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Provider Manual

Your source for commonly asked questions about healthcare coverage, claims procedures, policies and more.

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Coverage policy

Quickly search for coverage information using a keyword, procedure code, policy number or title.

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Providers' News

Find updates on the latest policies and procedures for providers.

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Coverage policy and pre-certification/pre-authorization

Coverage policy and pre-certification/pre-authorization information for out-of-area members.

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Prior authorization information for radiological services

Information to assist providers in filing claims, referral requests and other services.

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Prior authorization information for medical oncology drugs

Information for providers on requesting prior authorization for medical oncology drugs.

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Prior authorization information for step therapy protocol exception

Information for providers on an exception request process for drugs identified by the health plan as subject to step therapy.

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Prior authorization guide for Metallic policies

Use this guide to see prior authorization information for members with ID card prefixes: AEE, AXC, EXX, XCB, XCQ, XCR

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Medicare plans

Learn more about providing care for Medicare members.

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Radiology utilization for Arkansas Blue Cross FEP

Carelon Medical Benefits Management ® to manage radiology utilization for Arkansas Blue Cross FEP

About FEP program