Provider Guides and E-learning

ACA StandardHealth with Health Choice Plan (Resource Page)
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 (AZ Blue Webpage)

Preventive Services Recommendations (USPSTF Webpage)

Patient Education Resources (AZ Blue Health Library)

AZ Blue Patient-Centered Medical Home (PCMH) Program (PDF)

Arizona Community Grand Rounds Presentations (NARBHA Webpage)

ACR Appropriateness Criteria (ACR Webpage)
CHS Group Plans-Overview (PDF)
Contracting and Credentialing Process Overview (PDF)

Pharmacist Credentialing and Contracting – E-learning (PDF)

Pharmacist Credentialing and Contracting – Webinar Recording (Video)
Dental Products and Networks (Resource Page)

BlueDental Resources (BlueDental provider portal)

BlueDental Provider Manual

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

Content restricted by user role or network status (or both).
HIPAA Transaction Standard-AZ Blue 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).
FEP Plans-Overview (PDF)
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)

Medical Policy Access-Quick Guide (PDF)

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

Resources for Medicare Advantage Plans (Resource Page)

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

Content restricted by user role or network status (or both).
Member ID Card Information and Samples (PDF)
Prefix Information and Tips (Resource Page)
Networks and Products Overview (PDF)
No Surprises Act Information and Forms (Resource Page)
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).
AZ Blue Provider Operating Guide (Provider Resources > Guidelines > Provider Operating Guide)

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