Clinical Resources


Behavioral Health Care Management Program

Learn more about the Behavioral Health Care Management Program.


Clinical Practice Guidelines

Learn more about clinical practice guidelines.


Clotting Factor Product Initiative

Learn more about clotting factor product initiative.


eCards for Health

Learn more about eCards for health.


iEXCHANGE® - Automated Preauthorization and Referral System

Learn more about iEXCHANGE, the automated preauthorization and referral system.

For additional information, refer to the Pre-Service Review for Out-of-Area Members tip sheet, located with other tip sheets under iEXCHANGE® on the Provider Tools page. You can also refer to the Electronic Provider Access (EPA) FAQs for additional information. For more information about iEXCHANGE, including how to register if you are not a current user or training opportunities, visit the Provider Tools page.


Maternity Program: A Healthy Start for Mothers and Babies

Learn more about our our Special Beginnings maternity program - a healthy start for mothers and babies.


Pre-cert/Pre-auth Router (for out-of-area members)

Have the alpha prefix ready to find medical policy, pre-certification and pre-authorization information (for out-of-area members).


Radiology Quality Initiative/Preauth Program

Learn more about the radiology quality initiative/pre-auth program.

For additional information, refer to the Pre-Service Review for Out-of-Area Members tip sheet, located with other tip sheets under iEXCHANGE® on the Provider Tools page. You can also refer to the Electronic Provider Access (EPA) FAQs for additional information. For more information about iEXCHANGE, including how to register if you are not a current user or training opportunities, visit the Provider Tools page.

View the current procedural technology (CPT) codes affected by this program.


Wellness Guidelines

Wellness guidelines


Wellness Initiatives/Programs

Wellness initiatives/programs