Welcome Providers!

Effective January 1, 2024, Healthy Blue will no longer participate in Nebraska’s Medicaid Managed Care Program. Healthy Blue will continue to be responsible for proper and timely adjudication of all services rendered to its enrollees until 11:59 p.m. on December 31, 2023. Healthy Blue is also responsible for inpatient stays that begin on or before December 31, 2023, through discharge or 60 days, whichever is earlier.

For services provided January 1, 2024, and later, review the member’s ID card for the current health plan assignment or call 877-255-3092.

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Update Your Provider Information

Starting on January 1, 2021, WellCare of Nebraska will be operating on Healthy Blue systems, which will require providers to be enrolled with Healthy Blue and submitting claims in accordance with their Nebraska Medicaid enrollment profile. 

Failure to correct inaccurate information, or bill utilizing Medicaid enrollment profile data, will result in claim rejections as of January 1, 2021.  

Transitioning providers commonly need to update:
  • NPI
  • Taxonomy
  • Address including ZIP+4
  • Group affiliation
Please visit  Maximus to review your Medicaid enrollment profile to ensure all data is correct. 

COVID-19 Information

Healthy Blue is closely monitoring COVID-19 developments and how the novel coronavirus will impact our customers and provider partners.

Availity Access

Availity offers health care professionals free access to real-time information and instant responses in a consistent format, regardless of the payer.

With Availity, you can:

Request authorizations.
Submit claims.
Confirm eligibility.

Don’t have an Availity account?

Receive email from Healthy Blue

Healthy Blue is now sending some bulletins, policy change notifications, prior authorization update information, educational opportunities and more to providers via email.

Provider News

Get the latest articles and announcements on claims filings, products, benefits, administrative updates, new and revised procedures and guidelines, prescription information, and more.

Featured Resources

Pharmacy Information

Search for up-to-date drug information, including hundreds of brand-name and generic medications.

Prescription Drug Monitoring Program

The Prescription Drug Monitoring Program (PDMP) is a program through which prescriptions are tracked to help identify patient who may be misusing opiods or other controlled substances. All providers who prescribe C-II controlled substances to Medicaid members must review the prescription drug history in the Nebraska PDMP within seven (7) days prior to prescribing the C-II medication. For additional information, please see the PDMP presentation:

Maternal Child Program

When it comes to our pregnant members, we are committed to keeping both mom and baby healthy. That’s why we encourage all our moms-to-be to take part in our New Baby, New LifeSM program. The New Baby, New Life program is a comprehensive, proactive case management and care coordination program for all expectant mothers and their newborns.

Behavioral Health Provider

We work collaboratively with hospitals, group practices and independent behavioral health care providers, community and government agencies, human service districts, and other resources to successfully meet the needs of members with mental health, substance use, and intellectual and developmental disabilities.

Provider Tools & Resources