directly connect for assistance. umr.com/provider
5United Health Care - Behivoral Health+1 800-201-69918.00AM - 8.00 PM (EST)Ask for an agent through IVR to directly connect for assistance. uhcprovider.comcigna.com
6Cigna+1 800-997-16549.00  AM - 8.00 PM (EST)Wait for the IVR recording to end, call automatically connects to the customer advocate.cignaforhcp.cigna.com
7Cigna - NALC Plan+1 888-636-62529.00 AM - 8.00 PM (EST)Press 2 to get benefits and prior-auth details. cignaforhcp.cigna.com
8Healthnet+1 800-641-77615.00AM TO 9.00 PM PSTFill out the provider's details, then ask for an agent through IVR to directly connect for assistance.healthnet.com
9Palmetto GBA +1 855-696-0705Open 8 a.m. to 5 p.m. ET, Monday through Friday.Press 1, then 3 to connect directly to an agent.onlineproviderservices.com
10WellMed+1 877-757-44409.00 AM to 9.00 PM Monday to Friday.For claims and authorization, press 1 to get prior-authorization information, following which you will directly connect to the agent. identity.onehealthcareid.com
11MHS Ambetter+1 877-687-11808.00 Am to 8.00 PM Monday to Friday.Go through the IVR to get benefits or prior-authorization details.ambetter.mhsindiana.com
12Humana+1 800-457-47088.00 Am to 8.00 PM Monday to Friday.You will be directed to the customer service advocate after giving the complete provider's and member's details to the IVR.humana.com/provider
13Quantum Health+1 855-696-07058.30 Am to 5.30 PM  (PST) Monday to Friday.Press 1, then 3 to connect directly to an agent.https://www.ccbyqh.com/#/
14Care N Care Claims+1 844-806-8216Press 1 for benefits and then press 2 to directly connect to the live customer representative.
15Tricare East+1 800-444-54458.00 AM TO 7.00 PM EST Monday to FridayPress 1 and then press 2 for eligibility and benefits OR Press 3 for prior authorization.humanamilitary.com
16Tricare West+1 844-866-93788.00 AM TO 7.00 PM EST Monday to Friday.Press 1 and then press 2 for eligibility and benefits OR Press 3 for prior authorization.tricare-west.comcarelon.com
17Carelon (For Prior-Auth)+1 800-252-20218.00 AM TO 5 PM CST MON - FRIAsk for an agent through IVR to directly connect for prior authorization information.carelon.com
18Imagine Health800-457-4708 8.30 AM To 4.30 PM Monday to Friday.imaginehealth.com
19CHAMPVA800-733-83878:05 a.m. to 7:30 p.m. ET, Monday-Friday.
20Banker's Life Medicare Supplement(800) 621-37248.00 AM TO 8.00 PM EST Monday to Friday.providers.bankers.com
21Cigna Healthgram(800) 446 54399.00AM TO 8.00 PM Monday to Friday.Press 1, then 1 again, and then 4 to connect to a live representative.  healthgram.comambetter
22Ambetter(800) 442-16238.00 AM TO 8.00 PM CST Monday to Friday.Provide NPI to get connected to a representative.ambetterhealth.entrykeyid
23Medicaid Superior Health Plan+187739159218.00 AM To 8.00 PM Monday to Friday.Secondary insurance, provide details and you will get connected to the agent. www.superiorhealthplan.com
24Silver Bach+8553599999
25EviCore88862273297.00 AM TO 7.00 PM CST Monday to Friday.evicore.com
26WebTPA80047789578.00 AM TO 8.00 PM EST Monday to Friday.webtpa.comapps.availity.com
27Anthem BC855-641-4862 (For 4-digit long prefixes with an alphabet between numbers in member ID)800-444-2726 (For 3-digit long prefixes in member ID)8.00 AM TO 8.00 PM EST Monday to Friday.Provide NPI, Tax ID, Insurance ID and DOB to the IVR prompts. Then choose 1 for Eligibility and Benefits or 3 for Prior Auth info. After eligibility information is given, the IVR lets you choose 'Something Else' as an option which connects directly to a live representative. apps.availity.com
28AARP Weekdays from 7 AM to 11 PM (ET) and on Saturday from 9 AM to 5 PM (ET).aarpprovideronlinetool.uhc.comtri
29Tricare for Life SP+18667730404Monday 5.00 AM  TO MIDNIGHT, Tuesday to Thursday 12.00 AM TO Midnight. Friday 12.00 AM TO 10.00 PM (CST)tricare4u.com
30Secure Horizon (UHC)+180071874968.00 AM TO 8.00 PM CST M-S onehealthcareid.com
31Aetna Senior Suppleemt8002644000M-F 7:00 AM-7:00 PM CTaetnaseniorproducts.com
32Florida Blue‪(855) 714-8894‬8.00 AM- 8.00 PM ESTapps.availity.com
33Cover Health‪(800) 836-68908.00 AM- 8.00 PMPress 1, then 1 again, provide NPI to directly connect to a live Rep.cloverhealthprovider.com
34MedCost800-648-75638.00AM TO 5.30 PM ET Mon- Fri secure.healthx.com
35Cigna Supplemental Benefits866-459-42728.00AM TO 8.30 PM ET Mon- Fri secure.healthx.comwellcare.com
36Wellcare+1 866-822-13398.00 AM to 8.00 PM ET Mon–FriPress 1 for English then you will get connected to the live representative automatically. wellcare.com

