Provider Guides and E-learning

Appeals and Grievances (Resource Page)

Provider Disputes (PDF)

Member Appeals (PDF)
BlueCard and National Programs (PDF)

BlueCard Provider Guide (PDF)
Claims and Remits (Resource Page)

Claims E-learning (Education & Training > Provider E-learning)

Content restricted by user role or network status (or both).
Care Management Programs (PDF)

Health and Wellness Programs (BCBSAZ Webpage)

Preventive Services Recommendations (USPSTF Webpage)

Patient Education Resources (BCBSAZ Health Library)

BCBSAZ Patient-Centered Medical Home (PCMH) Program (PDF)

Arizona Community Grand Rounds Presentations (NARBHA Webpage)

ACR Appropriateness Criteria (ACR Webpage)
Dental Products and Networks (Resource Page)

BlueDental E-learning (Education & Training > Provider E-learning)

BlueDental Resources (BlueDental provider portal)

Content restricted by user role or network status (or both).
HIPAA Transaction Standard-BCBSAZ Companion Guide (PDF)

Electronic Resources (PDF)

Electronic Transaction Options (Resource Page)

EFT and ERA Information (Resource Page)

Provider Resources E-learning (Education & Training > Provider E-learning)

Content restricted by user role or network status (or both).
Eligibility and Benefits Resources (Resource Page)

Eligibility, Benefits, and Prior Authorization E-learning (PDF) (Education & Training > Provider E-learning)

Content restricted by user role or network status (or both).
Compliance (PDF)

Fraud, Waste, and Abuse-Information and Reporting Tool (Resource Page)
Medicaid Provider Enrollment Requirements-by State (PDF)
Medical Policies-Overview and Access Guide (PDF)

InterQual Search Tool User Guide (PDF)

Prior Authorization & Medical Policies by Benefit Plan Type (Resource Page)
Medicare Advantage Products and Networks-Overview (PDF)

Medicare Advantage E-learning (Education & Training > Provider E-learning)

Resources for Medicare Advantage Plans (Resource Page)

Content restricted by user role or network status (or both).
Member ID Card Information and Samples (PDF)
BCBSAZ Prefix List (Excel)

Prefix Information and Tips (Resource Page)
Networks and Products Overview (PDF)
No Surprises Act Information and Forms
PCP-HMO Products and Networks (PDF)

PCP-HMO E-learning (Education & Training > Provider E-learning)

PCP-HMO Auth/Referral Request and Status Tool-User Guide (Education & Training > Provider E-learning)

PCP-HMO Information and Resources (Resource Page)

Content restricted by user role or network status (or both).
Pharmacy Benefits (PDF)

Pharmacy Formularies, Coverage Guidelines, and Prior Authorization (Resource Page)
Medical Policies and Prior Authorization (PDF)

Prior Authorization & Medical Policies by Benefit Plan Types (Resource Page)
eviCore Program Overview (PDF)

eviCore FAQs for Providers (PDF)

eviCore Resource Page (eviCore Webpage)
Provider Directory E-learning (Education & Training > Provider E-learning)

Provider Directory (Directory Access)

Content restricted by user role or network status (or both).
2023 BCBSAZ Provider Operating Guide (Complete Guide or Sections)

Content restricted by user role or network status (or both).
Provider Portal User Guide (PDF)