Skip to main content

New Digital Provider and Facility Reference Manual

June 26, 2020

To: All Providers

Our Provider and Facility Reference Manual has been upgraded and is now available in a digital format. The new manual offers streamlined accessibility and functionality to provide a better, more interactive user experience.

The new format includes all the same information you need, including:

  • Our policies and procedures
  • How to file claims
  • Services we offer providers
  • Reimbursement
  • Information about our health care products
  • Government and regulatory mandates

Easy Search and Navigation

A drop-down menu will allow you to easily locate the manual section you need. Once you’ve selected a section, you can then navigate by subsection to access more specific information. You can also search the manual by entering key words into the search bar.

Up-to-Date Information

We will be making frequent updates, ensuring that information found in the manual is more current.

Print and Share

You will now be able to print individual sections or send them via email.

The manual is now posted on the provider website homepage in the same location as before, under “Quick Links” in the bottom right-hand corner. Click the link below to access and explore.

Recent Articles

  • Pregnancy During the COVID-19 Pandemic
    For many pregnant women, the COVID-19 pandemic has raised new questions about how to get the care they need while staying healthy. According to the Centers for Disease Control and Prevention (CDC), pregnant women might be at a higher risk for severe illness or hospitalization if they contract COVID-19 and they may need additional support during these unprecedented times. Here, we offer guidance and resources for your pregnant patients.
  • Reminder: Ancillary Claims Must Be Approved by Supervising Physician
    To ensure proper processing and avoid denials or rejections, ancillary claims, lab orders, specialty pharmacy prescriptions, and referrals for your BlueShield patients must be completed in full by the supervising physician of record.
  • Drug Therapy Guidelines Updates July 2020
    New drug therapy guidelines have been developed with the guidance of our Pharmacy and Therapeutics Committee. These guidelines will be posted by August 1 and will be effective September 1. Five medications will require preauthorization.
  • Individual Provider Recontracting Initiative
    We will be amending and restating our existing contracts. Starting next month, all directly contracted individual providers will be sent an updated contract. The New York State Department of Health (DOH) requires that each provider sign and return their amended/restated contract.
  • New Digital Provider and Facility Reference Manual
    We’ve upgraded our Provider and Facility Reference Manual, which is now available in digital format. The new manual offers a better, more interactive user experience. Here, we highlight some of the new features.

Working with Us

Additional Resources

We want to hear from you! Have a topic request for the next Blue Bulletin? Email us

Stay in Touch! Sign up to receive emails for provider news and information