Provider Resources

Welcome Providers!

Preferred Network Arrangements

CBA Blue administers many national and regional Employer Group Benefit Plans for Vermont-based businesses and organizations. CBA Blue medical plans utilize the national BlueCard® network. When a member sees a BlueCard® provider, they receive the benefit of the savings that the local Blue plan has negotiated. Dental plans administered by CBA Blue include access to our Dental Blue® Network.

Blue Exchange

In many cases, providers can send eligibility and benefits inquiries to the local Blue Cross Blue Shield (BCBS) plan when dealing with a TPA that is part of the BCBS network. This process works because of the integrated systems and standards established through BlueExchange and the BlueCard® Program, which ensures seamless coordination between BCBS entities. Here's how it typically works:

How the Process Works:

Provider Sends Inquiry to Local Plan
Providers are generally encouraged to send eligibility and benefit inquiries to their local BCBS plan. This is the same process they would use for members enrolled in traditional BCBS plans.

BlueExchange Routes the Inquiry:
The local BCBS plan uses the BlueExchange system to route the inquiry to the appropriate "home plan" or TPA that holds the member's policy. This routing is seamless and invisible to the provider.

Response Returns Through the Local Plan:
The home plan or TPA responds to the inquiry via BlueExchange, sending the information back to the local plan, which then forwards it to the provider.

Prior Authorizations

Depending on a member’s plan, you may be required to request prior authorization or precertification for any number of services. Please use our Authorization Request Form located here:

Online Authorization Request https://forms.cobaltbenefitsgroup.com

Healthcare providers submitting directly to CBA Blue:

Updates to your service, office, or billing address can be submitted to the Provider Maintenance Department by using the Provider Demographic Change Request Form.

Please note submitted updates/changes will only apply to CBA Blue plans, please also contact your BC/BS VT provider representative with any updates if applicable.

Questions about claims, benefit information or verification of benefits?

If you have questions about a claim, eligibility or verification of benefits please call and speak with a LIVE representative at 888-222-9206.

Need Help with Online Portal Registration or Password Assistance?

For assistance with portal registration or portal password assistance, please call 888-962-2583.