Blue Choice PPOSM Physician and Professional Provider Manual

Please access the latest version of the Blue Choice Physician and Professional Provider Manual below. This manual was developed to provide you and your staff with administrative guidelines with respect to the Blue Choice PPO Network.

From the table of contents, you can view and print content by section. This manual will be updated, as needed, and these updates will be posted to this site. These files are in a PDF format and require Adobe Reader to open and view them.

If you have trouble opening these files or accessing the information, please contact your Provider Relations office for additional options in receiving the latest version of this manual.


Blue Choice PPO Download Section
Cover Page 
Table of Contents and Welcome  
A. Support Services  
B. Physician, Other Professional Provider Roles and Responsibilities  
C. iExchange 
D. Referral Notification Program 
E. Preauthorization 
F. Filing Claims 
G. Federal Employee Program (FEP)  
H. Pharmacy  
I. Behavioral Health Services  
J. Quality Improvement Program  
K. Disease Management Programs  
L. Privacy of Health Information  
M. Blue Distinction and BlueCompare  
N. Hospital Acquired Conditions/Serious Reportable Events  
O. Rights and Responsibilities