Resource center

Provides information about updating credentialing and network status for providers and organizations.

Blue Distinction® is a designation awarded by the Blue Cross and Blue Shield companies to medical facilities that have demonstrated expertise in delivering quality healthcare.

Total Care recognizes doctors that focus on health care instead of sick care. Total Care is coordinated, patient-focused and, in many cases, more affordable healthcare.

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

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

Find out which procedures are covered by your policy or if your procedure requires prior authorization.

Need to contact one of our helpful Network Development Representatives? Find personal assistance near you.

The InterQual® guidelines are used by our utilization management team to help assess whether a given medical condition and known or represented circumstances of a case support medical service(s) as the most appropriate treatment, or whether the medical condition/circumstances presented could be appropriately addressed with an alternative treatment. Use the self-registration tool at the link to create a login and view the criteria. Individuals without an email address should contact the plan to receive the criteria information via mail. Please consult your provider for applicable policies and/or criteria.