tools for medical providers
Advanced Health
Information Network (AHIN) — Determine eligibility, check claim
status, correct errant claims and submit new claims. View demo and
Enrollment Information
BlueCard® Guide
BlueCard News
Coverage Policy
Electronic Data Interchange (EDI) —
Resource for the Health Insurance Portability and Accountability Act (HIPAA) requirements
and testing.
5010 Resource Center
ICD-10 Resource Center
Forms for Providers
HealthConnect Blue — Health information and interactive health
coaching.
Medical
benefits covered by your patient's health plan
My BlueLine — Interactive voice
response telephone system.
Medical Policy and Pre-certification/Pre-authorization
— Policy and pre-certification/pre-authorization information for out-of-area
members.
Other Insurance/Coordination of Benefits (COB) (PDF)— We want to pay your eligible claims as fast as possible, so please fill out this form to let us know what other insurance you may have.
Prior Authorization Information for Radiological Services
Provider Manual — Policies and procedures
to assist providers in filing claims, referral requests and other services.
Providers' News
— Quarterly publication.
Referral Reminder — Forms for referral
to specialists.
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tools for dental providers
Authorization Form for Clinic/Group Billing (PDF)— Use for notification that a practitioner is joining a clinic or group.
Provider Change of Data Form (PDF)— Use to report a change of address or other data. Completion of this form DOES NOT create any network participation.
Termination Form for Clinic/Group Billing (PDF)— Use for notification that a practitioner is leaving a clinic.
Accident Form for Dental Injury (PDF)
Claims and Benefits Information
Dental Bulletin
provider participation information
Blue Distinction Centers
Medical and Dental Network Development Representatives
Network Participation Guidelines
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