BCBS Provider Services Phone Numbers by State 2024

StateToll Free Number
1Alabama+1 800-517-6425
2Alaska+1 800-722-4714
3Arizona
4Arkansas+1 800-827-4814
5California+1 800-677-6669
6Colorado+1 888-817-3717
7Connecticut+1 800-934-0331
8Delaware
9DC+1 800-842-5975
10Florida+1 800-7272-2227
11Georgia
12Hawaii+1 808-948-6330
13Idaho
14Illinois+1 844-806-8216
15Indiana+1 800-972-8088
16Lowa
17Kansas
18Kentucky
19Loiusiana+1 800-495-2583
20Maine+1 800-934-0331
21Maryland+1 800-842-5975
22Massachusetts+1 800-882-2060
23Michigan+18773915921
24Minneasota+1 800-344-8525
25Mississippi+1 800-257-5825
26Missouri
27Montana+1 800-447-7828
28Nebraska+1 800-635-0579 (IVR)
29Nevada
30New Hampshire+1 800-934-0331
31New Jersey+1 800-624-1110
32New Mexico+1 888-349-3706 (IVR)
33New York+1 800-552-6630
34Western New York
35Northeastern New York+1 800-444-4552
36North Carolina
37North Dakota+1 800-368-2312
38Ohio
39Oklahoma+1 800-496-5774
40Oregon
41Pennsylvania
42Rhode Island+1 800-230-9020
43South Carolina+1 800-868-2510
44South Dakota
45Tennesse+1 800-924-7141
46Texas+1 800-451-0287
47Utah
48Vermont+1 833-592-9956
49Virginia+1 800-842-5975
50Washington
51Wisconsin
52Wyoming+1 800-442-2376
Disclaimer
The information contained in this document is intended for general informational purposes only and does not constitute medical or insurance advice. Insurance plan details and contact information are subject to change. For claims enquiry, please contact the claims department of the respective states.
Updated May 2024

Glossary of Insurance-terms

Authorization: Similar to pre-authorization, but may also refer to a referral needed from a primary care physician to see a specialist. Verification staff may need to confirm if an authorization is required for a specific service.
Benefits: The specific services or treatments covered by a patient's health insurance plan. Verification staff review the plan details to understand what services are covered and any limitations or exclusions.
Claims: A formal request for payment submitted to the insurance company by a healthcare provider for services rendered to a patient. Verification staff may need to gather information to ensure a claim is submitted accurately.
Claim Denial: A situation where the insurance company refuses to pay for a submitted claim. Verification staff may need to follow up on denied claims to understand the reason and potentially appeal the decision.
COB (Coordination of Benefits: When a patient has more than one health insurance plan, COB determines which plan is primary and pays first. Verification staff may need to understand COB rules if a patient has multiple insurance policies.
COB Payment Tracking: The process of tracking payments made by different insurance companies under COB rules to ensure the patient is not overbilled.
Copay (Copayment): A fixed dollar amount you pay for a covered medical service, like a doctor's visit or prescription medication. Unlike a deductible, a copay is typically paid at the time of service, often directly to the provider. Think of it like a set fee you pay for certain covered services.
Deductible: The amount of money you must pay out-of-pocket for covered medical services before your insurance plan starts sharing the cost. Think of it like a down payment you make on your healthcare expenses each year. Once you reach your deductible, your insurance plan typically kicks in and starts covering a portion of the remaining costs according to your plan benefits.
Eligibility: This refers to whether a patient is currently covered under a specific health insurance plan and has benefits in effect. Verification staff confirm a patient's eligibility to ensure the insurance plan will cover healthcare services.
EOB (Explanation of Benefits): A document you receive from your insurance company after a covered medical service is provided. This document explains the charges associated with the service, how much your insurance plan paid, and how much you are responsible for paying. Think of it as a receipt that details your portion of the bill after insurance has been applied.
EOB Review: The process of reviewing the Explanation of Benefits (EOB) document to ensure the insurance company covered services as expected and identify any discrepancies that might require clarification.
In-network: Refers to doctors, hospitals, and other healthcare providers who have contracted with your insurance company to provide services at a negotiated rate. These providers agree to accept specific rates from your insurance company for covered services. Using in-network providers generally results in lower out-of-pocket costs for you because your insurance plan has already negotiated a discounted price.
Maximum Out-of-Pocket (MOOP): The maximum amount you will have to pay out-of-pocket for covered medical services in a plan year after you've met your deductible. This includes deductibles, copays, and coinsurance. Once you reach your MOOP, your insurance plan typically covers 100% of allowed charges for covered services for the rest of the plan year.
Out-of-network: Refers to doctors, hospitals, and other healthcare providers who have not contracted with your insurance company. These providers do not have a pre-arranged agreement with your insurance plan on pricing. Using out-of-network providers typically results in higher out-of-pocket costs for you because your insurance plan may not cover as much of the service or may not cover it at all.
Pre-authorization (PA): Another term for pre-authorization, used to confirm if approval is needed from the insurance company before a specific service is performed. Verification staff obtain prior authorization to ensure coverage and avoid potential claim denials.
Premium: The regular monthly payment you make to your insurance company to maintain coverage under your health insurance plan. Think of it as your monthly subscription fee for having health insurance.
Prior Authorization: In some cases, your insurance company may require pre-authorization before covering certain medical services, such as surgery or hospitalization. This means you or your doctor needs to get approval from the insurance company before the service is performed. This helps the insurance company manage costs and ensure the service is medically necessary according to their plan guidelines.
Referral: A written order from a primary care physician for a patient to see a specialist. Verification staff may need to confirm if a referral is required and ensure it's valid.