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Blue Choice

Manuals & Guides

Please refer to these helpful guides and manuals.

  • 2018 BlueCard Program Manual - This manual provides you with an overview and describes the advantages of the program. It will also help you guide through eligibility verification, precertification and claims filing processes for out-of-area members. 
  • Habilitative and Rehabilitative Services FAQs - This document provides you with answers to the most common questions related to habilitative and rehabilitative services.
  • Healthier Moms and Babies - Our maternity health magazine gives information about our maternity managed care programs, informs you of helpful tools to engage your patients and provides you with resources to integrate your patient care with our services. There are articles about the Birth Outcomes Initiative, using the Screening, Brief Intervention and Referral to Treatment (SBIRT) process  in your practice, benefits of Centering Pregnancy and more. Centering Pregnancy is offered by Centering Healthcare Institute (CHI). CHI is an independent organization that provides care management on behalf of BlueChoice HealthPlan.
  • Improving Patient Satisfaction for Providers
  • 2018 Member Identification Card Reference Guide - This guide provides you with an overview of our various plans and associated networks.
  • Medical Forms Resource Center Guide - This guide details how to use the MFRC online tool, which allows you to submit your precertification requests for some services electronically. The system is fast and easy to use and ensures accuracy. It also cuts down on follow up calls as all the required information is outlined on the form.
  • Precertification and Referral Guide - Learn how to submit a referral or precertification request through My Insurance ManagerSM and determine which services we can automatically authorize.
  • Preventive Care Guide - This guide provides an outline of the services the Affordable Care Act approves as preventive for non-grandfathered plans.
  • Provider Reconsideration Process- Get instructions about the provider appeal process for medical necessity and billing/coding disputes. Also, learn when it is appropriate for a provider to file a reconsideration. 
  • View the latest edition of our Provider Office Administrative Manual.
  • Quick Reference Card - Use this table to identify the most efficient method to obtain benefit information and get preauthorization for certain services. 
  • Submit Clinical Attachments Online - Learn how to submit clinical attachments for pending precertification requests online.
  • What You Need to Know About Anesthesia - This guide gives an overview of anesthesia procedures, modifiers and filing guidelines. 
  • What You Need to Know About Claim Attachments - This guide provides you with an overview of the Claim Attachment feature in My Insurance ManagerSM. Use Claim Attachments to attach records or documents to claims that require additional documentation. 
  • What You Need to Know About Medical Specialty Drug Prior Authorizations - This guide provides you with an overview of the specialty medical drugs prior authorization requirements and the steps to get prior authorizations.
  • What You Need to Know about Skilled Nursing Facilities - This booklet gives an overview of procedures, authorization requirements and claims filing guidelines for skilled nursing facilities (SNFs).