We are committed to supporting you in providing quality care and services to the members in our network. Here you will find frequently used forms, PDFs, provider manuals and guides, prior authorization information, practice policies, and support for delivering benefits to our members.
Provider forms are located in our online library for easy access.
Healthy Blue offers training and tutorials to support providers in continuing their education. Presentations, videos and other training documentation will be added as they become available.
The Healthy Blue provider manuals and guides provide key administrative information, including the quality improvement program, utilization management program, quality standards for participation, claims appeals, and reimbursement and administration policies.
Many of the tools you need, such as eligibility and benefits inquiry, claims submission, claims status inquiry, and authorizations, can now be accessed by logging into your account on the Availity Portal . Availity is an independent company that provides a secure portal on behalf of BlueChoice HealthPlan.
The Healthy Blue behavioral health provider network includes psychiatrists, psychologists, social workers, psychiatric nurses, and other mental health and employee-assistance health care professionals. Our facility network includes hospital inpatient units, residential treatment centers, partial hospitalization programs, and intensive outpatient services and programs.
Healthy Blue makes determinations based on selected inpatient or outpatient medical services including surgeries, major diagnostic procedures and referrals to validate medical necessity.
Patient360 is an independent company that provides a clinical data registry on behalf of BlueChoice HealthPlan.
HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA).