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.


eviCore Preauthorization Program

Learn more about the eviCore Preauthorization program.


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.



Clinical Resources

Preauthorizations/Notifications/Referral Requirements Lists




Note: Blue Choice PPO Fully Insured member ID cards will indicate "TDI".


Effective through 1/1/2018 Blue Choice PPO Fully Insured Members PDF Document


Note: Blue Choice PPO Self-Insured for HAS (Primary, Advanced or Premier) members ID cards will indicate: Providers: This is a _______________(Primary, Advanced or Premier) package


Effective through 1/1/2018 Blue Choice Self Insured HAS Primary PDF Document


Effective through 1/1/2018 Blue Choice Self Insured HAS Advanced PDF Document


Effective through 1/1/2018 Blue Choice Self Insured HAS Premier PDF Document


Note: Blue Choice PPO Self-Insured member ID cards without HAS will not list a HAS package or list TDI on the card


Effective through 1/1/2018 Blue Choice Self Insured Without HAS PDF Document


Effective through 7/31/2017 Blue PremierSM PDF Document


Effective 8/1/2017 - 12/31/2017 Blue PremierSM PDF Document


Effective 1/1/2018 Blue PremierSM PDF Document


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 Program

Learn more about the radiology quality initiative/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.


Special Beginnings — A Maternity Program

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


Wellness Initiatives/Programs

Wellness initiatives/programs


Preventive Care Guidelines/Patient Wellness Guidelines

Learn more about Preventive Care Guidelines/Patient Wellness Guidelines