Contact us
Call one of our Customer Advocates
Phone (8 a.m. to 8 p.m.)
October 1 to March 31: seven days a week
April 1 to September 30: Monday through Friday
Toll-Free
1-888-494-2583 (TTY 711)
Fax
208-387-6811
Call us at 1-888-494-2583 after hours. Follow simple prompts for automated prior authorizations or to check the status of a claim.
Leave a message and we will call you back the next day.
You can send us an email with your questions. We will respond the next day, if not sooner.
Log in to your member account to review deductibles and claims, view drug list information, and more.
Llame a Blue Cross of Idaho Care Plus, Inc. al 1-888-494-2583 (TTY: 711). Estamos disponibles para atenderlo de 8 a.m. a 8 p.m., los siete días a la semana, desde el 1 de octubre hasta el 31 de marzo. Entre el 1 de abril y el 30 de septiembre, abrimos de lunes a viernes de 8 a.m. a 8 p.m
If you need to get a drug that is medically necessary but is not included as a covered drug under your plan, you can work with your doctor to request an exception. This is called an organizational determination or a pharmacy exception. If you need a fast decision, we can help there too.
If we haven't covered a service claim the way you think we should, you can ask us to reconsider the decision. This is called an appeal. We can help with your appeal by reviewing the situation and even get an independent review for you.
If you have a problem with how a service was provided, let us know. This is called a grievance. We will look in to your situation to see how it can be resolved.
Generally, we respond to your questions and issues the same day. Sometimes we will need medical records or additional information. In these cases, we are still required to respond to you no later than the timeframes outlined here.
| Request | Standard response | Expedited response |
|---|---|---|
| Pharmacy organizational determinations | ||
| Pharmacy organizational determinations | Within 72 hours | Within 24 hours |
| Pharmacy claims payment appeals | ||
| Pharmacy claims payment appeals | Within 7 days | Within 72 hours |
| Medical organizational determinations | ||
| Medical organizational determinations | ||
| Prior Authorization (pre-service) | ||
| Prior Authorization (pre-service) | Within 14 days | Within 72 hours |
| Claim (post service) | ||
| Claim (post service) | Within 60 days | N/A |
| Grievances and other complaints | ||
| Grievances and other complaints | Within 30 days | N/A |
We have free interpreter services to answer any questions you may have about our health or drug plan. To get an interpreter, just call us at 1-888-494-2583 (TTY: 711). Someone who speaks English can help you. This is a free service in the following languages: English, Spanish, Mandarin, Cantonese, Vietnamese, German, Korean, Russian, Hindi, Italian, Portuguese, French Creole, Polish, Japanese, Bantu, Farsi.
ESPAÑOL: Tenemos servicios de interprete sin costo alguno para responder cualquier pregunta que pueda tener sobre nuestro plan de salud o medicamentos. Para hablar con un interprete, por favor llame al 888-494-2583 (TTY: 711). Alguien que hable espanol le podra ayudar. Este es un servicio gratuito.
Blue Cross of Idaho and Blue Cross of Idaho Care Plus, Inc. (collectively referred to as Blue Cross of Idaho) complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex.
Powered by Blue Cross of Idaho Care Plus, Inc.
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