Provider Manual

The provider manual provides important information about BCBSAZ Health Choice Pathway.


Chapter 1	Introduction to BCBSAZ Health Choice Pathway Exhibit 1-1 Provider Escalation Notice
Chapter 2	Member Services Exhibit 2.1 Member Dual ID Card Exhibit 2.2 Medicare ID Card
Chapter 3	Provider Responsibility
Chapter 4	Cultural Competency
Chapter 5	Quality Management
Chapter 6	Medical Authorizations and Notifications Exhibit 3-6.12 Maternal Risk Assessment Form Exhibit 5-1 Care Management Referral Form Prior Authorization Grid effective 1/5/24 Prior Authorization Grid effective 11/15/23 Prior Authorization Grid effective 8/10/2023 Prior Authorization Grid effective 5/1/2023 Prior Authorization Grid effective 2/1/2023 Exhibit 6-2 Medical Services and Behavioral Prior Authorization Form Exhibit 17-1 Pharmacy Medication Prior Authorization Form
Chapter 7	Inpatient & Outpatient Hospital Care
Chapter 8	Coordination of Benefits or Other Insurance Liability
Chapter 9	Grievance, Appeals, Claim Resubmission and Reconsiderations
Chapter 10	Drug Formulary Exhibit 17-1 Pharmacy Medication Prior Authorization Form
Chapter 11	Transplant Services
Chapter 12	Covered Benefits Exhibit 12-1 2023 – 2024 Supplemental Benefit Comparison Chart Exhibit 12-2 2024 CPT and CDT Codes for Supplemental Benefits American Specialty Health (ASH) Provider Search
Chapter 13	Care Management