The Patient Care Summary transaction is accessed after submitting a Health Eligibility inquiry. Click directly on the Health Eligibility link or on the Patient Care Summary hyperlink found on the Blue e homepage. After entering the required information for Health Eligibility, the display returned includes a button to access the Patient Care Summary.
For information and guidelines about who should be accessing Patient Care Summaries, please see the section Additional Information for Blue e Administrators, below.
The Patient Care Summary - derived from BCBSNC claims data -lets healthcare professionals know how their patients are doing on approximately 50 nationally established evidence-based practice guidelines. The first page of the summary provides the first 10 instances of both Rx prescriptions and medical appointments on file. Subsequent pages contain up to 12 months of Rx information and 36 months of medical care records.
The Patient Care Summary reflects data collected on claims filed with BCBSNC. Treatment that was not filed as a BCBSNC claim is not included in the report. The Patient Care Summary is currently available to BCBSNC commercial customers including the State Health Plan. The PCS is currently not available for customers of Medicare Supplement Plans, Medicare Advantage, and the Federal Employee Program.
To learn more about the Patient Care Summary, see Patient Care Summary FAQs, which includes frequently asked questions and a list of all measures addressed in the Patient care Summary.
For step by step information on how to access and navigate the PCS see Patient Care Summary Job Aid. This job aid also includes an overview of each section of the report.
If you have questions about the content of the Patient Care Summary, please call BCBSNC Provider Blue Line at 1-800-214-4844.
Blue e administrators will have the ability to allow an existing Blue e user to see the report by changing the user's role to one that includes access to the PCS. User roles that include access to PCS have been distributed to administrators for assignment. You may have one or all of the roles identified below. Administrators can see the User Roles available for assignment by clicking on the Role Tab when you go to Entity Management from the Blue e Home Page.
These roles should be assigned judiciously, as the Patient Care Summary includes a high level of protected information. The table below identifies the Blue e user roles that include the Patient Care Summary access, as well as suggestions on assigning these roles.
| Blue e Role with PCS | Role Description | Who Should Get This Role? |
| PHYSPCS | Professional plus PCS | Suggested for personnel who perform a broad spectrum of functions, both for patient management and professional billing, and also need access to detailed patient medical history. |
| BSBCPCS | PCS Institutional Professional | Suggested for personnel who perform a broad spectrum of functions, both for patient management and UB04 or CMS1500 billing and financial accounts management, and are allowed to see patient medical history. |
| PHYSADMINPCS | Professional Entity Admin plus PCS | Suggested for personnel who need to perform patient management functions, are allowed to see patient medical history, and also act as Blue e administrators for other personnel. |
| PCSONLY | Patient Care Summary & Eligibility | Suggested for personnel that need to check patient eligibility and have access to detailed patient medical history. |