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Provider forms

Access forms for dental and medical providers.

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Health Information Network (HIN)

Provides access to patient information including demographics, eligibility and benefits, claims, claim submission, claim correction, claim status, remittance advices, fee schedules, and more.

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Electronic Data Interchange (EDI)

Your resource for the Health Insurance Portability and Accountability Act (HIPAA) requirements and testing.

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HEDIS measures

Get details for specific HEDIS® Star measures.

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BlueCard® program

A program linking providers across the country into a single electronic network for claims processing and reimbursement.

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Value-based programs

Learn more about our value-based care program, which rewards providers for coordinating care and for positive health outcomes.

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Blue Distinction Centers

The Blue Distinction program highlights medical facilities demonstrating expertise in delivering quality healthcare.

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Network development reps (NDRs)

Contact one of our medical network representatives with questions or billing issues.

Contact NDRs

Prior approval for requested services

The primary coverage criteria of certain services must be established through a prior Approval or pre-authorization process before they can be performed.

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Prior approval statistics

See our prior approval statistics each quarter for medical, pharmacy and transplants.

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Network participation guidelines

Access network participation guidelines and policies for credentialing standards.

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