Resources to help you support our members
Eligibility and Benefits
Get information about eligibility and benefits inquiries, member ID cards, prefixes, telehealth, and more.
Prior Auth and Medical Policies
Check prior authorization requirements, how to request, and where to find medical policies.
Claims and Remits
Navigate to claim status and remits, and find resources for claim submission, coding, and pricing.
Appeals and Grievances
Get information and forms for member appeals and provider disputes.
Find formularies, drug lists, pharmacy coverage guidelines, forms, and more.
See information about dental networks, products, and access BlueDental resources.
Medicare Advantage Plans
Get information about our Medicare Advantage networks, products, and third-party plan administrators.
CHS Group Plans (Network Rental)
See what’s unique about our Corporate Health Services (CHS) group plans, administered by TPAs.
Find tools, forms, and resources specific to our PCP Coordinated Care HMO (PCP-HMO) plans.
Join us in population health initiatives and check out our patient engagement resources.
Provider Operating Guide
Our comprehensive Provider Operating Guide puts it all together for you.
Standards for Quality Care
Quality care: It’s what makes a difference. It’s what leads to quality health outcomes.
Access our provider forms.
Provider Guides and E-Learning
Check out our provider guides and e-learning slides for staff training.
Fraud, Waste and Abuse
Get confidential reporting options and tips to avoid fraud, waste, and abuse.
Request a contract or update your contract information.
Check out our options for electronic transactions, EFT, and ERA.